Global Leadership Initiative on Malnutrition criteria with different muscle assessments including muscle ultrasound with hospitalized internal medicine patients

Abstract

Background:The aim of this study is to identify cutoff values for muscle ultrasound (US) to be used in Global Leadership Initiative on Malnutrition (GLIM) criteria, and to define the effect of reduced muscle mass assessment on malnutrition prevalence at hospital admission.Methods: A total of 118 inpatients were enrolled in this cross-sectional study. Six different muscles were evaluated by US. Following defining thresholds for muscle US to predict low muscle mass measured by bioelectrical impedance analysis, malnutrition was diagnosed by GLIM criteria with seven approaches, including calf circumference, mid-upper arm circumference (MAC), handgrip strength (HGS), skeletal muscle index (SMI), rectus femoris (RF) muscle thickness, and cross-sectional area (CSA) in addition to without using the reduced muscle mass criterion. Results:The median age of patients was 64 (18-93) years, 55.9% were female. RF muscle thickness had moderate positive correlations with both HGS (r = 0.572) and SMI (r = 0.405). RF CSA had moderate correlation with HGS (r = 0.567) and low correlation with SMI (r = 0.389). The cutoff thresholds were 11.3 mm (area under the curve [AUC] = 0.835) and 17 mm (AUC = 0.737) for RF muscle thickness and 4 cmš (AUC = 0.937) and 7.2 cmš (AUC = 0.755) for RF CSA in females and males, respectively. Without using the reduced muscle mass criterion, malnutrition prevalence was 46.6%; otherwise, it ranged from 47.5% (using MAC) to 65.2% (using HGS). Conclusions:Muscle US may be used in GLIM criteria. However, muscle US needs a standard measurement technique and specific cutoff values in future studies.

Decreased abdominal wall muscle mass defined by muscle ultrasound is associated with malnutrition according to Global Leadership Initiative on Malnutrition criteria in renal transplant recipients: A cross‐sectional study

“…Muscle ultrasonography (US) is an easy-to-apply, radiation-free, and accessible tool in transplantation clinics, and it has been previously shown that muscle US could be used for the diagnosis of reduced muscle mass for the phenotypic GLIM criteria. 18 The purpose of this study was to determine the prevalence of malnutrition in stable RTRs using the GLIM criteria, to assess the use of muscle US in the diagnosis of reduced muscle mass, and to compare the performance of various muscle US measurements to diagnose malnutrition according to the GLIM criteria as a phenotypic criterion for malnutrition.…”

“…The assessment of muscle mass, for instance using dual‐energy x‐ray absorptiometry (DEXA) or bioelectrical impedance analysis (BIA), as recommended by GLIM, is typically not part of routine care because of practical and time considerations, even though standard anthropometric measurements, such as weight and height, are routinely performed at outpatient visits. Muscle ultrasonography (US) is an easy‐to‐apply, radiation‐free, and accessible tool in transplantation clinics, and it has been previously shown that muscle US could be used for the diagnosis of reduced muscle mass for the phenotypic GLIM criteria 18 …”

Prognostic value of creatinine-to-cystatin c ratio in patients with type 2 diabetes mellitus: a cohort study

“…However, these methods require specific devices and have limitations such as exposure to radiation and lack of cost-effectiveness [ 10 ]. Bioelectrical impedance analysis (BIA) is a cost-effective measurement of muscle mass but is adversely influenced by the volume status of patients [ 11 ]. Recently, the serum creatinine-to-cystatin C ratio (Scr/Scys), also known as the sarcopenia index (SI), is suggested as a surrogate marker of muscle mass in patients with type 2 diabetes mellitus (T2DM), chronic obstructive pulmonary disease (COPD) and cancer [ 12 – 14 ].…”