Malnutrition identified based on GLIM criteria and diet quality in post-stroke rehabilitation patients

BAHAT-ÖZTÜRK G., Aydın T., Kesiktaş F. N., Ahısha Y. C., ÖREN ÇELİK M. M., Erdoğan T., ...Daha Fazla

Irish Journal of Medical Science, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s11845-025-04185-y
  • Dergi Adı: Irish Journal of Medical Science
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Anahtar Kelimeler: Calcium, Diet, GLIM, Malnutrition, Protein, Stroke
  • İstanbul Üniversitesi Adresli: Evet

Özet

Background: Malnutrition is one of the important consequences of stroke and has been strongly associated with negative clinical outcomes. Aims: We aimed to investigate (1) the prevalence of malnutrition based on the Global Leadership Initiative on Malnutrition (GLIM) criteria in post-stroke rehabilitation patients, (2) the associations of malnutrition with stroke-related clinical characteristics, and (3) the dietary intake of patients after stroke. Methods: Eighty-one post-stroke patients undergoing in-patient rehabilitation were included. Spasticity, motor function, ambulation levels, functionality and burden of co-morbidities were assessed making use of the Modified-Ashworth-Scale (MAS), Brunnstrom Staging, the Functional-Ambulation-Classification (FAC), the Barthel-Index and the Cumulative-Illness-Rating-Scale (CIRS), respectively. GLIM criteria were used for the diagnosis of malnutrition. We considered two alternative definitions of low muscle mass (LMM), i.e., skeletal muscle mass (SMM)/ height2, and SMM/body mass index (BMI). Dietary intake was evaluated using a 24-hour recall. Results: Malnutrition was present in 21% and 53.1% of the participants when SMM was adjusted for height2 and BMI, respectively. The MAS-hip [odds ratio (OR) = 14.973, p = 0.03], FAC (OR = 0.01, p = 0.002) and CIRS (OR = 2.33, p = 0.006) were independently associated with GLIM (LMM adjusted for height2)-identified malnutrition; while ankle spasticity by MAS was the only independent associate of GLIM (LMM adjusted for BMI)-identified malnutrition (OR = 0.36, p = 0.047). Of the 10 participants, nine did not reach a protein intake of at least 1 g/kg/d. The median daily intake of calories and elemental calcium was low. Conclusions: Malnutrition was found to be highly prevalent among post-stroke rehabilitation patients, with prevalence varying based on the approach to the standardization of muscle mass and was associated with indicators of functional impairment.