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GLIM标准在诊断不同疾病营养不良中的现状
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Abstract:
营养不良与疾病的发展相关联，会增加其发生率和预后不良等的发生，但长期以来缺乏统一的诊断标准。GLIM (全球领导人发起的营养不良)标准的确立为诊断各种疾病相关的营养不良提供了统一的标准。GLIM标准采用两步诊断法：先筛查是否存在营养不良风险，再评估明确诊断和分级。该标准包括3项表型标准(非意愿性体重减轻、低BMI、肌肉量减少)和2项病因标准(食物摄入或吸收不良；疾病负担/炎症反应)，应用1项表型标准加1项病因标准可对营养不良作出诊断，再依据3个表型标准对营养不良的严重程度进行等级划分。GLIM标准已应用于多种疾病的营养不良诊断，本文按人群分类，分别从老年人群、肿瘤患者、非肿瘤消化系统疾病患者、代谢性疾病患者、传染病和风湿病患者的诊断效能等方面进行阐述。
Malnutrition is associated with the development of diseases, increasing its incidence and poor prognosis, but there has been a lack of unified diagnostic criteria for a long time. The establishment of the GLIM (global leader initiated malnutrition) standard provides a unified standard for diag-nosing malnutrition related to various diseases. The GLIM standard adopts a two-step diagnostic method: first screen for the risk of malnutrition, and then evaluate and clarify the diagnosis and grading. This standard includes three phenotypic criteria (involuntary weight loss, low BMI, and decreased muscle mass) and two etiological criteria (food intake or absorption disorders; disease burden/inflammatory response). The application of one phenotypic criterion plus one etiological criterion can diagnose malnutrition, and the severity of malnutrition can be graded based on the three phenotypic criteria. The GLIM standard has been applied to the diagnosis of malnutrition in various diseases. This article categorizes the population and elaborates on the diagnostic efficacy of elderly people, cancer patients, non tumor digestive system disease patients, metabolic disease pa-tients, infectious disease and rheumatic disease patients.
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