Abstract：
OBJECTIVE: The following article examines the rationale for an inflammation-first approach for diagnosing cachexia and how the current Global Leadership Initiative on Malnutrition (GLIM) framework may be adapted to facilitate this.
RESULTS: Recently, the GLIM have published guidance on the measurement of inflammation in the context of cachexia, advocating that C-reactive protein (CRP) should be utilized for quantification. The inclusion of a systemic inflammatory biomarker for the diagnosis of cachexia questions whether it may be more aptly considered a systemic inflammatory syndrome.
CONCLUSIONS: The current consensus of the GLIM is that cachexia is \'disease-related malnutrition with inflammation\'. In line with this definition, the GLIM proposed a two-step diagnostic framework: screening for malnutrition using validated screening tools and then confirming the presence of disease-related malnutrition with phenotypic (nonvolitional weight loss, low BMI, and reduced muscle mass) and aetiologic criterion reduced food intake/assimilation, and inflammation or disease burden). The GLIM are to be commended for guidance on the measurement of systemic inflammation in their current proposal, given the relative importance to clinical outcomes in patients with cancer. However, the use of CRP is somewhat rudimentary and contrasts other cancer cachexia guidelines and contemporary clinical cancer research.
RESULTS: Recently, the GLIM have published guidance on the measurement of inflammation in the context of cachexia, advocating that C-reactive protein (CRP) should be utilized for quantification. The inclusion of a systemic inflammatory biomarker for the diagnosis of cachexia questions whether it may be more aptly considered a systemic inflammatory syndrome.
CONCLUSIONS: The current consensus of the GLIM is that cachexia is \'disease-related malnutrition with inflammation\'. In line with this definition, the GLIM proposed a two-step diagnostic framework: screening for malnutrition using validated screening tools and then confirming the presence of disease-related malnutrition with phenotypic (nonvolitional weight loss, low BMI, and reduced muscle mass) and aetiologic criterion reduced food intake/assimilation, and inflammation or disease burden). The GLIM are to be commended for guidance on the measurement of systemic inflammation in their current proposal, given the relative importance to clinical outcomes in patients with cancer. However, the use of CRP is somewhat rudimentary and contrasts other cancer cachexia guidelines and contemporary clinical cancer research.
摘要：
目的：以下文章探讨了诊断恶病质的炎症优先方法的基本原理，以及如何调整当前的全球营养不良领导力倡议（GLIM）框架来促进这一点。
结果：最近，GLIM已经发布了关于恶病质背景下炎症测量的指南，主张应利用C反应蛋白（CRP）进行定量。包含用于诊断恶病质的全身性炎症生物标志物质疑其是否可以更恰当地被认为是全身性炎症综合征。
结论：目前GLIM的共识是恶病质是“与炎症相关的营养不良”。根据这个定义,GLIM提出了一个两步诊断框架：使用经过验证的筛查工具筛查营养不良，然后确认与表型相关的疾病相关营养不良的存在（非自愿体重减轻，低BMI,和减少的肌肉质量)和病因学标准减少了食物摄入/同化，和炎症或疾病负担)。在目前的建议中，GLIM对全身性炎症的测量提供了指导，考虑到癌症患者临床结局的相对重要性。然而,CRP的使用在一定程度上是基本的,与其他癌症恶病质指南和当代临床癌症研究形成对比.
结果：最近，GLIM已经发布了关于恶病质背景下炎症测量的指南，主张应利用C反应蛋白（CRP）进行定量。包含用于诊断恶病质的全身性炎症生物标志物质疑其是否可以更恰当地被认为是全身性炎症综合征。
结论：目前GLIM的共识是恶病质是“与炎症相关的营养不良”。根据这个定义,GLIM提出了一个两步诊断框架：使用经过验证的筛查工具筛查营养不良，然后确认与表型相关的疾病相关营养不良的存在（非自愿体重减轻，低BMI,和减少的肌肉质量)和病因学标准减少了食物摄入/同化，和炎症或疾病负担)。在目前的建议中，GLIM对全身性炎症的测量提供了指导，考虑到癌症患者临床结局的相对重要性。然而,CRP的使用在一定程度上是基本的,与其他癌症恶病质指南和当代临床癌症研究形成对比.
