Search Results (105)

Background and Objectives: Adverse clinical outcomes are associated with malnutrition and frailty, which are highly prevalent among hospitalized older patients. This study aimed to evaluate their predictive value for the duration of hospitalization, short-term survival, and rehospitalization of patients admitted to internal medicine wards. Materials and Methods: This prospective cohort study included 134 acutely ill patients aged ≥50 years who were hospitalized in an internal medicine department and evaluated within the first 48 h of admission. Nutritional status was evaluated using the Mini nutritional assessment–short form (MNA-SF), Nutritional Risk Screening 2002 (NRS-2002), and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty was evaluated using the FRAIL scale and Clinical Frailty Scale (CFS). The primary outcomes were prolonged hospitalization (>10 days), mortality, and rehospitalization at 3 and 6 months post-discharge. Results: According to MNA-SF, 33.6% of patients were malnourished; 44% had nutritional risk per NRS-2002, and 44.8% were malnourished per GLIM. Frailty prevalence was 53.7% (FRAIL) and 59% (CFS). Malnutrition defined by all three scales (MNA-SF, NRS-2002, GLIM) was significantly associated with prolonged hospitalization (p = 0.043, 0.014, and 0.023, respectively), increased rehospitalization at both 3 months (p < 0.001) and 6 months (p < 0.001). Mortality was also significantly higher among malnourished patients. Higher CFS scores and low handgrip strength were additional predictors of adverse outcomes (p < 0.05). In multivariable analysis, GLIM-defined malnutrition and CFS remained independent predictors of rehospitalization and mortality. Conclusions: Frailty and malnutrition are highly prevalent and independently associated with prolonged hospital stay, short-term rehospitalization and mortality. Routine screening at admission may facilitate early identification and guide timely interventions to improve patient outcomes. These findings might guide hospital protocols in aging health systems and support the development of standardized geriatric care pathways. Full article

Background: Prehabilitation programs improve postoperative outcomes in vulnerable patients undergoing major surgery. However, current screening tools such as the Malnutrition Universal Screening Tool (MUST) may lack the sensitivity needed to identify those who would benefit most. Muscle quality assessed by Computed Tomography (CT), specifically muscle radiodensity in Hounsfield Units (HUs), has emerged as a promising alternative for risk stratification. Objective: To evaluate the prognostic performance of CT-derived muscle radiodensity in predicting adverse postoperative outcomes in colorectal cancer patients, and to compare it with the performance of the MUST score. Methods: This single-center cross-sectional study included 201 patients with non-metastatic colon cancer undergoing elective laparoscopic resection. Patients were stratified based on enrollment in a multimodal prehabilitation program, either within an Enhanced Recovery After Surgery (ERAS) protocol or a non-ERAS pathway. Nutritional status was assessed using MUST, SARC-F questionnaire (strength, assistance with walking, rise from a chair, climb stairs, and falls), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. CT scans at the L3 level were analyzed using automated segmentation to extract muscle area and radiodensity. Postoperative complications and hospital stay were compared across nutritional screening tools and CT-derived metrics. Results: MUST shows limited sensitivity (<27%) for predicting complications and prolonged hospitalization. In contrast, CT-derived muscle radiodensity demonstrates higher discriminative power (AUC 0.62–0.69), especially using a 37 HU threshold. In the non-ERAS group, patients with HU ≤ 37 had significantly more complications (33% vs. 15%, p = 0.036), longer surgeries, and more severe events (Clavien–Dindo ≥ 3). Conclusions: Opportunistic CT-based assessment of muscle radiodensity outperforms traditional screening tools in identifying patients at risk of poor postoperative outcomes, and may enhance patient selection for prehabilitation strategies like the ERAS program. Full article

