JPEN. Journal of parenteral and enteral nutrition · 2026
Combined GLIM-defined malnutrition and sarcopenia and the risk of 2-year mortality in adults with heart failure: A FRAGILE-HF study post hoc analysis.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Matsuo Koji, Kamiya Kentaro, Maeda Daichi, Hamazaki Nobuaki, Uchida Shota, Yamashita Masashi, Konishi Masaaki, Kasai Takatoshi, Saito Hiroshi, Ogasahara Yuki, Kitai Takeshi, Iwata Kentaro, Jujo Kentaro, Wada Hiroshi, Maekawa Emi, Momomura Shin-Ichi, Kagiyama Nobuyuki, Matsue Yuya
Аннотация
BACKGROUND: Malnutrition is common in older patients with heart failure and predicts poor outcomes. However, the prognostic value of assessing muscle function and fat stores alongside GLIM remains unclear. We therefore tested whether assessing handgrip strength and fat mass index alongside GLIM improves risk stratification for mortality.
METHODS: We conducted a post hoc analysis of patients ≥65 years in the multicenter observational FRAGILE-HF cohort. Malnutrition was evaluated using GLIM criteria at hospital discharge. Handgrip strength and fat mass index were also measured at discharge; low handgrip strength was defined as <28 kg in men and <18 kg in women, and low fat mass index as <4.62 kg/m2 in men and <5.86 kg/m2 in women. Patients were classified into four groups by GLIM-defined malnutrition and low handgrip strength and, separately, by GLIM-defined malnutrition and low fat mass index. Associations with 2-year all-cause mortality were examined using Cox proportional hazards regression.
RESULTS: Of 1332 patients, 834 were analyzed (median age, 81 years; 57.6% men). In four-group analyses, GLIM-defined malnutrition with low handgrip strength (HR, 2.06; 95% CI, 1.14-3.73; P = 0.02) and GLIM-defined malnutrition with low fat mass index (HR, 1.87; 95% CI, 1.25-2.80; P = 0.01) had higher mortality than the corresponding reference groups (absence of malnutrition with normal handgrip strength and absence of malnutrition with normal fat mass index).
CONCLUSION: Assessing handgrip strength or fat mass index alongside GLIM identified subgroups at higher risk of 2-year mortality.
METHODS: We conducted a post hoc analysis of patients ≥65 years in the multicenter observational FRAGILE-HF cohort. Malnutrition was evaluated using GLIM criteria at hospital discharge. Handgrip strength and fat mass index were also measured at discharge; low handgrip strength was defined as <28 kg in men and <18 kg in women, and low fat mass index as <4.62 kg/m2 in men and <5.86 kg/m2 in women. Patients were classified into four groups by GLIM-defined malnutrition and low handgrip strength and, separately, by GLIM-defined malnutrition and low fat mass index. Associations with 2-year all-cause mortality were examined using Cox proportional hazards regression.
RESULTS: Of 1332 patients, 834 were analyzed (median age, 81 years; 57.6% men). In four-group analyses, GLIM-defined malnutrition with low handgrip strength (HR, 2.06; 95% CI, 1.14-3.73; P = 0.02) and GLIM-defined malnutrition with low fat mass index (HR, 1.87; 95% CI, 1.25-2.80; P = 0.01) had higher mortality than the corresponding reference groups (absence of malnutrition with normal handgrip strength and absence of malnutrition with normal fat mass index).
CONCLUSION: Assessing handgrip strength or fat mass index alongside GLIM identified subgroups at higher risk of 2-year mortality.