GLIM criteria to identify malnutrition in patients in hospital settings: A systematic review.

Malnutrition is recognized as one of the main public health problems in hospitals. The Global Leadership Initiative on Malnutrition (GLIM) has established a global consensus on the criteria for diagnosing malnutrition in adults in hospital settings. This study aimed to evaluate the ability of the GLIM criteria as a tool to identify malnutrition in hospital settings and to compare the prevalence of malnutrition identified by GLIM criteria with that identified by other screening and/or nutrition assessment methods. This was a systematic review. Searches were performed using MEDLINE/PubMed, Scopus, and Virtual Health Library, based on established descriptors. The included studies were observational and used screening and/or nutrition assessment tools to compare the prevalence of malnutrition and predictive capacity identified by GLIM criteria in patients aged >18 years in hospital settings. Twelve studies were included in this systematic review. A total of 4066 individuals with different pathologies and clinical conditions participated in the included studies. The prevalence of malnutrition, according to the GLIM criteria, ranged from 16% to 80%. In four studies, the prevalence of malnutrition based on GLIM was higher than that based on the other indicators. Six studies that evaluated the predictive ability of GLIM criteria identified satisfactory sensitivity and specificity. Four studies found low to high agreement between GLIM and the other methods. GLIM criteria can identify malnutrition and find a high prevalence and severity of malnutrition in the hospital setting, proving them to be a sensitive and specific instrument, with good agreement between screening and nutrition assessment methods.

Association of adductor pollicis muscle thickness and anthropometric indicators in community older adults / Associação da espessura do músculo adutor do polegar e indicadores antropométricos em idosos da comunidade

INTRODUCTION: The measurement of the adductor pollicis muscle thickness (APMT) has been investigated as an index for muscle mass and undernutrition. OBJECTIVE: However, there are few studies related to community-living older adults. METHODS: Cross-sectional study carried out with community-dwelling older adults, of both sexes. The APMT, the body mass index (BMI), arm circumference (AC), arm muscle circumference (AMC), and calf circumference (CC) were evaluated. For APMT classification, the 25th percentile value (P25 ≤9 mm) of the sample was considered to identify muscle mass deficit. Chi-square test, Pearson's correlation, and Poisson regression were performed, with a significance level of p<0.05. RESULTS: Among men, APMT showed a correlation with AC (r=0.350; p<0.01), and among women it was with BMI (r=0.337; p=0.01). There was an association between the BMI classification and the APMT percentile (p=0.020). Older adults with BMI<23 kg/m² were 1.28 times more likely to have APMT≤P25 (p=0.007) and older adults with adequate BMI were 1.23 times more likely (p=0.023). Older adults with reduced CC have a 1.18 times more chance of presenting APMT≤P25 (p=0.064). CONCLUSION: APMT has been associated with BMI in older adults, proving to be a good parameter for the assessment of malnutrition.

INTRODUÇÃO: A espessura do músculo adutor do polegar (EMAP) tem sido sugerido como um índice de massa muscular e desnutrição. OBJETIVO: Verificar a associação da EMAP com indicadores antropométricos convencionais em idosos da comunidade. MÉTODOS: Estudo transversal realizado com 159 idosos da comunidade, de ambos os sexos, com média de idade de 70,9±29,4 anos. Foram avaliados a EMAP, o índice de massa corporal (IMC), as circunferências do braço (CB), muscular do braço (CMB) e da panturrilha (CP). Para classificação da EMAP se considerou o valor do percentil 25 (P25≤9 mm) da amostra para identificar déficit de massa muscular. Teste Qui-quadrado, Correlação de Pearson e Regressão de Poisson foram realizados, sendo adotado um nível de significância de p<0,05. RESULTADOS: Entre os homens, a EMAP apresentou correlação com a CB (r=0,350; p<0,01) e entre as mulheres foi com o IMC (r=0,337; p=0,01). Houve associação entre a classificação do IMC e o percentil da EMAP (p=0,020). Os idosos com IMC<23 kg/m² tinham 1,28 vezes mais chances de possuir EMAP≤P25 (p=0,007) e idosos com IMC adequado tinham 1,23 vezes mais chance (p=0,023). Idosos com CP reduzido apresentaram 1,18 vezes mais chance de apresentar EMAP≤P25 (p=0,064). Conclusão: A EMAP apresentou associação com o IMC em idosos, demostrando ser um bom parâmetro para a avaliação da desnutrição.

