Different combinations of the GLIM criteria for patients awaiting a liver transplant: Poor performance for malnutrition diagnosis but a potentially useful prognostic tool

Santos, Bárbara Chaves; Fonseca, Ana Luísa Ferreira; Ferreira, Lívia Garcia; Ribeiro, Hélio; Correia, Maria Isabel Toulson Davisson; Lima, Agnaldo Soares; Penna, Francisco Guilherme Cancela e; Anastácio, Lucilene Rezende

doi:10.1016/j.clnu.2021.11.008

Cited by 21 publications

(21 citation statements)

References 56 publications

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“…The first intriguing finding of this study is that malnutrition, according to the GLIM criteria, is associated with sarcopenia in patients with CLD and this predictive value is comparable with other representative nutritional assessment methods, including the SGA and RFH‐GA. Considering that the prognostic ability of the GLIM criteria in the field of CLD remains unclear thus far, 16–19 another interesting finding in our study is that the GLIM criteria can independently predict mortality in patients with CLD. This study expands our knowledge of the potential usefulness of the GLIM criteria for identifying sarcopenia and assessing the risk of death.…”

Section: Discussionmentioning

confidence: 62%

“…Several studies have shown that the GLIM criteria can predict mortality in community-dwelling older adults and patients with cancer 14,15 ; however, limited evidence is available on the usefulness of the GLIM criteria in patients with CLD. [16][17][18][19] The primary aim of this study was to evaluate the usefulness of the GLIM criteria for predicting mortality in patients with CLD. The secondary outcomes were to examine the prevalence of malnutrition and association between the GLIM criteria and sarcopenia.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of the Global Leadership Initiative on Malnutrition criteria to predict sarcopenia and mortality in patients with chronic liver disease

Miwa

Hanai

Nishimura

et al. 2022

Hepatology Research

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Aim The Global Leadership Initiative on Malnutrition (GLIM) criteria, a newly developed global consensus around core diagnostic criteria for malnutrition, needs validation studies for use in daily clinical settings. This study aimed to determine whether the GLIM criteria could predict sarcopenia and mortality in patients with chronic liver disease (CLD). Methods We retrospectively reviewed 858 patients with CLD who were treated at our hospital between March 2013 and December 2019. Sarcopenia was diagnosed based on the criteria proposed by the Japan Society of Hepatology. Malnutrition was assessed using the GLIM criteria, subjective global assessment (SGA), and Royal Free Hospital‐global assessment (RFH‐GA) and their predictive ability for sarcopenia and mortality were assessed using the logistic regression analysis and the Cox proportional hazards regression model, respectively. Results Among the eligible 406 patients, 67% were men, the median age was 74 years, and 26% had sarcopenia. The prevalence of malnutrition according to the GLIM criteria, SGA, and RFH‐GA was 21%, 35%, and 26%, respectively. Comparing malnourished with well‐nourished patients, the odds ratio for complicating sarcopenia was 2.54 (95% confidence interval [CI], 1.44–4.49) for the GLIM criteria, 2.13 (95% CI, 1.09–4.15) for the SGA, and 2.78 (95% CI, 1.56–4.95) for the RFH‐GA. During a median follow‐up period of 2.0 years, 176 (43%) patients died. After adjusting for confounding factors, the GLIM criteria could independently predict mortality (hazard ratio, 1.95; 95% CI, 1.37–2.81). Conclusions The GLIM criteria are useful in identifying sarcopenia and predicting mortality in patients with CLD.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Usefulness of the Global Leadership Initiative on Malnutrition criteria to predict sarcopenia and mortality in patients with chronic liver disease

Miwa

Hanai

Nishimura

et al. 2022

Hepatology Research

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“…Lindqvist et al 10 reported malnutrition is present in 32% of the 133 patients with chronic liver disease, based on GLIM criteria. Santos et al 11 compared the rate of malnutrition according to distinct GLIM combinations on 152 patients with cirrhosis awaiting liver transplantation with estimated prevalence ranging from 0.7% to 30.9%. However, aforesaid studies did not include any screening scheme, which may affect the retrieved findings.…”

Section: Discussionmentioning

confidence: 99%

“…Limited information exists in the application of GLIM to patients with cirrhosis. With the reported prevalence of malnutrition ranging from 0.7% to 57.3%, a knowledge gap exists on how best to diagnose malnutrition in cirrhosis 8–11 . The GLIM process is a stepwise method of introducing a verified screening tool before determining an individual's phenotypic and etiologic criteria.…”