Background/Objectives: Rheumatoid arthritis (RA) is a chronic inflammatory disease frequently accompanied by comorbid conditions that contribute to disability and worsen long-term outcomes. Among these, malnutrition and osteosarcopenia remain under-recognised. This cross-sectional study aimed to assess the prevalence of malnutrition and osteosarcopenia among elderly women with RA and explore the clinical impact of these conditions. Methods: Sixty-five women over 65 years with RA were evaluated using Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition and EWGSOP2-based assessments for sarcopenia; bone status was measured by dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and three-dimensional DXA (3D-DXA). Results: Malnutrition was identified in 49.2% and osteosarcopenia in 52.3% of participants. A significant bidirectional association was observed: malnourished patients had higher rates of osteosarcopenia (65.6% vs. 34.4%; p < 0.05), and osteosarcopenic patients were more frequently malnourished (61.8% vs. 39.1%; p < 0.05). Both conditions were associated with older age, lower body mass index (BMI), impaired muscle parameters, and reduced bone mineral density. Malnourished and osteosarcopenic patients reported worse fatigue and lower physical quality of life, despite similar inflammatory activity. Significant correlations were found between muscle mass indices and bone quality metrics assessed by 3D-DXA. These findings highlight a substantial burden of malnutrition and osteosarcopenia in elderly women with RA, even with well-controlled disease despite similar inflammatory activity (mean Disease Activity Score 28: 2.8 ± 1.0; 43.1% in remission. Conclusions: There is a substantial burden of malnutrition and osteosarcopenia in elderly women with RA that support the integration of systematic nutritional and musculoskeletal screening into routine care. Future studies should evaluate age- and disease-specific mechanisms and assess the benefit of multidisciplinary strategies to prevent frailty and improve long-term outcomes. Full article

Background/Objectives: Assessing oral intake in patients with disease-related malnutrition (DRM) and sarcopenia remains a clinical challenge. This study aimed to evaluate the relationship between oral intake adjusted to nutritional requirements and the presence of sarcopenia in patients with DRM. Methods: This was a prospective observational study involving 118 outpatients with DRM, diagnosed according to Global Leadership Initiative on Malnutrition criteria. Sarcopenia was assessed using the European Working Group on Sarcopenia in Older People criteria. A 3-day dietary intake record was collected at the beginning of nutritional follow-up. Caloric (kcal/day) and protein (g/day) intakes were calculated. Energy needs were estimated using the Harris-Benedict equation with stress factors, and protein needs were set at 1.5 g/kg/day. Intake was categorized based on whether energy and protein intake exceeded or fell below 70% of requirements. Results: The mean age was 62.2 years, and 58.8% were female. Sarcopenia was present in 42% of patients. No significant difference was found in body mass index between patients with and without sarcopenia. Mean caloric intake was 29.6 kcal/kg/day and protein intake was 1.3 g/kg/day. Average fulfilment was 78.3% for energy and 86.8% for protein. Patients with sarcopenia had significantly lower intake of calories and macronutrients. Sarcopenia was more prevalent in those with <70% fulfilment of caloric and protein requirements. Multivariate analysis showed increased risk of sarcopenia (Odds ratio (OR): 4.27; 95% Confidence Interval (CI): 1.30–14.03; p = 0.017) and severe malnutrition (OR: 5.17; 95% CI: 1.63–16.42; p < 0.01) in patients with low protein intake. Conclusions: In patients with DRM, insufficient intake of calories and protein was associated with a higher prevalence of sarcopenia. There was an increased risk of sarcopenia and severe malnutrition in patients with lower protein intake. Full article

Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria provide a standardized approach for assessing the nutritional status of patients and demonstrate strong predictive value for the prognosis of patients with gastric cancer. However, these criteria do not incorporate indicators of adipose tissue metabolic activity, which may reflect pro-tumor microenvironmental factors. This study investigated the combined predictive value of malnutrition, defined by the GLIM criteria, and preoperative adipose tissue ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) uptake for recurrence-free survival (RFS) in patients with gastric cancer following radical surgery. Methods: A total of 105 patients were retrospectively enrolled and classified into malnourished and non-malnourished groups based on the GLIM criteria. Preoperative ¹⁸F-FDG positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) was used to measure the mean standardized uptake value (SUVmean) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). The predictive values of these indicators for RFS in patients with gastric cancer were assessed. Results: Multivariate survival analysis was used to identify GLIM-defined malnutrition (p = 0.020) and increased preoperative VAT SUVmean (p = 0.042) as independent risk factors for RFS. The combined analysis revealed that patients with both malnutrition and a high preoperative VAT SUVmean had the poorest RFS (HR = 18.41, p < 0.001). The predictive model integrating GLIM criteria and VAT SUVmean outperformed the GLIM criteria alone. Conclusions: This study demonstrated that combining malnutrition defined by the GLIM criteria with preoperative visceral adipose tissue ¹⁸F-FDG uptake optimizes recurrence risk stratification and exhibits superior prognostic predictive efficacy compared to using the GLIM criteria alone. This approach provides new insights into individualized prognostic assessment and intervention strategies. Full article

Background: Oral frailty is a state between normal oral function and oral hypofunction. Oral frailty progresses to oral hypofunction and dysphagia, which leads to malnutrition, and then to physical frailty and sarcopenia. Oral frailty is reported to be associated with physical frailty and malnutrition in hemodialysis patients, but there have been no reports on peritoneal dialysis (PD) patients. Methods: This prospective cohort study investigated the associations of oral frailty with physical frailty, sarcopenia, and malnutrition in patients on PD. Patients were divided into an oral frailty group and a non-oral frailty group according to the Oral Frailty Index-8. Patients were assessed for physical frailty, sarcopenia, and malnutrition at baseline and 1 year later, and changes in each measure were compared between the two groups. Physical frailty was assessed using the Revised Japanese version of the Cardiovascular Health Study Criteria (Revised J-CHS) and the FRAIL scale. Sarcopenia was assessed using the diagnostic criteria reported by the Asian Working Group for Sarcopenia in 2019 (AWGS2019 criteria) and the Screening Tool for Sarcopenia Combined with Calf Circumference (SARC-CalF), skeletal muscle index (SMI), calf circumference (CC), grip strength, and gait speed. Nutritional status was assessed with the Short-Form Mini-Nutritional Assessment (MNA-SF), the Malnutrition Universal Screening Tool (MUST), the Global Leadership Initiative on Malnutrition (GLIM) criteria, weight, and body mass index (BMI). Results: Of the 58 eligible patients, 51 completed the study. The oral frailty group was significantly older and had slower gait speed, fewer teeth, higher intact parathyroid hormone, higher C-reactive protein, higher frequency of cardiovascular disease, and lower employment at baseline. The oral frailty group had significantly worse physical frailty (Revised J-CHS, p = 0.047; FRAIL scale, p = 0.012), sarcopenia (SMI, p = 0.018; CC, p = 0.002), and nutritional status (MNA-SF, p = 0.029; MUST, p = 0.005; GLIM criteria, p = 0.022; weight, p < 0.001; BMI, p < 0.001). However, there were no significant differences in the worsening of sarcopenia (AWGS2019 criteria, SARC-CalF, grip strength, and gait speed). Conclusions: Oral frailty in patients on PD was associated with the development and progression of physical frailty and malnutrition, and may be associated with the development and progression of sarcopenia. Full article

Introduction: Idiopathic pulmonaryy fibrosis (IPF) is a progressive interstitial lung disease with a poor prognosis. While comorbidities like pulmonary hypertension and lung cancer have been studied extensively, less attention has been paid to the implications of malnutrition and sarcopenia in patients with IPF. This study aimed to assess the prevalence of malnutrition, sarcopenia, and the combined malnutrition-sarcopenia syndrome in patients with IPF using the latest diagnostic criteria from the Global Leadership Initiative on Malnutrition (GLIM) and the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Methods: A prospective, observational, multicenter study was conducted, focusing on patients with idiopathic pulmonary fibrosis (IPF). All participants provided informed consent, and the study followed ethical guidelines. Malnutrition was diagnosed based on the GLIM criteria, requiring one phenotypic and one etiological criterion, with muscle mass assessed via bioelectrical impedance analysis (BIA). Sarcopenia was screened following the EWGSOP2 recommendations. The statistical analysis was performed using JAMOVI version 2.3.22, with significance set at p < 0.05. Results: The findings revealed that 77.65% of the participants were malnourished, and 20% had sarcopenia. The malnourished patients had significantly lower body weight, height, and muscle mass compared to the non-malnourished patients. Furthermore, the patients with malnutrition exhibited poorer health-related quality of life scores. This study also identified the malnutrition-sarcopenia syndrome in 8.23% of the participants. Conclusions: Malnutrition, based on the GLIM criteria was identified in three out of four patients with IPF, while sarcopenia according to the EWGSOP2 was present in one out of five. This study underscores the necessity for routine screening for malnutrition and sarcopenia in patients with IPF. Full article

