Keywords
Validity
reliability
malnutrition
GLIM
Abstract
Objectives: The study aimed to evaluate the validity and reliability of the GLIM diagnostic criteria at Hanoi Medical University Hospital.
Methods: A cross-sectional study was conducted on 200 patients aged 18 to under 70 years who were admitted within 48 hours.
Results: Malnourished according to GLIM had significantly longer hospital stays (10.0 ± 8.96 days) and lower clinical indicators, including BMI, subcutaneous fat thickness, body fat percentage, muscle mass, bone mass, visceral fat, and prealbumin levels (p < 0.05). The GLIM criteria demonstrated a sensitivity of 71.9%, a specificity of 88.2%, a positive predictive value of 74.2%, a negative predictive value of 87%, and an area under the receiver operating characteristic curve (AUC) of 0.8 (95%CI = 0.74-0.86) for malnutrition diagnosis. Severe malnutrition according to the GLIM criteria, based on the phenotypic standard at a BMI threshold of < 17.0 kg/m² (for individuals < 70 years old), has a sensitivity of 70%, a specificity of 98.4%, and an AUC of 0.84. The inter-rater reliability between two independent GLIM evaluators was excellent, with a Kappa coefficient of 0.89.
Conclusion: The GLIM criteria demonstrate high validity and reliability in diagnosing malnutrition.
References
[1]
Fu H, Li P, Sun S, Li L, Validation of the Global Leadership Initiative on Malnutrition Criteria for Predicting Adverse Outcomes in Acute Pancreatitis, TCRM, 2024, Volume 20: 543-556, doi:10.2147/TCRM.S471127.
Google Scholar
[2]
Norman K, Pichard C, Lochs H, Pirlich M, Prognostic impact of disease-related malnutrition. Clin Nutr, 2008, 27 (1): 5-15, doi:10.1016/j.clnu.2007.10.007.
Google Scholar
[3]
Cederholm T, Jensen G.L, Correia MITD et al, GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community, Clin Nutr, 2019, 38 (1): 1-9, doi:10.1016/j.clnu.2018.08.002.
Google Scholar
[4]
de van der Schueren M.A.E, Keller H, GLIM Consortium et al, Global Leadership Initiative on Malnutrition (GLIM): Guidance on validation of the operational criteria for the diagnosis of protein-energy malnutrition in adults. Clin Nutr, 2020, 39 (9): 2872-2880, doi:10.1016/j.clnu.2019.12.022.
Google Scholar
[5]
Shahbazi S, Hajimohammadebrahim - Ketabforoush M, Vahdat Shariatpanahi M, Shahbazi E, Vahdat Shariatpanahi Z, The validity of the global leadership initiative on malnutrition criteria for diagnosing malnutrition in critically ill patients with COVID-19: A prospective cohort study, Clin Nutr ESPEN, 2021, 43: 377-382, doi:10.1016/j.clnesp.2021.03.020.
Google Scholar
[6]
Ji T, Li Y, Liu P, Zhang Y, Song Y, Ma L, Validation of GLIM criteria on malnutrition in older Chinese inpatients, Front Nutr, 2022, 9: 969666, doi:10.3389/fnut.2022.969666.
Google Scholar
[7]
Brito J.E, Burgel C.F, Lima J et al, GLIM criteria for malnutrition diagnosis of hospitalized patients presents satisfactory criterion validity: A prospective cohort study, Clin Nutr, 2021, 40 (6): 4366-4372, doi:10.1016/j.clnu.2021.01.009.
Google Scholar
[8]
Fontane L, Reig M.H, Garcia-Ribera S et al, Validity and Applicability of the Global Leadership Initiative on Malnutrition (GLIM) Criteria in Patients Hospitalized for Acute Medical Conditions, Nutrients, 2023, 15 (18): 4012, doi:10.3390/nu15184012.
Google Scholar
[9]
What is subjective global assessment of nutritional status? Detsky - 1987, Journal of Parenteral and Enteral Nutrition - Wiley Online Library, Accessed September 21, 2024, https://aspenjournals.onlinelibrary.wiley.com/doi/10.1177/014860718701100108.
