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Evaluation of malnutrition at hospital admission using the Global Leadership Initiative on Malnutrition criteria: comparison of bioelectrical impedance analysis and calf circumference for muscle mass assessment

Published online by Cambridge University Press:  29 December 2025

Susetyowati Susetyowati Open the ORCID record for Susetyowati Susetyowati [Opens in a new window] ,
Andi Yasmin Syauki ,
Ahmad Syauqy Open the ORCID record for Ahmad Syauqy [Opens in a new window] ,
Riani Witaningrum ,
Farah Faza  and
Safira Tasya Amelia
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: Susetyowati Susetyowati; Email: susetyowati@ugm.ac.id
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Abstract

The Global Leadership Initiative on Malnutrition (GLIM) provides a consensus-based diagnostic framework for malnutrition in hospitalised patients, which includes at least one phenotypic and one aetiologic criterion. In GLIM, appendicular skeletal muscle based on bioelectrical impedance analysis (ASMBIA) and calf circumference (CC) are two common techniques for muscle mass assessment, but their accuracy remains debated. Therefore, the present 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 analysed 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, handgrip strength, sarcopenia and fat-free mass index. 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 standardised, clinically relevant approach for diagnosing malnutrition in hospitalised patients, with CC emerging as a highly sensitive assessment to examine muscle mass.

Keywords

MalnutritionHospitalGlobal Leadership Initiative on MalnutritionMuscle massBioimpedance AnalysisCalf circumference

Information

Type
Research Article
Information
British Journal of Nutrition , Volume 135 , Issue 4 , 28 February 2026 , pp. 408 - 416
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

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