Performance of adiposity indicators in predicting metabolic syndrome in older adults.

OBJECTIVE: To evaluate the association between some indicators of adiposity and markers of metabolic disorder, evaluate their performance in predicting metabolic syndrome (MetS), and identify their cutoff values among older adults, both in the overall sample and according to sex. METHODS: Cross-sectional study in 159 older men and women. MetS was defined according to the harmonized criteria. The assessments included waist circumference (WC), waist-to-height ratio (WHtR), conicity index (C index), lipid accumulation product (LAP), visceral adiposity index (VAI), body mass index (BMI), A body shape index (ABSI), area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. RESULTS: LAP and WHtR resulted in the largest AUC values (>0.80). In both sexes, the best indicators were LAP, WC, and WHtR. Both LAP and WHtR presented the highest Youden's index values in the overall sample, with cutoff values of approximately 46.9 (sensitivity 75.0%, specificity 76.7%) and 0.56 (sensitivity 79.3%, specificity 69.8%), respectively. When analyzed by sex, BMI, WC, WHtR, and LAP yielded the highest Youden's index values for the prediction of MetS in older women. CONCLUSION: The indicators LAP, WC, and WHtR performed well in identifying the presence of MetS in older women and could be used to individually or collectively assess and monitor MetS.

Performance of adiposity indicators in predicting metabolic syndrome in older adults.

OBJECTIVE: To evaluate the association between some indicators of adiposity and markers of metabolic disorder, evaluate their performance in predicting metabolic syndrome (MetS), and identify their cutoff values among older adults, both in the overall sample and according to sex. METHODS: Cross-sectional study in 159 older men and women. MetS was defined according to the harmonized criteria. The assessments included waist circumference (WC), waist-to-height ratio (WHtR), conicity index (C index), lipid accumulation product (LAP), visceral adiposity index (VAI), body mass index (BMI), A body shape index (ABSI), area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. RESULTS: LAP and WHtR resulted in the largest AUC values (>0.80). In both sexes, the best indicators were LAP, WC, and WHtR. Both LAP and WHtR presented the highest Youden's index values in the overall sample, with cutoff values of approximately 46.9 (sensitivity 75.0%, specificity 76.7%) and 0.56 (sensitivity 79.3%, specificity 69.8%), respectively. When analyzed by sex, BMI, WC, WHtR, and LAP yielded the highest Youden's index values for the prediction of MetS in older women. CONCLUSION: The indicators LAP, WC, and WHtR performed well in identifying the presence of MetS in older women and could be used to individually or collectively assess and monitor MetS.

Performance of adiposity indicators in predicting metabolic syndrome in older adults

ABSTRACT Objective: To evaluate the association between some indicators of adiposity and markers of metabolic disorder, evaluate their performance in predicting metabolic syndrome (MetS), and identify their cutoff values among older adults, both in the overall sample and according to sex. Subjects and methods: Cross-sectional study in 159 older men and women. MetS was defined according to the harmonized criteria. The assessments included waist circumference (WC), waist-to-height ratio (WHtR), conicity index (C index), lipid accumulation product (LAP), visceral adiposity index (VAI), body mass index (BMI), A body shape index (ABSI), area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Results: LAP and WHtR resulted in the largest AUC values (>0.80). In both sexes, the best indicators were LAP, WC, and WHtR. Both LAP and WHtR presented the highest Youden's index values in the overall sample, with cutoff values of approximately 46.9 (sensitivity 75.0%, specificity 76.7%) and 0.56 (sensitivity 79.3%, specificity 69.8%), respectively. When analyzed by sex, BMI, WC, WHtR, and LAP yielded the highest Youden's index values for the prediction of MetS in older women. Conclusion: The indicators LAP, WC, and WHtR performed well in identifying the presence of MetS in older women and could be used to individually or collectively assess and monitor MetS.