Background: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes in nutritional and functional status in post-ICU COVID-19 patients following nutritional and physical rehabilitation interventions. Secondary aims included assessing adherence to and tolerance of the oral nutritional supplement (ONS) used in the nutritional intervention. Methods: The study enrolled adults who had been admitted to the ICU due to severe COVID-19. At hospital discharge, the patients underwent a nutritional intervention based on oral nutritional supplements (ONSs) with 100% serum lactoprotein enriched with leucine and vitamin D and a physical rehabilitation program. They were followed up during three months. Performed assessments included Subjective Global Assessment (SGA), Global Leadership Initiative on Malnutrition (GLIM) criteria, Barthel index (BI), handgrip strength and Timed Up and Go test, bioelectrical impedance analysis (BIA), nutritional ultrasound (US), and tolerance and adherence to ONS. Sample size was calculated based on handgrip strength, and parametric and non-parametric tests were used to assess differences between the baseline and three-month outcomes. Results: The study included 96 patients (71.9% male, mean age 58.8 years, mean body mass index (BMI) of 28.8 kg/m², 36.5% obese). A total of 85 patients (62 men and 23 women) completed the 90-day follow-up. The mean weight gain after the intervention was 6.8 (SD 5.2) kg (similar in men and women; p = 0.263). The proportion of patients with malnutrition according to the SGA or GLIM criteria decreased from 100% to 11.8% and 36.4%, respectively (p < 0.00001 in both cases). The proportion of patients with functional limitations by BI decreased from 66.7% to 27.0% (p < 0.0001). Handgrip strength increased more than 40% in both men and women (p < 0.00001). The time to perform the Timed Up and Go (TUG) test decreased more than 40% in both men and women (p < 0.00001). According to BIA, the mean fat mass did not increase significantly in either men or women. The mean fat-free mass index (FFMI) increased significantly in both men and women. There were also significant increases in body cell mass, skeletal muscle mass index, and appendicular skeletal muscle mass index. The phase angle (PhA) increased significantly in both men (26.5%) and women (17.4%). In a multivariate analysis, age and baseline PhA were related to the PhA increase (adjusted R² = 0.5573). The US study showed a significant increase in the mean measurements of muscle area, muscle circumference, X-axis, and Y-axis in the rectus femoris. Regarding abdominal fat, there were no significant increases in total, superficial, or preperitoneal adipose tissue by US. Participants engaged in a median interquartile range (IQR) of 70 (0–120) min/week of strength exercise and 60 (0–120) min/week of moderate physical exercise. The supplement was well tolerated, and poor adherence (less than 50%) was low (4% of the participants). Conclusions: A three-month intervention, including ONS and physical rehabilitation, is associated with a significant improvement in nutritional and functional status. Patients gained weight primarily by increasing their muscle mass. There was no significant increase in fat mass, as measured by BIA or US. The intervention was well tolerated and had good adherence. Full article

