{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T14:54:59Z","timestamp":1788274499238,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background and aims: Malnutrition in lung transplantation (LT) candidates increases postoperative morbidity and mortality. Early diagnosis of malnutrition could attenuate adverse prognostic factors. This study aimed to assess the prevalence of nutritional risk and malnutrition using GLIM criteria in LT candidates and clinically characterize those with malnutrition. Methods: A prospective longitudinal study was conducted from 2000 to 2020 of LT candidates who underwent complete nutritional assessment (nutritional screening, anthropometry, bioelectrical impedance, blood laboratory tests and malnutrition diagnosis using GLIM criteria). Results: Obstructive diseases (45.6%), interstitial diseases (36.6%) and cystic fibrosis\/non-cystic fibrosis bronchiectasis (15.4%) were the main conditions assessed for LT. Of the 1060 candidates evaluated, 10.6% were underweight according to BMI, 29% were at risk of malnutrition and 47% were diagnosed with malnutrition using GLIM criteria. Reduced muscle mass was the most frequent GLIM phenotypic criterion. Malnutrition was more prevalent in patients with cystic fibrosis\/non-cystic fibrosis bronchiectasis (84.5%) and obstructive (45.4%) and interstitial (31.3%) diseases. GLIM criteria detected some degree of malnutrition in all diseases requiring LT and identified patients with higher CRP levels and worse respiratory function, anthropometric measurements and visceral protein and lipid profiles. Conclusions: LT candidates present a high prevalence of malnutrition using the GLIM algorithm. GLIM criteria detected malnutrition in all diseases requiring LT and defined patients with worse clinical-analytical profiles.<\/jats:p>","DOI":"10.3390\/nu16030376","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T08:54:03Z","timestamp":1706518443000},"page":"376","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Global Leadership Initiative on Malnutrition-Diagnosed Malnutrition in Lung Transplant Candidates"],"prefix":"10.3390","volume":"16","author":[{"given":"Alfonso","family":"Cala\u00f1as-Continente","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, University Hospital Reina Sofia, Avenida Menendez Pidal s\/n, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4928-7771","authenticated-orcid":false,"given":"Jes\u00fas","family":"Guti\u00e9rrez-Botella","sequence":"additional","affiliation":[{"name":"Biostatech Advice Training and Innovation in Biostatistics, SL. Edificio Emprendia, Campus Vida s\/n, 15782 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Garc\u00eda-Curr\u00e1s","sequence":"additional","affiliation":[{"name":"Biostatech Advice Training and Innovation in Biostatistics, SL. Edificio Emprendia, Campus Vida s\/n, 15782 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00aa Jes\u00fas","family":"Cobos","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine and Lung Transplantation, University Hospital Reina Sofia, Avenida Menendez Pidal s\/n, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Manuel","family":"Vaquero","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine and Lung Transplantation, University Hospital Reina Sofia, Avenida Menendez Pidal s\/n, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aura","family":"Herrera","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, University Hospital Reina Sofia, Avenida Menendez Pidal s\/n, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00aa Jos\u00e9","family":"Molina","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, University Hospital Reina Sofia, Avenida Menendez Pidal s\/n, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00aa \u00c1ngeles","family":"G\u00e1lvez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, University Hospital Reina Sofia, Avenida Menendez Pidal s\/n, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.healun.2018.07.020","article-title":"The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-fifth adult lung and heart-lung transplant report-2018; Focus theme: Multiorgan Transplantation","volume":"37","author":"Chambers","year":"2018","journal-title":"J. Heart Lung Transpl."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2521","DOI":"10.1016\/j.clnu.2021.02.047","article-title":"A GLIMmer of insight into lung transplant nutrition: Enhanced detection of malnutrition in lung transplant patients using the GLIM criteria","volume":"40","author":"Emsley","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.healun.2021.07.005","article-title":"Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation","volume":"40","author":"Leard","year":"2021","journal-title":"J. Heart Lung Transpl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1034\/j.1399-3003.2000.16f05.x","article-title":"Prevalence and consequences of nutritional depletion in lung transplant candidates","volume":"16","author":"Schwebel","year":"2000","journal-title":"Eur. Respir. