全球(营养)领导层倡议营养不良标准在维持性血液透析患者中的应用

Application of Global Leadership Initiative on Malnutrition standard in patients with maintenance hemodialysis

目的探讨全球(营养)领导层倡议营养不良(GLIM)标准在维持性血液透析(MHD)患者营养状况评估中的应用价值。方法选择MHD患者102例,同时使用GLIM和主观整体评估(SGA)进行营养状况评估,比较GLIM与SGA的一致性。采集MHD患者一般病史、实验室检测等,分析上述指标与GLIM的相关性。结果MHD患者采用SGA与GLIM评价,营养不良发生率均较高(48.0%和45.1%)。2种方法在营养不良定性评估的一致性良好(Kappa值0.782);在营养不良分级评估的一致性一般(Kappa值0.595)。根据GLIM标准,体质量指数(BMI)、白蛋白(ALB)、甘油三酯(TG)、总胆固醇(TC)及血肌酐(Scr)较低,女性且年长者,更容易被识别为营养不良。其中,BMI、ALB是GLIM的独立影响因素。结论GLIM标准与传统方法相比具有较好的一致性,且和多项营养指标存在相关性,可应用于MHD患者的营养评估。

Objective To explore the application value of Global Leadership Initiative on Malnutrition(GLIM)standard in assessment of nutritional status of patients with maintenance hemodialysis(MHD).Methods A total of 102 patients with MHD were selected and conducted with both GLIM and Subjective Global Assessment(SGA)for assessment of nutritional status,and the consistency between GLIM and SGA was compared.General medical history and laboratory tests of MHD patients were collected,and correlations between these indexes and GLIM were analyzed.Results The incidence of malnutrition was higher in MHD patients evaluated by SGA and GLIM(48.0%and 45.1%).There was a good consistency of two methods in qualitative evaluation of malnutrition(Kappa value was 0.782).In the assessment of the severity of malnutrition,the consistency of two methods was moderate(Kappa value was 0.595).According to GLIM standard,cases with lower body mass index(BMI),albumin(ALB),triglyceride(TG),total cholesterol(TC)and serum creatinine(Scr)and older female cases were more likely to be identified as malnutrition,and BMI and ALB were the independent influencing factors of GLIM.Conclusion Compared with conventional methods,GLIM standard has a better consistency and is correlated with multiple nutritional indexes,which can be applied to the nutritional evaluation of MHD patients.