AUTHOR=Chen Xiaoyu , Han Peipei , Zhu Xiaoyan , Song Peiyu , Zhao Yinjiao , Zhang Hui , Yu Chen , Niu Jianying , Ding Wei , Zhao Junli , Zhang Liming , Qi Hualin , Zhang Suhua , Guo Qi 

TITLE=Comparison of three nutritional screening tools for detecting sarcopenia in patients with maintenance hemodialysis

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.996447

DOI=10.3389/fpubh.2022.996447

ISSN=2296-2565

ABSTRACT=Background: Malnutrition, dynapenia, and sarcopenia are prevalent conditions amongst maintenance hemodialysis (MHD) patients. They are related to numerous adverse health outcomes. The aim of this study was to compare the effect of three nutritional screening tools on predicting the risk of dynapenia and sarcopenia in MHD patients.
Methods: During July 2020 - April 2021, a total of 849 MHD patients were enrolled at 7 different health-care facilities in Shanghai, China in this multi-center cross-sectional study. Geriatric nutritional risk index (GNRI), malnutrition inflammation score (MIS) and creatinine (Cr) index were used for nutritional assessment. The cutoff values of muscle mass and strength to define dynapenia, pre-sarcopenia and sarcopenia were based on the consensus by the Asia Working Group of Sarcopenia in 2019.
Results: Among 849, almost 60% were malnourished with majority suffering from dynapenia (27.7%), followed by sarcopenia (22.7%), and pre-sarcopenia (6.2%).The area under the receiver-operating characteristic curve for GNRI was 0.722 (95% confidence interval [CI] = 0.684–0.760) and 0.723 (95% CI = 0.663–0.783) in predicting sarcopenia and pre-sarcopenia. The GNRI (odds ratio [OR] =6.28, 95% CI: 4.05–9.73), MIS (OR =1.91, 95% CI: 1.31–2.78), and the Cr index (OR =2.73, 95% CI: 1.71–4.34) were all significantly associated with the risk of sarcopenia. More importantly, the sarcopenia predictability of the GNRI appears greater than the MIS and Cr index, while MIS was similar to Cr index. Similarly, the superiority of GNRI prediction was also found in pre-sarcopenia, but not in dynapenia.
Conclusions: All three nutritional screening tools were significantly associated with an increased risk of sarcopenia. The sarcopenia predictability of the GNRI was greater than the MIS and Cr index.