GLIM Criteria Nutritional Diagnosis And Clinical Related Factors Analysis Of Hospitalized Patients With Autoimmune Rheumatic Disease

Objective:Evaluate the applicability of Global Leadership Initiative on Malnutrition(GLIM criteria)for malnutrition diagnosis in hospitalized patients with Autoimmune Rheumatic Disease.To explore the relationship between CRP and anthropometric indexes and blood biochemistry,as well as the predictive efficacy of inflammatory indexes on malnutrition of ARDs,so as to provide the basis for diagnosing malnutrition of hospitalized patients in Rheumatology and Immunology Department.And identify malnutrition caused by chronic systemic inflammation at an early stage,so as to provide clinicians with comprehensive management of ARDs.Methods:Using a small sample cross-sectional survey,109 hospitalized patients were selected as the research object in the Department of Rheumatology and Immunology,which were in the First Hospital of Shanxi Medical University from July 2021 to August 2021.The nutritional status of patients was evaluated by GLIM criteria within 48 hours after admission,and the prevalence of malnutrition in hospitalized patients with ARDs was investigated.Compare the differences of general demographic data,anthropometric indexes,blood biochemical indexes,dietary status and inflammatory indexes between malnutrition group and non-malnutrition group.Spearman correlation analysis of correlation between anthropometric indexes,biochemical indexes.Meanwhile,the predictive value of erythrocyte sedimentation rate,hs-C-reactive protein and interleukin-6 for malnutrition in patients with autoimmune rheumatism was analyzed.Results:(1)Nutritional risk screening among 109 patients showed that there were 51 nutritional risks in NRS2002.Different age groups(18-39 years old,40-59 years old,≥60 years old)had different nutritional risks.People over 60 years old were more prone to malnutrition risks than the other two groups(X~2=17.904,P<0.005).(2)Among the 109 patients,39 were diagnosed as malnourished(35.8%)and 70 were diagnosed as malnourished(64.2%).There was no statistical difference in sex and dietary structure between the two groups(P>0.05).There were statistical differences in age,complications,living conditions and education level(P<0.05).(3)In the semi-quantitative food frequency questionnaire method,the food of hospitalized patients with ARDs is mainly cereals and potatoes,among which 72 people meet the Dietary reference intakes that cereals and potatoes reach 250-400g per day.There is a significant difference in cereal and potato food frequency between GLIM positive group and GLIM negative group(X~2=20.622,P<0.05),but others are not statistically significant.(4)In GLIM criteria,weight,body mass index,mid-arm circumference,Calf circumference and grip strength in malnutrition group were lower than those in non-malnutrition group,and the difference was statistically significant(P<0.05);Albumin,prealbumin,red blood cell count and hemoglobin in malnutrition group were lower than those in non-malnutrition group,and the difference was statistically significant(P<0.05).C-reactive protein,interleukin-6,hypersensitivity-CRP,erythrocyte Sedimentation Rate and neutrophil-lymphocyte ratio were higher than those in the malnutrition group,and the difference was statistically significant(P<0.05).There was no significant difference in blood lipid profile,uric acid,creatinine,urea,platelet,lymphocyte count and platelet-lymphocyte ratio between the two groups(P>0.05).(5)In all patients,erythrocyte sedimentation rate,high-sensitivity C-reactive protein and interleukin-6 was positively correlated with C-reactive protein(r_s values were 0.535,0.439,0.447,P<0.01).C-reactive protein was negatively correlated with BMI,calf circumference,upper arm circumference,grip strength,albumin,prealbumin,hemoglobin,red blood cells(r_s values respectively were-0.256,-0.272,-0.254,-0.352,-0.480,-0.466,-0.484 and-0.432).(6)The hs-C-reactive protein(AUC=0.680,cut-off value=37.2mg/L)in ROC curve has the highest predicted value for malnutrition of ARDs,and the difference is statistically significant(P<0.01).Conclusion:The risk of malnutrition among inpatients in the Department of Rheumatology and Immunology is 51(46.8%).In this study,the incidence of malnutrition is 35.8%.The study proves that the GLIM criteria has good adaptability for autoimmune rheumatic diseases.It is common that the diet structure is relatively simple,mainly carbohydrate.Patients in malnutrition group generally have hypoalbuminemia,lower BMI,lower weight,lower hemoglobin,lower muscle strength and chronic inflammation state.And high-sensitivity C-reactive protein index has predicted value for malnutrition in patients with Autoimmune Rheumatic Disease.Early identification of patients with malnutrition,improving patients’nutritional status and combining medical nutrition therapy to improve patients’chronic inflammatory state may improve diseases such as rheumatic immune patients and the quality of life.