Evaluation of malnutrition at hospital admission using the Global Leadership Initiative on Malnutrition criteria: comparison of bioelectrical impedance analysis and calf circumference for muscle mass assessment.

Prevalence of malnutrition at hospital admission varied substantially depending on the GLIM phenotypic criteria and muscle mass assessment method used.

• Malnutrition prevalence was 72.7% using three phenotypes, 55.9% with two phenotypes, 22.1% via ASMBIA, and 62.6% using CC.
• A total of 605 patients were screened from four hospitals in Indonesia between August and October 2024.
• The large variation in prevalence estimates (22.1% to 72.7%) highlights the substantial impact of method selection on malnutrition diagnosis.

Calf circumference demonstrated substantially higher sensitivity for detecting malnutrition compared to bioelectrical impedance analysis-based appendicular skeletal muscle mass.

• Sensitivity was greatest for CC at 86.1%, followed by two phenotypes at 76.8%, while ASMBIA had the poorest sensitivity at 30.5%.
• This comparison was made across all GLIM criteria combinations.
• The poor sensitivity of ASMBIA (30.5%) suggests it may miss a substantial proportion of malnourished patients when used as the muscle mass criterion.

Malnutrition diagnosed by GLIM criteria was significantly associated with multiple nutrition status indicators and clinical parameters.

• Significant associations (P < 0.05) were found between malnutrition and weight loss, BMI, mid-upper arm circumference, handgrip strength, sarcopenia, and fat-free mass index.
• Associations were identified using multivariate logistic regression analysis.
• All GLIM-based diagnostic methods correlated with malnutrition risk screening and nutrition status indicators.

All GLIM-based diagnostic methods evaluated in this study showed correlation with malnutrition risk screening tools and nutrition status indicators.

• This finding applied across all criteria combinations tested, including three phenotypes, two phenotypes, ASMBIA-based, and CC-based approaches.
• The study was conducted across four hospitals in Indonesia, providing a multi-site validation context.
• The correlations support the clinical relevance of the GLIM framework regardless of which muscle mass assessment method is employed.

The study evaluated and compared ASMBIA and calf circumference as two common techniques for muscle mass assessment within the GLIM diagnostic framework.

• GLIM requires at least one phenotypic and one aetiologic criterion for malnutrition diagnosis.
• Muscle mass assessment is one of the phenotypic criteria in the GLIM framework, and its accuracy using different methods has remained debated.
• The study screened 605 patients upon hospital admission, making it a relatively large cross-sectional comparison in an Indonesian hospital setting.