Background: Within 10 years of diagnosis, about 50% of patients with Crohn’s disease (CD) require surgery. Repeated small bowel resections can lead to the development of short bowel syndrome (SBS). It is estimated that 65–75% of CD patients are malnourished. This retrospective observational study was conducted in a Polish reference centre for home parenteral nutrition (HPN). The aim of the study was to investigate the nutritional status and characteristics of patients with CD referred to HPN and to analyse the course of their HPN treatment. Methods: The study group consisted of all adult patients (N = 46) with CD who qualified for HPN between November 2004 and April 2022. Results: The most common indication for HPN was SBS (n = 27; 58.70%), followed by ineffective gastrointestinal nutrition causing progressive malnutrition (N = 9; 19.57%), fistulas (N = 6; 13.04%), and short bowel syndrome and fistulas (N = 4; 8.70%). According to the results of Subjective Global Assessment (SGA), 47.83% (N = 22) of patients were diagnosed with severe malnutrition, followed by 15 patients (32.61%) with moderate malnutrition. Global Leadership Initiative on Malnutrition (GLIM) criteria showed that 71.73% (n = 33) of patients were malnourished on admission to the HPN centre. All patients received parenteral formulas based on individually tailored prescriptions. The results showed that patients with a stoma received statistically significantly higher PN volumes (p = 0.027) and higher amounts of amino acids (p = 0.046) and fat emulsion (p = 0.046). Septic complications were twice as common as mechanical or metabolic complications, although 43.47% of patients had no complications. At the time of data analysis, 19 patients (41.30%) had been successfully weaned from HPN, of whom 12 (26%) achieved nutritional autonomy after 136–1419 days (mean: 560 ± 380.9). Conclusions: Malnutrition is a major problem in CD patients, especially those with SBS. Early nutritional intervention and consideration of artificial nutrition in this study group (HPN) are necessary to prevent the long-term consequences of severe malnutrition. To our knowledge, this was the first study to report on Crohn’s patients referred to long-term HPN. Further studies are needed to assess the impact of HPN on functional, laboratory, and anthropometric outcomes with a view to optimising treatment outcomes. Full article

Background: Recent studies indicate that in progressive multiple sclerosis (MS)—an inflammatory and degenerative disease of the central nervous system—the biological pathways associated with these effects remain poorly understood. Changes in body weight, whether presenting as overweight or underweight, as well as alterations in adipose and muscle tissue, together with chronic inflammation, may contribute to the disease and influence its course. Objective: This case–control study aimed to measure inflammatory markers and myokine levels (myostatin and irisin), brain-derived neurotrophic factor (BDNF), and IL-6 in the serum of patients with multiple sclerosis and healthy control and assess whether the myokines and cytokines are associated with nutritional status. Methods: The study included 92 MS patients and 75 healthy volunteers. Nutritional status was assessed using the NRS (Nutritional Risk Screening) 2002 and GLIM (Global Leadership Initiative on Malnutrition) criteria. The risks of malnutrition or malnutrition were diagnosed based on ESPEN recommendations. Body composition analysis was performed using the BIA method with the InBody 120 analyzer. Routine laboratory parameters (albumin, lipidogram) were measured. Myostatin, irisin, BDNF, IL-6, and hsCRP were measured using ELISA methods. Statistical analysis was conducted using Statistica 13.0 software. Comparisons between the two groups were conducted using Student’s t-test for normally distributed variables and the Mann–Whitney U test for non-normally distributed variables; the differences between groups were calculated using either ANOVA or the Kruskal–Wallis test. Post hoc analysis by the Bonferroni method was applied. Results: In the MS group, high risks of malnutrition (69.0%) and malnutrition (14.0%) were observed. A statistically significant correlation was found between malnutrition (GLIM) and s-albumin (R = 0.2; p < 0.05) and hsCRP (R = 0.23; p < 0.05). The MS patient group displayed significantly lower levels of irisin, higher levels of hsCRP, and lower s-albumin compared to healthy volunteers. Malnourished patients with MS exhibited significantly lower irisin levels, as well as higher hsCRP in comparison to MS patients who were at risk or well nourished. The levels of myostatin, BDNF, and IL6 did not differ depending on nutritional status. Irisin correlated with hsCRP (R Spearman = −0.5; p = 0.01). Conclusions: Our findings highlight the interplay between chronic inflammation, nutritional status, and myokines level in multiple sclerosis. Full article

