Akademik Veri Yönetim Sistemi
World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, Barcelona, İspanya, 4 - 07 Mayıs 2023, ss.256
Objective: The Global Leadership Initiative on Malnutrition (GLIM) criteria suggest alternative methods to be used for assessment of muscle mass, and which of these methods is more strongly associated with adverse outcomes remains an issue to be clarified. Our primary outcome was to report malnutrition prevalence defined by six different GLIM approaches and study their relationship with mortality.
Methods: This retrospective follow-up study included the data of outpatients admitted to the outpatient clinic of a tertiary hospital. We used six different approaches for GLIM, based on method used to identify reduced muscle mass: i. skeletal muscle mass (SMM)/height², ii. SMM/BMI, iii. handgrip strength (HGS), iv. calf circumference (CC), v. CC adjusted for BMI, and vi. GLIM without third phenotypic criterion (P3). We evaluated survival in malnutrition with Kaplan-Meier log rank test. Cox proportional hazards model was used to identify the relationships of different GLIM versions with mortality.
Results: The study population included 224 older individuals, with a median age of 72, and female predominance (68.8%). The prevalence with different GLIM versions ranged between 4.0-34.1%. During a median follow-up period of 31 months, 14 (6.3%) participants died. According to unadjusted analyses, only GLIM (SMM / h²), GLIM (HGS), GLIM (CC) and GLIM (without P3) were significantly associated with increased mortality risk [HR (95%CI) were 3.8 (1.1-13.7), 4.3 (1.4-12.8), 4.6 (1.3-16.7) and 7.3 (2.0-26.5), respectively]. After final adjustments made for age and gender, it was revealed that none of the versions were predictors of mortality in older adults living in the community.
Conclusion: GLIM criteria have a room for improvement as different options for muscle mass assessment are allowed, and this study aimed to fill the gap in the literature on whether malnutrition diagnosed by alternative GLIM definitions had a predictive validity in community-dwelling older adults. Further outcome studies using larger cohorts and different pragmatic approaches are needed to detect the ideal GLIM definition for malnutrition assessment.