Glim criteria with different muscle assessments including muscle ultrasonography at hospitalized internal medicine patients.

Abstract

BACKGROUND\nThe aim of this study is to identify cut-off 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.\n\n\nMETHODS\nA 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 BIA, malnutrition was diagnosed by GLIM criteria with seven reduced muscle mass approaches including calf circumference (CC), mid-upper arm circumference (MAC), handgrip strength (HGS), skeletal muscle index (SMI), without using reduce muscle mass criterion, rectus femoris (RF) muscle thickness and cross-sectional area.\n\n\nRESULTS\nThe median (min-max) age of patients was 64 (18-93) years with a 55.9% female rate. Rectus femoris muscle thickness had moderate positive correlations with both HGS (r = 0.572) and SMI (r = 0.405). Rectus femoris CSA had moderate correlation with HGS (r = 0.567) and low correlation with SMI (r = 0.389). The cut-off thresholds to predict low muscle masses were 11.3 mm (AUC:0.835), and 17 mm (AUC:0.737) for RF muscle thickness, 4 cm² (AUC:0.937) and 7.2 cm² (AUC:0.755) for RF cross-sectional area in females and males, respectively. Without using the reduced muscle mass criterion, malnutrition prevalence was 46.6% whereas, ıt ranged from 47.5% (using MAC) to 65.2% (using HGS).\n\n\nCONCLUSIONS\nMuscle US may be used in GLIM criteria. However, muscle US needs standard measurements technique and specific cut-off values in future studies. This article is protected by copyright. All rights reserved.