Jensen Gordon L, Cederholm Tommy, Correia M Isabel T D, Gonzalez M Cristina, Fukushima Ryoji, Pisprasert Veeradej, Blaauw Renee, Braz Diana Cardenas, Carrasco Fernando, Cruz Jentoft Alfonso J, Cuerda Cristina, Evans David C, Fuchs-Tarlovsky Vanessa, Gramlich Leah, Shi Han Ping, Hasse Jeanette M, Hiesmayr Michael, Hiki Naoki, Jager-Wittenaar Harriët, Jahit Shukri, Jáquez Anayanet, Keller Heather, Klek Stanislaw, Malone Ainsley, Mogensen Kris M, Mori Naoharu, Mundi Manpreet, Muscaritoli Maurizio, Ng Doris, Nyulasi Ibolya, Pirlich Matthias, Schneider Stephane, de van der Schueren Marian, Siltharm Soranit, Singer Pierre, Steiber Alison, Tappenden Kelly A, Yu Jianchun, van Gossum André, Wang Jaw-Yuan, Winkler Marion F, Compher Charlene, Barazzoni Rocco
Dean's Office and Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA.
Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
JPEN J Parenter Enteral Nutr. 2025 May;49(4):414-427. doi: 10.1002/jpen.2756. Epub 2025 Apr 14.
The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 that comprised screening followed by assessment of three phenotypic criteria (weight loss, low body mass index [BMI], and low muscle mass) and two etiologic criteria (reduced food intake/assimilation and inflammation/disease burden). This planned update reconsiders the GLIM framework based on published knowledge and experience over the past 5 years.
A working group (n = 43 members) conducted a literature search spanning 2019-2024 using the keywords "Global Leadership Initiative on Malnutrition or GLIM." Prior GLIM guidance activities for using the criteria on muscle mass and inflammation were reviewed. Successive rounds of revision and review were used to achieve consensus.
More than 400 scientific reports were published in peer-reviewed journals, forming the basis of 10 systematic reviews, some including meta-analyses of GLIM validity that indicate strong construct and predictive validity. Limitations and future priorities are discussed. Working group findings suggest that assessment of low muscle mass should be guided by experience and available technological resources. Clinical judgment may suffice to evaluate the inflammation/disease burden etiologic criterion. No revisions of the weight loss, low BMI, or reduced food intake/assimilation criteria are suggested. After two rounds of review and revision, the working group secured 100% agreement with the conclusions reported in the 5-year update.
Ongoing initiatives target priorities that include malnutrition risk screening procedures, GLIM adaptation to the intensive care setting, assessment in support of the reduced food intake/assimilation criterion, and determination of malnutrition in obesity.
全球营养不良领导倡议（GLIM）于2019年推出了一种营养不良诊断方法，该方法包括筛查，随后评估三个表型标准（体重减轻、低体重指数[BMI]和低肌肉量）和两个病因标准（食物摄入/吸收减少和炎症/疾病负担）。本次计划更新基于过去5年已发表的知识和经验重新审视了GLIM框架。
一个工作组（n = 43名成员）使用关键词“全球营养不良领导倡议或GLIM”进行了2019 - 2024年的文献检索。回顾了先前使用肌肉量和炎症标准的GLIM指导活动。通过多轮修订和审查以达成共识。
400多篇科学报告发表在同行评审期刊上，形成了10篇系统评价的基础，其中一些包括GLIM有效性的荟萃分析，表明其具有很强的结构效度和预测效度。讨论了局限性和未来重点。工作组的研究结果表明，低肌肉量的评估应依据经验和可用的技术资源。临床判断可能足以评估炎症/疾病负担病因标准。建议不对体重减轻、低BMI或食物摄入/吸收减少标准进行修订。经过两轮审查和修订，工作组对5年更新报告中的结论达成了100%的一致。
正在开展的倡议针对的重点包括营养不良风险筛查程序、GLIM在重症监护环境中的应用、支持食物摄入/吸收减少标准的评估以及肥胖症中营养不良的判定。
