P600 - VALIDATION OF THE GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION CRITERIA IN ADULT PATIENTS WITH OBESITY 6 TO 24 MONTHS AFTER SLEEVE GASTRECTOMY

P600

VALIDATION OF THE GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION CRITERIA IN ADULT PATIENTS WITH OBESITY 6 TO 24 MONTHS AFTER SLEEVE GASTRECTOMY

A. N. Alotaibi¹, F. Y. Bamehriz², A. Alhamdan¹, N. A. Aljomah², M. M. A. Abulmeaty^1,*

¹Clinical Nutrition Program, Department of Community Health Sciences, ²Surgery Department, Upper GI Surgery, King Khalid University Hospital,, King Saud University, Riyadh, Saudi Arabia

Rationale: For nutritional assessment tools, post-operative weight loss and reduction in body mass index (BMI) are misleading. The Global Leadership Initiative on Malnutrition (GLIM) has not been validated for the 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 were evaluated using the GLIM and SGA. Anthropometric, body composition, and biochemical assessment were done. Agreement between both tools was determined using Kappa (κ) statistics, and the Receiver Operating Characteristics (ROC) curve was used to establish sensitivity and specificity. Also, a confusion matrix of actual malnutrition diagnosed with SGA and predicted malnutrition by GLIM was conducted. 

Results: 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) (Fig 1) with a sensitivity and specificity of 55.0% and 55.6%, respectively. The agreement between both tools was poor (κ = 0.104). The confusion matrix analysis showed accuracy = 55.32%, misclassification rate = 44.68%, sensitivity = 57.14%, specificity = 55.55%, precision = 47.82% for GLIM tool (Table 1).

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Conclusion: GLIM did not show sufficient agreement with SGA. Consequently, the GLIM criteria may need revision for post-sleeve gastrectomy patients. Weight-free components such as muscle mass,  muscle function, and fat-to-muscle mass ratio normalization are suggested for future study.

Disclosure of Interest: None declared