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Abstract：
Background: The aim of our study was to evaluate the effectiveness of Global Leadership Initiative on Malnutrition (GLIM) criteria in assessing malnutrition within the peritoneal dialysis (PD) population.Methods: We conducted a retrospective analysis involving 1057 PD patients across multiple institutions, characterized by an age of 56.1 ± 14.4 years, 464 (43.9%) female, and a median follow-up of 45 (25, 68) months. Malnutrition was diagnosed according to GLIM criteria. The endpoint event was overall mortality. The survival rate and hazard ratio (HR) of death between malnutrition and well-nourished were analyzed in all patients and various subgroups. Receiver operator characteristic curve and integrated discrimination improvement (IDI) were used to distinguish the efficacy of the nutritional tools prediction model.Results: According to the GLIM criteria, the prevalence of malnutrition among the study population was 34.9%. The adjusted HR of overall mortality was 2.91 (2.39 - 3.54, p < 0.001) for malnutrition versus well-nourished. In sensitivity analyses, the HR remained robust except the cardiovascular disease subgroup. The area under the curve of GLIM predicting 5-year mortality was 0.65 (0.62-0.68, p < 0.001). As a complex model for forecast the long-term mortality, the performance of adjusted factors combined with GLIM was poorer than combined malnutrition inflammation score (MIS) (IDI >0, p < 0.001), but fitter than combined geriatric nutritional risk index (GNRI) (IDI <0, p < 0.001).Conclusions: The GLIM criteria provide a viable tool for nutritional assessment in patients with PD, and malnutrition defined according to the GLIM can predict prognosis with an acceptable performance.
摘要：
背景：我们研究的目的是评估全球营养不良领导力倡议（GLIM）标准在评估腹膜透析（PD）人群营养不良方面的有效性。方法：我们进行了一项回顾性分析，涉及多个机构的1057名PD患者，以56.1±14.4岁为特征，464名（43.9%）女性，中位随访时间为45（25，68）个月。根据GLIM标准诊断营养不良。终点事件为总死亡率。在所有患者和各个亚组中，分析了营养不良与营养良好之间的生存率和死亡风险比（HR）。使用受试者算子特征曲线和综合辨别改善（IDI）来区分营养工具预测模型的功效。结果：根据GLIM标准，研究人群中营养不良的患病率为34.9%.营养不良与营养良好的总死亡率的校正HR为2.91（2.39-3.54，p<0.001）。在敏感性分析中，除心血管疾病亚组外,HR仍然稳健.GLIM预测5年死亡率的曲线下面积为0.65(0.62-0.68,p<0.001)。作为预测长期死亡率的复杂模型，校正因子联合GLIM的表现比联合营养不良炎症评分(MIS)差(IDI>0,p<0.001),但优于老年营养风险综合指数(GNRI)(IDI<0,p<0.001)。结论：GLIM标准为PD患者的营养评估提供了可行的工具，根据GLIM定义的营养不良可以预测预后，表现可接受。
