de Mateo Silleras Beatriz, Barrera Ortega Sara, Carreño Enciso Laura, de la Cruz Marcos Sandra, Redondo Del Río Paz
Department of Nutrition and Food Science, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain.
Spanish Society of Community Nutrition (SENC), 08029 Barcelona, Spain.
Nutrients. 2024 Apr 10;16(8):1116. doi: 10.3390/nu16081116.
Malnutrition (MN) is a highly prevalent condition in the elderly. It is associated with functional impairment, disability, frailty, and sarcopenia. The aim was to analyze the capacity of GLIM and ESPEN criteria to diagnose MN in a sample of institutionalized psychogeriatric patients. Clinical and anthropometric data were collected in a cross-sectional study. Patients' frailty, dependence, functional capacity, MNA, hand-grip strength (HS), and sarcopenia were evaluated. Body composition (BC) was estimated by conventional bioimpedance analysis. MN diagnosis was established using the ESPEN and the GLIM criteria based on fat-free mass index (GLIM-FFMI), appendicular skeletal muscle mass index (GLIM-ASMMI), skeletal muscle mass index (GLIM-SMMI), and HS (mGLIM). Ninety-two patients (57.6% men; mean age: 79.4 years) were studied. Depending on the diagnosis criteria, MN prevalence was between 25% (ESPEN) and 41.3% (GLIM-SMMI). Agreement between ESPEN and all GLIM criteria was poor, but it was excellent between all GLIM criteria (kappa > 0.8). Phenotypic criteria carried more weight in the diagnosis of MN than etiological ones. Depending on the parameter used, the prevalence of reduced muscle mass was notably different. Differences in BMI, BC, inflammation, and albumin are detected by the GLIM-FFMI criteria in the MN and non-MN subjects. Also, this criterion is the only one that identified differences in phase angle (PhA) between these groups. In the elderly, PhA can be very useful to monitor nutritional status.
营养不良（MN）在老年人中是一种高度普遍的状况。它与功能障碍、残疾、虚弱和肌肉减少症相关。目的是分析全球营养不良领导倡议（GLIM）和欧洲临床营养和代谢学会（ESPEN）标准在一组老年精神科住院患者样本中诊断MN的能力。在一项横断面研究中收集了临床和人体测量数据。评估了患者的虚弱程度、依赖性、功能能力、微型营养评定法（MNA）、握力（HS）和肌肉减少症。通过传统生物电阻抗分析估计身体成分（BC）。基于无脂肪质量指数（GLIM-FFMI）、四肢骨骼肌质量指数（GLIM-ASMMI）、骨骼肌质量指数（GLIM-SMMI）和HS（mGLIM），使用ESPEN和GLIM标准建立MN诊断。研究了92名患者（57.6%为男性；平均年龄：79.4岁）。根据诊断标准，MN患病率在25%（ESPEN）至41.3%（GLIM-SMMI）之间。ESPEN与所有GLIM标准之间的一致性较差，但所有GLIM标准之间的一致性极佳（kappa>0.8）。表型标准在MN诊断中比病因学标准权重更大。根据所使用的参数，肌肉量减少的患病率明显不同。GLIM-FFMI标准在MN和非MN受试者中检测到BMI、BC、炎症和白蛋白的差异。此外，该标准是唯一识别出这些组之间相位角（PhA）差异的标准。在老年人中，PhA对于监测营养状况可能非常有用。