Google Scholar
[10]
Balci C, Bolayir B, Eşme M et al, Comparison of the Efficacy of the Global Leadership Initiative on Malnutrition Criteria, Subjective Global Assessment, and Nutrition Risk Screening 2002 in Diagnosing Malnutrition and Predicting 5-Year Mortality in Patients Hospitalized for Acute Illnesses, JPEN J Parenter Enteral Nutr, 2021, 45 (6): 1172-1180, doi:10.1002/jpen.2016.
Google Scholar
[11]
Good performance of the Global Leadership Initiative on Malnutrition criteria for diagnosing and classifying malnutrition in people with esophageal cancer undergoing esophagectomy - PubMed, Accessed September 22, 2024, https://pubmed.ncbi.nlm.nih.gov/34399403/
Google Scholar
[12]
Zhang Z, Wan Z, Zhu Y, Zhang L, Zhang L, Wan H, Prevalence of malnutrition comparing NRS2002, MUST, and PG-SGA with the GLIM criteria in adults with cancer: A multi-center study, Nutrition, 2021, 83: 111072, doi:10.1016/j.nut.2020.111072.
Google Scholar
[13]
Bellanti F, Lo Buglio A, Quiete S et al, Comparison of Three Nutritional Screening Tools with the New Glim Criteria for Malnutrition and Association with Sarcopenia in Hospitalized Older Patients, J Clin Med, 2020, 9 (6): 1898, doi:10.3390/jcm9061898.
Google Scholar
[14]
IJmker-Hemink V, Heerschop S, Wanten G, van den Berg M, Evaluation of the Validity and Feasibility of the GLIM Criteria Compared with PG-SGA to Diagnose Malnutrition in Relation to One-Year Mortality in Hospitalized Patients, J Acad Nutr Diet, 2022, 122 (3): 595-601, doi:10.1016/j.jand.2021.07.011.
Google Scholar
[15]
Huo Z, Chong F, Yin L, Lu Z, Liu J, Xu H, Accuracy of the GLIM criteria for diagnosing malnutrition: A systematic review and meta-analysis, Clin Nutr, 2022, 41 (6): 1208-1217, doi:10.1016/j.clnu.2022.04.005.
Google Scholar
[16]
Hanley J.A, McNeil B.J, The meaning and use of the area under a receiver operating characteristic (ROC) curve, Radiology, 1982, 143 (1): 29-36, doi:10.1148/radiology.143.1.7063747.
Google Scholar
[17]
Shirai Y, Momosaki R, Kokura Y, Kato Y, Okugawa Y, Shimizu A, Validation of Asian Body Mass Index Cutoff Values for the Classification of Malnutrition Severity According to the Global Leadership Initiative on Malnutrition Criteria in Patients with Chronic Obstructive Pulmonary Disease Exacerbations, Nutrients, 2022, 14 (22): 4746, doi:10.3390/nu14224746.
Google Scholar
[18]
Akazawa N, Kishi M, Hino T, Tsuji R, Tamura K, Moriyama H, Using GLIM criteria, cutoff value for low BMI in Asian populations discriminates high or low muscle mass: A cross-sectional study, Nutrition, 2021, 81: 110928, doi:10.1016/j.nut.2020.110928.
Google Scholar
[19]
Shimizu A, Maeda K, Wakabayashi H et al, Predictive Validity of Body Mass Index Cutoff Values Used in the Global Leadership Initiative on Malnutrition Criteria for Discriminating Severe and Moderate Malnutrition Based on In-Patients With Pneumonia in Asians, Journal of Parenteral and Enteral Nutrition, 2021, 45 (5): 941-950, doi:10.1002/jpen.1959.
Google Scholar
[20]
Maeda K, Ishida Y, Nonogaki T, Mori N, Reference body mass index values and the prevalence of malnutrition according to the Global Leadership Initiative on Malnutrition criteria, Clin Nutr, 2020, 39 (1): 180-184, doi:10.1016/j.clnu.2019.01.011.
Google Scholar