Standardising and Simplifying the Global Leadership Initiative on Malnutrition (GLIM) for Its More General Application

This observational study of aims to test whether and how the results of GLIM change when using different approaches and methods to carry out its components.

Study Overview

• Status: Recruiting
• Conditions: Malnutrition
• Intervention / Treatment: Diagnostic test: Nutrition screening and assessment

Detailed Description

The main questions the study aims to answer are:

• What is the most effective pre-GLIM screening approach?
• Which of the simple, globally accessible muscle mass measurement methods works the best in the context of GLIM?
• How does using simpler approaches to screening and muscle mass measurement affect the performance of GLIM in detecting Subjective Global Assessment (SGA) defined malnutrition and 1-year mortality?

Participants will be/have:

• asked questions about their recent food intake and possible non-volitional weight loss
• assessed for malnutrition with SGA
• weighed, and their height will be measured (if not already recorded)
• their muscle mass measured with a measuring tape (mid-upper arm circumference and calf circumference) and bioelectrical impedance
• their muscle function measured using hand grip strength
• have their patient records looked at to extract their weight and height data (if present), diagnoses, routine blood test results, abdominal computed tomography (CT) scan (if present), dual-energy x-ray absorptiometry (DEXA) scan (if present), 1-year mortality and personal identification code for documentation (the latter will be deleted when the study period is over).

• Study Type: Observational
• Enrollment (Estimated): 300

Contacts and Locations

• Study Contact: Name: Grete Kurik, BSc; Phone Number: +372 53436535; Email: grete.kurik@ut.ee
• Study Contact Backup: Name: Alastair Forbes, MD; Email: alastair.forbes@ut.ee

Study Locations

• Estonia
  • Tartumaa
    • Tartu, Tartumaa, Estonia, 50406
      • Recruiting
      • Tartu Ulikooli Kliinikum
      • Contact: Grete Kurik, BSc; Phone Number: +372 53436535; Email: grete.kurik@ut.ee
      • Contact: Alastair Forbes, MD; Phone Number: +372 58830422; Email: 2020aforbes@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Inpatients of day patients admitted to the Tartu University Hospital.

Description

Inclusion Criteria:

• Age of 18+ years
• Able and willing to sign the consent form
• Inpatients of the Tartu University Hospital
• Admitted within 72 hours before enrolment

Exclusion Criteria:

• Age of <18 years
• Inability or refusal to sign the consent form
• Pregnant or lactating women
• More than 72 hours passed since admission
• Patients isolating with an infection

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Inpatients of the Tartu University Hospital; Inclusion Criteria: Age of 18+ years, able and willing to sign the consent form, inpatients of the Tartu University Hospital, admitted within 72 hours before enrolment. Exclusion Criteria: Age of <18 years, inability or refusal to sign the consent form, pregnant or lactating women, more than 72 hours passed since admission, patients isolating with an infection.

Diagnostic test: Nutrition screening and assessment; The patient is interviewed for changes in body weight in the last six months and food intake in the last two weeks. The investigator evaluates the patient's diet, symptoms related to their nutritional status, and functional capacity according to the Subjective Global Assessment (SGA). The SGA tool itself is completed by the researcher. Height and weight of the patient are measured, if not yet recorded, and BMI is calculated. The patient's muscle mass is measured using mid-upper arm circumference (MUAC), calf circumference (CC) and bioelectrical impedance (BIA), and their muscle function assessed using hand grip strength.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Subjective Global Assessment (SGA) defined malnutrition	Subjective Global Assessment (SGA) can be considered a method that is close to a "gold standard" for malnutrition assessment. Therefore, the study will analyse how different approaches to screening and muscle mass measurement affect the performance of GLIM in detecting Subjective Global Assessment (SGA) defined malnutrition.	baseline, pre-intervention/procedure/surgery
One-year mortality	One year after the data collection, we will look at the patient records to collect the 1-year mortality data. This will give information about whether and how different approaches to components of GLIM affect its ability to predict one-year mortality.	through study completion, an average of 1 year
Computed tomography (CT) defined muscle mass	One of the GLIM criteria is "reduced muscle mass", and this study will investigate how muscle mass measured with simpler methods compares against muscle mass measured with CT.	baseline, pre-intervention/procedure/surgery
DEXA defined muscle mass	One of the GLIM criteria is "reduced muscle mass", and this study will investigate how muscle mass measured with simpler methods compares against muscle mass measured with DEXA.	baseline, pre-intervention/procedure/surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bioelectrical impedance (BIA) defined muscle mass	One of the GLIM criteria is "reduced muscle mass", and this study will investigate how muscle mass measured with simpler methods compares against muscle mass measured with BIA.	baseline, pre-intervention/procedure/surgery

Collaborators and Investigators

• Sponsor: University of Tartu
• Collaborators: Tartu University Hospital
• Investigators: Principal Investigator: Alastair Forbes, MD, University of Tartu, Tartu University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): December 13, 2023
• Primary Completion (Estimated): March 31, 2025
• Study Completion (Estimated): June 30, 2025

Study Registration Dates

• First Submitted: November 1, 2023
• First Submitted That Met QC Criteria: December 6, 2023
• First Posted (Actual): December 11, 2023

Study Record Updates

• Last Update Posted (Actual): March 28, 2025
• Last Update Submitted That Met QC Criteria: March 24, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: muscle mass; GLIM; nutrition assessment; GLIM criteria; nutrition screening
• Additional Relevant MeSH Terms: Nutrition Disorders; Malnutrition
• Other Study ID Numbers: 23092

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No