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.nut.2018.03.052","article-title":"Cystic fibrosis, body composition, and health outcomes: A systematic review","volume":"55\u201356","author":"Calella","year":"2018","journal-title":"Nutrition"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.jamda.2016.12.081","article-title":"Normal Weight but Low Muscle Mass and Abdominally Obese: Implications for the Cardiometabolic Risk Profile in Chronic Obstructive Pulmonary Disease","volume":"18","author":"Beijers","year":"2017","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"680","DOI":"10.4187\/respcare.04358","article-title":"Fat-Free Mass Index for Evaluating the Nutritional Status and Disease Severity in COPD","volume":"61","author":"Luo","year":"2016","journal-title":"Respir. Care."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/resp.12941","article-title":"Fat-free mass index predicts survival in patients with idiopathic pulmonary fibrosis","volume":"22","author":"Nishiyama","year":"2017","journal-title":"Respirology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1164\/rccm.201405-0973OC","article-title":"Body composition and mortality after adult lung transplantation in the United States","volume":"190","author":"Singer","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clnu.2018.08.002","article-title":"GLIM criteria for the diagnosis of malnutrition\u2014A consensus report from the global clinical nutrition community","volume":"38","author":"Cederholm","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1079\/BJN20041258","article-title":"Malnutrition in hospital outpatients and inpatients: Prevalence, concurrent validity and ease of use of the \u201cmalnutrition universal screening tool\u201d (\u2019MUST\u2019) for adults","volume":"92","author":"Stratton","year":"2004","journal-title":"Br. J. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1002\/jpen.1872","article-title":"Assessing Malnutrition in Systemic Sclerosis With Global Leadership Initiative on Malnutrition and European Society of Clinical Nutrition and Metabolism Criteria","volume":"45","author":"Rosato","year":"2021","journal-title":"JPEN J. Parenter. Enteral Nutr."},{"key":"ref_13","first-page":"2872e80","article-title":"Global Leadership Initiative on Malnutrition (GLIM): Guidance on validation of the operational criteria for the diagnosis of protein-energy malnutrition in adults","volume":"39","author":"Keller","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1002\/jpen.1873","article-title":"Evaluation of the Global Leadership Initiative on Malnutrition Criteria Using Different Muscle Mass Indices for Diagnosing Malnutrition and Predicting Survival in Lung Cancer Patients","volume":"45","author":"Yin","year":"2021","journal-title":"JPEN J. Parenter. Enteral Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Kalu\u017aniak-Szymanowska, A., Krzymi\u0144ska-Siemaszko, R., Wieczorowska-Tobis, K., and Deskur-\u015amielecka, E. (2022). Optimal Assessment of Nutritional Status in Older Subjects with the Chronic Obstructive Pulmonary Disease-A Comparison of Three Screening Tools Used in the GLIM Diagnostic Algorithm. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph19031025"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.clnu.2015.03.001","article-title":"Diagnostic criteria for malnutrition\u2014An ESPEN Consensus Statement","volume":"34","author":"Cederholm","year":"2015","journal-title":"Clin. Nutr."},{"key":"ref_17","unstructured":"R Core Team (2022). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: https:\/\/www.R-project.org\/."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"44","DOI":"10.21037\/atm.2019.12.62","article-title":"Nutritional status and lung transplantation: An intriguing problem","volume":"8","author":"Nosotti","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1164\/ajrccm.158.2.9711023","article-title":"Peripheral muscle weakness in patients with chronic obstructive pulmonary disease","volume":"158","author":"Bernard","year":"1998","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1093\/ajcn\/71.3.733","article-title":"Skeletal muscle weakness is associated with wasting of extremity fat-free mass but not with airflow obstruction in patients with chronic obstructive pulmonary disease","volume":"71","author":"Engelen","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_21","unstructured":"The Malnutrition Advisory Group (2021, January 14). The MUST Report: Nutritional Screening of Adults: A Multidisciplinary Responsibility. BAPEN. Available online: https:\/\/www.bapen.org.uk\/screening-and-must\/must\/must-report."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1177\/0884533608321130","article-title":"Nutrition screening tool for hospitalized patients","volume":"23","author":"Anthony","year":"2008","journal-title":"Nutr. Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.jand.2019.09.011","article-title":"Position of the Academy of Nutrition and Dietetics: Malnutrition (Undernutrition) Screening Tools for All Adults","volume":"120","author":"Skipper","year":"2020","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1007\/s40520-021-01880-5","article-title":"Malnutrition, assessed by the Global Leadership Initiative on Malnutrition (GLIM) criteria but not by the mini nutritional assessment (MNA), predicts the incidence of sarcopenia over a 5-year in the SarcoPhAge cohort","volume":"33","author":"Beaudart","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kalu\u017aniak-Szymanowska, A., Krzymi\u0144ska-Siemaszko, R., Lewandowicz, M., Deskur-\u015amielecka, E., Stachnik, K., and Wieczorowska-Tobis, K. (2021). Diagnostic Performance and Accuracy of the MNA-SF against GLIM Criteria in Community-Dwelling Older Adults from Poland. Nutrients, 