P585 - PREVALENCE OF LOW MUSCLE MASS AND MALNUTRITION IN HOSPITAL PATIENTS WITH OVERWEIGHT AND OBESITY: A MATTER OF METHODS

P585

PREVALENCE OF LOW MUSCLE MASS AND MALNUTRITION IN HOSPITAL PATIENTS WITH OVERWEIGHT AND OBESITY: A MATTER OF METHODS

J. J. in 't Hulst¹, B. S. van der Meij^1,2, E. Vasse³, P. L. Lakenman⁴, M. de Geus⁴, J. W. Borkent ^1,2, M. A. de van der Schueren^1,2,* on behalf of on behalf of the SCOOP-consortium

¹Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, ²Department of Human Nutrition and Health, Wageningen University & Research, Wageningen, ³The Nutrition & Healthcare Alliance, Ede, ⁴Department of Internal Medicine, Division of Dietetics, Erasmus Medical Center, Rotterdam, Netherlands

 

Rationale: The GLIM criteria are widely used to diagnose malnutrition. However, in a population with overweight or obesity (BMI ≥25 kg/m²), the validity of Bioelectrical Impedance Analysis (BIA) and calf circumference (CC) for assessing low muscle mass is uncertain due to potential inaccuracies related to factors such as increased hydration status and inaccurate prediction equations (in BIA) or increased subcutaneous fat (in CC).

Methods: This multicenter cross-sectional study included hospitalized adult patients (≥18 y) with a BMI ≥25 kg/m². Malnutrition was diagnosed using GLIM criteria, with low muscle mass assessed by both BIA (GLIM-BIA) and corrected CC (GLIM-CC). Etiologic criteria included reduced food intake and inflammation.

Results: 518 patients were included (63.4 ± 15.6 years, 47.1% female, BMI: 31.0 ± 5.4 kg/m²). Malnutrition prevalence was 23.6% (80/339) using GLIM-BIA and 41.6% (141/339) using GLIM-CC (Table 1).

 

Table 1: GLIM-criteria frequencies in 518 hospitalized patients with a BMI ≥25 kg/m²

Phenotypic criteria	N	N (%)
Unintended weight loss in the past year*	518	107 (20.7%)
Low muscle mass
·        BIA†	406	18 (4.4%)
·        CC‡	460	141 (30.7%)
Etiological criteria
Reduced food intake or assimilation¶	179	89 (49.7%)
Inflammation§	294	269 (91.5%)

* >5% in 6 months or >10% beyond.

†  M:<17kg/m², F:<15kg/m².

‡  M:<33 cm, F:<32 cm; CC reduced by 3cm (BMI 25–30kg/m²) or 7cm (BMI ≥30kg/m²).

¶ <50% energy needs >1 week, any reduction for 2 weeks, or chronic GI condition affecting absorption.

^§ CRP ≥3 mg/L: ≤3 days (inpatients), ≤10 days (outpatients).

Conclusion: The prevalence of malnutrition in hospitalized patients with overweight or obesity varies strongly by the method used to assess low muscle mass. The lack of a gold standard for low muscle mass assessment in the population with overweight or obesity highlights the need to establish standardized methods and reliable cut-off points.

 

 

 

 

Disclosure of Interest: None declared