The GLIM criteria for defining malnutrition can predict physical function and prognosis in patients with cardiovascular disease
Abstract
Background & aims The Global Leadership Initiative on Malnutrition (GLIM) published a new international standard for defining malnutrition in 2018. The GLIM criteria were compared with the European Society for Clinical Nutrition and Metabolism (ESPEN) criteria in relation to physical function and mortality risk in patients with cardiovascular disease (CVD). Methods A total of 921 CVD patients ≥ 20 years old (67.8 ± 13.4 years, 631 men) hospitalised for heart failure, acute coronary syndrome and other conditions were stratified according to the presence or absence of malnutrition according to the GLIM and ESPEN criteria. Physical function was assessed by measuring grip strength, 6-minute walking distance and quadriceps isometric strength before hospital discharge, and the endpoint was all-cause mortality. Results During the median follow-up period of 2.3 years (interquartile range, 0.9-3.5 years), 194 deaths occurred in the study population. Malnutrition defined by the GLIM criteria was significantly associated with low physical function. Malnutrition defined by both the GLIM and ESPEN criteria was significantly related to all-cause mortality (P < 0.05). Conclusions Malnutrition defined according to the GLIM criteria was a predictor of both low physical function and mortality in patients with CVD.
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Use of GLIM criteria for malnutrition diagnosis in patients with cardiovascular disease has confirmed prognostic value, correlating with poorer physical function and higher mortality.
“Use of Global Leadership Initiative on Malnutrition criteria for malnutrition diagnosis for patients with cardiovascular disease has confirmed prognostic value, correlating with poorer physical function and higher mortality.”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [35]
The Agency for Healthcare Research and Quality report underscores the significant impact of malnutrition on patient outcomes, including morbidity, mortality, length of stay, higher readmission rates, and health care costs.
“It also underscores the significant impact of malnutrition on patient outcomes, including morbidity, mortality, and length of stay, as well as higher readmission rates and health care costs.”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [35]
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Di Angelantonio, E., Bhupathiraju, S. N., Wormser, D., Gao, P., Kaptoge, S., de Gonzalez, A. B., Cairns, B. J., Huxley, R., Jackson, C. L., Joshy, G., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30175-1 · Cited by 2,821 · see citing works
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Bian, W., Li, Y., Wang, Y., Chang, L., Deng, L., Li, Y., Jiang, H., & Zhou, P. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1174945 · Cited by 47 · see citing works
“It has been reported that malnutrition diagnosed by the GLIM criteria is significantly associated with a poor prognosis (6, 15, 78); it will not only increase the complications of patients (79) and prolong the length of hospital stay (80) but also increase the mortality rate (73).”
BackgroundVest, A. R., DiDomenico, R. J., Lichtenstein, L., Slater, T., Ekpo, E., Damluji, A. A., Bohula, E., Alviar, C. L., on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology, & Council on Cardiovascular and Stroke Nursing (2026) · Circulation · doi:10.1161/cir.0000000000001405 · Cited by 15 · see citing works
- Authors
- Kootaka, Y., Kamiya, K., Hamazaki, N., Nozaki, K., Ichikawa, T., Nakamura, T., Yamashita, M., Maekawa, E., Reed, J. L., Yamaoka-Tojo, M., Matsunaga, A., & Ako, J.
- Affiliations
- Kitasato University (JP)
- Kitasato University Hospital (JP)
- University of Ottawa (CA)
- Corresponding author
- Kamiya, Kentaro
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 40
- Issue
- 1
- Pages
- 146-152
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W3023019899
- Cited by
- 81
- References
- 1
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 12 · 2023: 16 · 2022: 20 · 2021: 12 · 2020: 3
- FWCI
- 7.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (19K11371, 19K19884, 18K10757)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- malnutrition, GLIM criteria, ESPEN criteria, cardiovascular disease, physical function, all-cause mortality, heart failure, acute coronary syndrome, grip strength, 6-minute walk distance, nutritional assessment
- MeSH terms
- Walk Test, Functional Status, Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Hospitalization, Humans, Male, Middle Aged, Nutritional Status, Predictive Value of Tests, Prognosis, Retrospective Studies, Nutrition Assessment, Risk Assessment, Hand Strength, Malnutrition, Muscle Strength
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