13.","DOI":"10.3390\/nu13072183"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"D\u00e1valos-Yerovi, V., Marco, E., S\u00e1nchez-Rodr\u00edguez, D., Duran, X., Meza-Valderrama, D., Rodr\u00edguez, D.A., Mu\u00f1oz, E., Tejero-S\u00e1nchez, M., Muns, M.D., and Guill\u00e9n-Sol\u00e0, A. (2021). Malnutrition According to GLIM Criteria Is Associated with Mortality and Hospitalizations in Rehabilitation Patients with Stable Chronic Obstructive Pulmonary Disease. Nutrients, 13.","DOI":"10.3390\/nu13020369"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3171","DOI":"10.1038\/s41598-017-03388-3","article-title":"Malnutrition-sarcopenia syndrome predicts mortality in hospitalized older patients","volume":"7","author":"Hu","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1210\/endrev\/bnaa030","article-title":"Metabolic Consequences of Solid Organ Transplantation","volume":"42","author":"Bhat","year":"2021","journal-title":"Endocr. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.healun.2013.04.005","article-title":"Impact of nutritional state on lung transplant outcomes","volume":"32","author":"Chamogeorgakis","year":"2013","journal-title":"J. Heart Lung Transpl."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/S1053-2498(00)00315-6","article-title":"Nutritional assessment of the lung transplant patient: Body mass index as a predictor of 90-day mortality following transplantation","volume":"20","author":"Madill","year":"2001","journal-title":"J. Heart Lung Transpl."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/j.healun.2010.05.005","article-title":"The impact of recipient body mass index on survival after lung transplantation","volume":"29","author":"Allen","year":"2010","journal-title":"J. Heart Lung Transpl."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1016\/j.transproceed.2014.04.004","article-title":"Body mass index in lung transplant candidates: A contraindication to transplant or not?","volume":"46","author":"Ruttens","year":"2014","journal-title":"Transpl. Proc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/j.athoracsur.2015.10.041","article-title":"Core Muscle Size Predicts Postoperative Outcome in Lung Transplant Candidates","volume":"101","author":"Weig","year":"2016","journal-title":"Ann. Thorac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/ncp.10588","article-title":"The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper","volume":"36","author":"Evans","year":"2021","journal-title":"Nutr. Clin. Pract."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Keller, U. (2019). Nutritional Laboratory Markers in Malnutrition. J. Clin. Med., 8.","DOI":"10.3390\/jcm8060775"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1007\/BF01709333","article-title":"Nutritional status, ICU duration and ICU mortality in lung transplant recipients","volume":"22","author":"Plochl","year":"1996","journal-title":"Intensive Care Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.chest.2019.11.043","article-title":"Underweight patients with cystic fibrosis have acceptable survival following lung transplantation: A United Network for Organ Sharing Registry Study","volume":"157","author":"Ramos","year":"2020","journal-title":"Chest."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/ncp.10810","article-title":"Key approaches to diagnosing malnutrition in adults","volume":"37","author":"Malone","year":"2022","journal-title":"Nutr. Clin. Pract."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1016\/j.clnu.2022.02.001","article-title":"Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition","volume":"41","author":"Barazzoni","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3522","DOI":"10.1016\/j.clnu.2020.11.034","article-title":"Malnutrition according to GLIM criteria in stable renal transplant recipients: Reduced muscle mass as predominant phenotypic criterion","volume":"40","author":"Bakker","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1007\/s11605-016-3114-2","article-title":"Clinical Significance of the Glasgow Prognostic Score for Survival after Colorectal Cancer Surgery","volume":"20","author":"Eren","year":"2016","journal-title":"J. Gastrointest. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/resp.13184","article-title":"Prognostic significance of Glasgow prognostic score in patients with acute exacerbation of idiopathic pulmonary fibrosis","volume":"23","author":"Kang","year":"2018","journal-title":"Respirology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.ccm.2022.06.012","article-title":"Updates in Nutrition Management of Cystic Fibrosis in the Highly Effective Modulator Era","volume":"43","author":"Wilson","year":"2022","journal-title":"Clin. Chest Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"111725","DOI":"10.1016\/j.nut.2022.111725","article-title":"Improving nutrition in cystic fibrosis: A systematic literature review","volume":"102","author":"Mielus","year":"2022","journal-title":"Nutrition"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/3\/376\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:50:20Z","timestamp":1760104220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/3\/376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,27]]},"references-count":44,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["nu16030376"],"URL":"https:\/\/doi.org\/10.3390\/nu16030376","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,27]]}}}