Background: Malnutrition in amyotrophic lateral sclerosis (ALS) is associated with disease severity, and epigenetic regulation may be involved. The aim of this study was to assess the methylation levels of specific DNA sequences from the nuclear and mitochondrial genomes in a population with ALS to elucidate their relationship with nutritional status and the evolution of the disease. Methods: Patients with ALS were evaluated between 2013 and 2021 (n = 66). They were categorized according to their nutritional status, using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and disease progression, using the ALS Functional Rating (ALSFRS-R) Scale. DNA samples were extracted from leukocytes at the time of diagnosis for analysis of DNA methylation levels of markers of oxidative stress, mitochondrial function and global methylation (D-loop, GSTP1, and LINE-1). Results: According to the GLIM criteria, 29 (43.9%) patients had malnutrition (22.7%—moderate; 21.2%—severe), which was positively correlated with ALS disease progression (r = 0.414; p < 0.01) and death (r = 0.687; p < 0.01). Mortality occurred in 43.9% of the patients (median time to death, 18.7 (1.7–82.7) months). A significant association was observed between DNA methylation levels of the D-loop, GSTP1, and the CpG1 site of LINE-1 and malnutrition, disease progression at diagnosis, and death. The D-loop was the best predictor of malnutrition (AUC, 0.79; p < 0.01), disease progression (AUC, 0.70; p < 0.01), and mortality (AUC, 0.71; p < 0.01). Conclusions: This study revealed, for the first time, the early detection of D-loop methylation levels as a potential biomarker of nutritional status in patients with ALS, which may be useful for personalized nutritional management aimed at counteracting disease progression. Full article

Background: Patients undergoing cardiovascular surgery often experience postoperative complications and Activities of Daily Living (ADL) decline, even in the absence of preoperative malnutrition. Since postoperative ADL decline is particularly serious in elderly patients, this study aimed to identify a nutritional assessment tool that is effective in predicting postoperative ADL decline. Methods: Patients undergoing open-heart surgery with cardiopulmonary bypass were assessed using eight nutritional assessment tools, including the Malnutrition Universal Screening Tool (MUST), the Global Leadership Initiative on Malnutrition (GLIM) criteria, the Nutritional Risk Screening 2002 (NRS-2002), the Subjective Global Assessment (SGA), the Controlling Nutritional Status (CONUT) score, the Prognostic Nutritional Index (PNI), the Geriatric Nutritional Risk Index (GNRI), and the Mini Nutritional Assessment-Short Form (MNA-SF). Results: A total of 197 patients were enrolled in this study, with a mean age of 70.4 ± 11.6 years old; 31.0% were female. Depending on the nutritional assessment tool, 17.8% to 78.2% of patients were identified as at risk of malnutrition. Among the various assessment tools, the MUST was the most effective in predicting postoperative ADL decline (OR 4.75, 95% CI 1.37–16.5, p = 0.014) and was also associated with severe complications and length of hospital stay (OR 3.08, 95% CI 0.20–0.76, p = 0.009). On the other hand, nutritional risk detected by assessment tools other than MUST, including MNA-SF and GLIM, could predict postoperative complications but showed no relationship to ADL decline. Conclusions: We concluded that MUST was the most useful preoperative nutritional assessment tool for predicting outcomes, particularly for assessing the risk of postoperative ADL decline in patients undergoing cardiovascular surgery. Full article

