Abstract Background Malnutrition is still underdiagnosed in inflammatory bowel disease (IBD), partly due to the lack of a universally accepted definition. The Global Leadership Initiative on Malnutrition (GLIM) proposed a consensus-based diagnostic criteria in 2018. This study aims to assess the validity of GLIM criteria in identifying malnutrition in IBD outpatients, compare them with other diagnostic tools, and evaluate the association between malnutrition and patients’ quality of life and fatigue. Methods This monocentric, prospective, observational study included all IBD patients attending the IBD outpatient clinic at the Fondazione IRCCS San Gerardo dei Tintori (Monza, Italy) between June and August 2024. Malnutrition risk was assessed using the Malnutrition Universal Screening Tools (MUST), while malnutrition was diagnosed by means of World Health Organization (WHO) criteria, Subjective Global Assessment (SGA), European Society of Clinical Nutrition and Metabolism (ESPEN) criteria, and GLIM criteria. Quality of life and fatigue were assessed with the validated Italian version of the Inflammatory Bowel Disease Questionnaires (IBDQ) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Continuous variables were expressed as mean ± standard deviation (SD) and compared between groups using an independent samples t-test. Agreement among diagnostic criteria was evaluated using Gwet’s AC1, a chance-corrected agreement coefficient, using SGA as the semi-gold standard. Results 99 IBD patients (49 CD, 50 UC; mean age 47.3 ±18.5; 57.6% male) were included. 22% of patients were at risk of malnutrition according to MUST. Malnutrition was diagnosed in 5%, 10% and 7.1%, according to SGA, ESPEN and WHO criteria, respectively. GLIM criteria identified 12 malnourished patients (12.1%), among whom malnutrition was associated with younger age at diagnosis (30.6 vs 35.2 years, p = 0.037), male sex (83.3%, p = 0.006), and more active disease (moderate disease in 50% vs 3.5%, p 0.0001). GLIM criteria showed substantial agreement with SGA (AC1 0.9045345, CI 0.84112-0.96794) and with ESPEN (AC1 0.8935198, CI 0.82888-0.95816), but poor agreement with WHO criteria (AC1 0.500557, CI 0.38331-0.61781). Quality of life scores were slightly lower among malnourished patients, though without significant differences compared to well-nourished individuals. Conclusion GLIM criteria identified a higher prevalence of malnutrition in IBD outpatients compared to other diagnostic tools and demonstrated substantial concordance with SGA, which is considered the semi-gold standard. These findings support the use of GLIM as an appropriate, accurate and applicable tool for diagnosing malnutrition in IBD outpatients. Conflict of interest: Dr. Laffusa, Alice: No conflict of interest Ratti, Edoardo: No conflict of interest Pirola, Lorena: Consulting fees and participation on advisory board: Abbvie. Honoraria for presentations, speakers bureaus and educational events: Pfizer, Janssen, Takeda. Receipt of equipment and materials: Celltrion. Support for attending meetings and/or travel: Abbvie, Johnson and Johnson, Takeda, Pfizer, Giuliani, Ferring, Eli Lilly, Alfasigma, Cadigroup Mulinacci, Giacomo: No conflict of interest Savino, Alberto: No conflict of interest Fichera, Maria: No conflict of interest Massironi, Sara: None to declare Invernizzi, Pietro: No conflict of interest Galimberti, Stefania: No conflict of interest Viganò, Chiara: Consultancy and lecture fees from: AbbVie, Galapagos, Janssen-Cilag, Johnson & Johnson, Pfizer, Takeda, Celltrion, Alfasigma, Eli Lilly and research grant from Celltrion and Pfizer.
Laffusa et al. (Thu,) studied this question.