Section: Introductionmentioning

confidence: 99%

“…With the reported prevalence of malnutrition ranging from 0.7% to 57.3%, a knowledge gap exists on how best to diagnose malnutrition in cirrhosis. [8][9][10][11] The GLIM process is a stepwise method of introducing a verified screening tool before determining an individual's phenotypic and etiologic criteria. The lack of clearly defined cutoff values pertaining to specific criteria and scarce evidence regarding the diagnostic ability of GLIM with particular screening tools may account for this ambiguity and discordance.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the GLIM criteria with specific screening tool for diagnosing malnutrition in hospitalized patients with cirrhosis: A descriptive cross‐sectional study

Yang

Guo

Mao

et al. 2022

J Parenter Enteral Nutr

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Background The Global Leadership Initiative on Malnutrition (GLIM) has been built to diagnose malnutrition; however, its validity among patients with cirrhosis remains enigmatic. We aimed to investigate the prevalence of malnutrition according to GLIM criteria and compare the differences by using a specific screening tool. Methods We conducted a descriptive cross‐sectional study analyzing hospitalized patients. The Royal Free Hospital‐Nutritional Prioritizing Tool (RFH‐NPT) was chosen as the screening tool. Estimated prevalence was shown with and without the initial screening process. Diverse combinations of phenotypic and etiologic criteria and distinct body mass index (BMI) cutoffs were applied to detect frequency of malnourished patients with cirrhosis. Results Overall, 363 patients were recruited (median age, 64 years; 51.2% female). The prevalence of malnutrition according to GLIM criteria with and without RFH‐NPT screening was 33.3% and 36.4%, respectively. Low BMI and inflammation represented the most prevalent combination resulting in a malnutrition diagnosis (42.4%), followed by low BMI and reduced food intake (39.4%). By contrast, the least prevalence was found when combining reduced muscle mass with inflammation to diagnose malnutrition. Furthermore, the frequency of malnourished and well‐nourished participants was not statistically different when using divergent BMI reference values across the study population. Conclusions GLIM criteria may serve a specific proxy to diagnose malnutrition, along with RFH‐NPT screening. Relevant investigation is required to report on the applied combination of phenotypic/etiologic criteria, taking into consideration the marked impact of different models. More attempts are warranted to delineate the prognostic role of GLIM criteria in the context of cirrhosis.

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Handgrip strength is a substitutive metric to the GLIM criteria–defined malnutrition and predicts long‐term mortality among hospitalized patients with cirrhosis

et al. 2023

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BackgroundHospitalized patients with cirrhosis are prone to debilitating health conditions and fluid fluctuations, posing barriers to accurately obtain anthropometric measures and physical examinations as surrogates for muscle mass within the Global Leadership Initiative on Malnutrition (GLIM). We hypothesize the handgrip strength (HGS) would serve as a substitutive metric, by comparing the diagnostic consistency and prognostic accuracy with computed tomography–demarcated skeletal muscle index (SMI)–defined malnutrition according to the GLIM criteria.MethodsPatients with cirrhosis underwent a two‐step approach involving nutrition risk screening and those fulfilling GLIM consensus were further diagnosed. The evaluation of muscle mass as one constituent contained in the GLIM criteria was conducted by SMI and HGS, respectively. Consistency test, Kaplan‐Meier curve, and multivariate Cox regression were used to assess the performance of GLIM‐SMI and GLIM‐HGS.ResultsAmong 184 hospitalized patients with cirrhosis, 63 (34.2%) and 78 (42.4%) were diagnosed with malnutrition following GLIM‐SMI and GLIM‐HGS criteria, respectively. Considering the GLIM‐SMI a gold standard, GLIM‐HGS had a sensitivity of 87.3% and a specificity of 81.0%. GLIM‐HGS criteria denoted good agreement (κ value = 0.858, P < 0.001) as compared with GLIM‐SMI. Both criteria were independently associated with 1‐year all‐cause mortality, whereas GLIM‐SMI showed slightly higher hazard ratios. Moreover, HGS positively correlated with SMI in the population alongside more pronounced correlation among patients at nutrition risk.ConclusionHGS may serve as a substitutive metric of muscle mass contained in the GLIM criteria to diagnose malnutrition and predict long‐term mortality among patients with cirrhosis.

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Different combinations of the GLIM criteria for patients awaiting a liver transplant: Poor performance for malnutrition diagnosis but a potentially useful prognostic tool

Cited by 21 publications

References 56 publications

Usefulness of the Global Leadership Initiative on Malnutrition criteria to predict sarcopenia and mortality in patients with chronic liver disease

Usefulness of the Global Leadership Initiative on Malnutrition criteria to predict sarcopenia and mortality in patients with chronic liver disease

Comparison of the GLIM criteria with specific screening tool for diagnosing malnutrition in hospitalized patients with cirrhosis: A descriptive cross‐sectional study

Handgrip strength is a substitutive metric to the GLIM criteria–defined malnutrition and predicts long‐term mortality among hospitalized patients with cirrhosis

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