Background/Objectives: Malnutrition frequently occurs following bariatric surgery and can lead to higher morbidity rates, hospitalizations, and extended hospital stays. Nutritional assessment tools such as the Global Leadership Initiative on Malnutrition (GLIM) are not validated for diagnosis of malnutrition following bariatric surgery. This study aimed to assess the validity of GLIM criteria in evaluating the nutritional status of post-sleeve gastrectomy patients compared to the Subjective Global Assessment (SGA). Methods: A total of 47 adult patients who underwent sleeve gastrectomy (SG) from 6 months to 2 years prior were evaluated using the GLIM and SGA. Additionally, multiple pass 24 h recall was collected for two days, and macronutrient analyses were conducted using ESHA software (version 11.11.x). Agreement between both tools was determined using Kappa (κ) statistics, and the Receiver Operating Characteristics (ROC) curve was used to establish sensitivity and specificity. Results: The study found that malnutrition was diagnosed in 48.9% and 42.6% of patients according to the GLIM and SGA criteria, respectively. The GLIM criteria exhibited inadequate accuracy (AUC = 0.533; 95% CI, 0.38–0.72) with a sensitivity and specificity of 55.0% and 55.6%, respectively. The agreement between both tools was determined to be poor (κ = 0.104). Conclusions: GLIM did not show sufficient agreement with SGA. Consequently, the criteria of GLIM may need revision for better diagnosis of malnutrition in post-sleeve gastrectomy patients. Full article

Background/Objectives: Sarcopenia, defined by a loss of muscle mass, strength, and function, is a potential comorbidity in axial spondyloarthritis (axSpA). Its prevalence, along with malnutrition, remains unclear. Methods: This cross-sectional study assessed sarcopenia (using the European Working Group on Sarcopenia in Older People (EWGSOP-2) criteria), presarcopenia, and malnutrition (using the Global Leadership Initiative on Malnutrition (GLIM) criteria) in a Spanish axSpA cohort. We included 94 patients aged ≥ 50 years. Sarcopenia was evaluated using the SARC-F questionnaire and by measuring muscle strength, mass, and performance. Presarcopenia was defined as low muscle mass alone. Malnutrition was assessed using body mass index (BMI) and fat-free mass index (FFMI). Results: The prevalence of sarcopenia, presarcopenia, and malnutrition was 3.2%, 23.4%, and 10.6%, respectively. Sarcopenia correlated with worse functionality and quality of life (Bath Ankylosing Spondylitis Functional Index (BASFI) 7.6 ± 1.2 vs. 3.6 ± 2.5, p = 0.02; ASAS Health Index (ASAS-HI) 11 ± 2 vs. 5.6 ± 3.7, p = 0.03). Presarcopenia was linked to a lower BMI (24.7 ± 4.1 vs. 29.1 ± 4.2, p < 0.01), FFMI (16.1 ± 2 vs. 19.6 ± 2.6, p < 0.01), and reduced biologic treatment use (31.8% vs. 61.1%, p = 0.03). Malnourished patients had lower muscle mass (5.14 ± 0.73 vs. 6.23 ± 0.96, p < 0.01). SARC-F showed 100% sensitivity and 75.8% specificity for sarcopenia detection. Conclusions: Despite low sarcopenia prevalence, presarcopenia and malnutrition are frequent, highlighting the need for early detection in axSpA. Full article

Background/Objectives: Dehydration and malnutrition are common conditions in older adults. Although both are regulated by different pathways, they seem to share common risk factors, such as dysphagia and dementia. Only scarce data on their co-occurrence are published. An exploratory analysis of a multicenter prospective trial on the determinants of malnutrition to evaluate the potential association between malnutrition and dehydration in older hospitalized patients was performed. Methods: Patients underwent a comprehensive geriatric assessment, their nutritional status was evaluated using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and routine laboratory tests were performed, including calculated serum osmolality. Results: A total of 454 patients were included in the analysis. Of those, 45% were classified as malnourished based on MNA-SF, and 42% according to GLIM criteria. Dehydration as determined by calculated serum osmolality was present in 32%. Multivariate binomial regression analysis revealed elevated serum creatinine (p < 0.001) and higher body mass index (BMI) (p = 0.020) as predictive factors for dehydration. Overlap between dehydration and malnutrition was present in 13% of patients; malnourished patients had no higher risk for dehydration and vice versa (p = 0.903). Conclusions: Malnutrition and dehydration are common in hospitalized older adults but do not frequently occur together. We identified that BMI and creatinine levels are significant predictors of dehydration risk among this population. Consequently, the implementation of separate screening assessments for malnutrition and dehydration is recommended to better identify and address these conditions individually. Full article