{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T14:23:16Z","timestamp":1779200596738,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,5,22]],"date-time":"2018-05-22T00:00:00Z","timestamp":1526947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Granular diagnostic criteria for adult malnutrition are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study uses analytic morphomics to define the Morphomic Malnutrition Score (MMS), a robust screening tool for severe malnutrition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study population (n\u00a0=\u00a0643) consisted of 2 cohorts: 1) 124 emergency department patients diagnosed with severe malnutrition by a registered dietitian (RD) and an available computed tomography (CT) scan within 2 days of RD evaluation, and 2) 519 adult kidney donor candidates to represent a healthy cohort. Body composition markers of muscle area and abdominal adiposity were measured from patient CT scans using analytic morphomic assessment, and then converted to sex\u2010 and age\u2010adjusted percentiles using the Reference Analytic Morphomics Population (RAMP). RAMP consists of 6000 patients chosen to be representative of the general population. The combined cohort was then randomly divided into training (n\u00a0=\u00a0453) and validation (n\u00a0=\u00a0190) sets. MMS was derived using logistic regression. The model coefficients were transformed into a score, normalized from 0 to 10 (10\u00a0=\u00a0most severe).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Severely malnourished patients had lower amounts of muscle and fat than kidney donors, specifically for dorsal muscle group area at the twelfth thoracic vertebral level (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), psoas muscle area at the fourth lumbar vertebral level (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001), and subcutaneous fat area at the third lumbar vertebral level (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001)\u2014all parameters in MMS. MMS for severely malnourished patients was higher than kidney donors (7.7\u00a0\u00b1\u00a02.2 vs 3.8\u00a0\u00b1\u00a02.0, respectively; <jats:italic>P\u2010<\/jats:italic>value\u00a0&lt;\u00a00.001). An MMS\u00a0&gt;\u00a06.1 was accurate in determining nutrition diagnosis (82.1% sensitivity; 88.3% specificity; 85.2% balanced accuracy).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MMS provides an evidence\u2010based, granular assessment to distinguish severely malnourished adults from a healthy population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.1175","type":"journal-article","created":{"date-parts":[[2018,5,22]],"date-time":"2018-05-22T10:10:14Z","timestamp":1526983814000},"page":"1263-1271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Morphomic Malnutrition Score: A Standardized Screening Tool for Severe Malnutrition in Adults"],"prefix":"10.1002","volume":"42","author":[{"given":"Christopher","family":"Lee","sequence":"first","affiliation":[{"name":"Morphomic Analysis Group University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Raymond","sequence":"additional","affiliation":[{"name":"Department of Patient Food and Nutrition Services  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2869-9584","authenticated-orcid":false,"given":"Brian A.","family":"Derstine","sequence":"additional","affiliation":[{"name":"Morphomic Analysis Group University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua M.","family":"Glazer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Wisconsin  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Goulson","sequence":"additional","affiliation":[{"name":"Morphomic Analysis Group University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avinash","family":"Rajasekaran","sequence":"additional","affiliation":[{"name":"Morphomic Analysis Group University of Michigan  Ann Arbor Michigan USA"},{"name":"University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill","family":"Cherry\u2010Bukowiec","sequence":"additional","affiliation":[{"name":"Department of Surgery Michigan Medicine  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace L.","family":"Su","sequence":"additional","affiliation":[{"name":"Morphomic Analysis Group University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Surgery Michigan Medicine  Ann Arbor Michigan USA"},{"name":"Department of Medicine Michigan Medicine  Ann Arbor Michigan USA"},{"name":"Gastroenterology Section VA Ann Arbor Healthcare System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stewart C.","family":"Wang","sequence":"additional","affiliation":[{"name":"Morphomic Analysis Group University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Surgery Michigan Medicine  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,22]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"A.S.P.E.N. 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