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Accepted manuscript

Evaluation of Malnutrition at Hospital Admission Using the Global Leadership Initiative on Malnutrition (GLIM) Criteria: Comparison of Bioelectrical Impedance Analysis (BIA) and Calf Circumference for Muscle Mass Assessment

Published online by Cambridge University Press:  29 December 2025

Susetyowati Susetyowati*
Affiliation:
Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Andi Yasmin Syauki
Affiliation:
Clinical Nutrition Study Program, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
Ahmad Syauqy
Affiliation:
Department of Nutrition Science, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
Riani Witaningrum
Affiliation:
Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Farah Faza
Affiliation:
Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Safira Tasya Amelia
Affiliation:
Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
*
Corresponding author: Prof. Dr. Susetyowati, DCN., M.Kes, Department of Nutrition and Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Sleman, 55281 D.I. Yogyakarta, Indonesia, Email: susetyowati@ugm.ac.id, Phone: +62 818 277 781
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Abstract

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The Global Leadership Initiative on Malnutrition (GLIM) provides a consensus-based diagnostic framework for malnutrition in hospitalized patients which includes at least one phenotypic and one etiologic criterion. In GLIM, Appendicular Skeletal Muscle based on Bioelectrical Impedance Analysis (ASMBIA) and calf circumference (CC) are two commonly techniques for muscle mass assessment, but their accuracy remains debated. Therefore, current study evaluates the prevalence of malnutrition upon hospital admission applied by GLIM criteria and mainly compares the effectiveness of ASMBIA and CC. We screened a total of 605 patients from four hospitals in Indonesia (August–October 2024). Multivariate logistic regression analyzed associations with clinical outcomes. Prevalence of malnutrition was 72.7% using three phenotypes, 55.9% with two phenotypes, 22.1% via ASMBIA, and 62.6% using CC. Significant associations (p < 0.05) were found between malnutrition and weight loss, BMI, mid-upper arm circumference (MUAC), handgrip strength (HGS), sarcopenia, and fat-free mass index (FFMI). For all criteria combinations, sensitivity was greater in CC (86.1%), followed by two phenotypes (76.8%), while the ASMBIA had the poorest sensitivity (30.5%). All GLIM-based diagnostic methods correlated with malnutrition risk screening and nutrition status indicators. The GLIM criteria provide a standardized, clinically relevant approach for diagnosing malnutrition in hospitalized patients, with CC emerging as a highly sensitive assessment to examine muscle mass.

Information

Type
Research Article
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society