Abstract Objective Consistency between malnutrition defined by Global Leadership Initiative on Malnutrition (GLIM) and Patient-Generated Sub
Abstract Objective Consistency between malnutrition defined by Global Leadership Initiative on Malnutrition (GLIM) and Patient-Generated Subjective Global Assessment (PG-SGA) has not been thoroughly elucidated in patients with cancer. The study aimed to compare their consistency, and summarize the impact of malnutrition defined by GLIM on adverse outcomes. Method PubMed, Embase, Cochrane library and Web of Science databases were searched from inception to May 1, 2024. Initially, the amalgamated sensitivity, specificity and area under curve (AUC) with 95% confidence intervals (CIs) were calculated. Subsequently, hazard ratios (HR) or odd ratios (OR) and 95% CIs for overall survival (OS), all-cause mortality, postoperative complications, disease-free survival (DFS) and recurrence-free survival (RFS) were pooled. Result Fifty-six studies (55,767 participants) were included. Compared with PG-SGA criteria, the overall sensitivity, specificity and area under curve (AUC) for GLIM was 0.71 (95% CI: 0.63–0.78), 0.80 (95% CI: 0.65–0.90) and 0.79 (95% CI: 0.75–0.83). Subgroup analysis revealed that the diagnostic value in Asian or among patients aged under 60 years were higher than non-Asian or those aged over 60 years. Moreover, GLIM-defined malnutrition was significantly associated with overall survival (OS) [hazard ratios (HR) = 1.57, 95% CI: 1.46–1.67], all-cause mortality (HR = 1.43, 95% CI: 1.29–1.57), postoperative complications [odd ratios (OR) = 1.57, 95% CI: 1.40–1.73], disease-free survival (DFS) (OR = 1.52, 95% CI: 1.36–1.68) and recurrence-free survival (RFS) (OR = 1.41, 95% CI: 1.10–1.72). Conclusion GLIM criteria exhibit moderate diagnostic accuracy for identifying malnutrition among patients with cancer, when compared to the PG-SGA. This accuracy is pronounced in the Asian and patients under the age of 60. Furthermore, GLIM-defined malnutrition was significantly associated with OS, DFS, RFS, all-cause mortality and postoperative complication risks in patients with cancer.
