Wang Jian, Liu Bingyue, Chen Jianxin
The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Hangzhou Zhanshi Traditional Chinese Hospital of Orthopaedics, Hangzhou, Zhejiang, China.
Front Nutr. 2024 Nov 20;11:1462487. doi: 10.3389/fnut.2024.1462487. eCollection 2024.
Malnutrition is a significant public health issue for patients with gastric cancer, particularly in East Asia, the region most affected globally. In response to the absence of adequate tools for assessing nutritional status, the Global Leadership Initiative on Malnutrition (GLIM) criteria were established in 2018, aiming to standardize the diagnosis of malnutrition. However, there is no consensus on the value of GLIM criteria for evaluating the nutritional status of patients with gastric cancer in East Asia. Given these facts, our study aimed to assess the validity of the GLIM criteria in East Asian patients with gastric cancer.
We conducted a rapid critical review of available literature, summarizing the existing problems in GLIM applications and possible improvement directions. After systematically summarizing the literature published in PubMed, Web of Science, and Cochrane Library, a total of 13 articles involving 7,679 cases were included in this study.
The results indicated a lack of sufficient data on sensitivity and specificity to fully validate the GLIM criteria for diagnosing malnutrition in East Asian patients with gastric cancer. Additionally, some studies have reported moderate agreement between the GLIM and the PG-SGA. Furthermore, malnutrition defined by GLIM is a risk factor for short and long-term outcomes in East Asian patients with gastric cancer. However, the prognostic effect of moderate malnutrition on these patients remains controversial.
Despite being in the early application stages, GLIM has shown promising potential in diagnosing and predicting the prognosis of malnutrition. However, future research should incorporate more comprehensive validity parameters, including sensitivity, specificity, and PPV/NPV, to achieve a more thorough understanding of GLIM's diagnostic efficacy. Furthermore, further optimization of GLIM is necessary to address the needs of more diverse populations and situations.
营养不良是胃癌患者面临的一个重大公共卫生问题，在东亚地区尤为突出，该地区是全球受影响最严重的地区。鉴于缺乏评估营养状况的适当工具，全球营养不良领导倡议（GLIM）标准于2018年制定，旨在规范营养不良的诊断。然而，对于GLIM标准在评估东亚胃癌患者营养状况方面的价值，目前尚无共识。基于这些事实，我们的研究旨在评估GLIM标准在东亚胃癌患者中的有效性。
我们对现有文献进行了快速批判性综述，总结了GLIM应用中存在的问题和可能的改进方向。在系统总结发表于PubMed、科学网和考克兰图书馆的文献后，本研究共纳入13篇文章，涉及7679例病例。
结果表明，缺乏足够的数据来充分验证GLIM标准在诊断东亚胃癌患者营养不良方面的敏感性和特异性。此外，一些研究报告了GLIM与患者主观全面评定法（PG-SGA）之间的中度一致性。此外，GLIM定义的营养不良是东亚胃癌患者短期和长期预后的危险因素。然而，中度营养不良对这些患者的预后影响仍存在争议。
尽管GLIM仍处于早期应用阶段，但在诊断和预测营养不良预后方面已显示出有前景的潜力。然而，未来的研究应纳入更全面的有效性参数，包括敏感性、特异性和阳性预测值/阴性预测值，以更全面地了解GLIM的诊断效能。此外，有必要进一步优化GLIM，以满足更多样化人群和情况的需求。
