Diagnosing malnutrition by the recently published Global Leadership Initiative on Malnutrition (GLIM) criteria requires using modern techniques for body composition measurements. We hypothesized that the prevalence of malnutrition identified by usual nutritional scores and according to GLIM criteria may be close to each other due to the number of components shared between them. Our aim was to compare the concurrent validity of four nutritional scores, malnutrition-inflammation score (MIS), objective score of nutrition on dialysis, geriatric nutritional index (GNRI), and nutritional risk index against the GLIM criteria for malnutrition in maintenance hemodialysis patients. This prospective observational study was performed on 318 maintenance hemodialysis outpatients (37% women) with a mean age of 68.7 ± 13.1 years and a median dialysis vintage of 21 months. According to the GLIM criteria, 45.9% of these patients were diagnosed with malnutrition. Nutritional scores, dietary intake and body composition parameters were measured. All nutritional scores showed a strong association with malnutrition in multivariable logistic regression models. In discriminating the nutritional risk, the ROC AUC was largest for GNRI (0.70, 95% CI: 0.65-0.75; P< .001). Nutritional risk index and MIS showed high specificity but lower sensitivity compared to GNRI and objective score of nutrition on dialysis. Compared to MIS, GNRI had better concurrent validity (higher sensitivity and acceptable specificity) but was inferior to MIS in terms of relation to certain etiologic and phenotypic components of the GLIM criteria (specifically, to dietary intake and decrease in dry weight). In summary, of the nutritional scores tested, GNRI is the most sensitive score in identifying malnutrition diagnosed by GLIM criteria, but MIS is more specific and better in predicting the individual components of the GLIM criteria.

通过最近发布的全球营养不良领导力倡议 (GLIM) 标准诊断营养不良需要使用现代技术进行身体成分测量。我们假设通过通常的营养评分和根据 GLIM 标准确定的营养不良患病率可能彼此接近，因为它们之间共享的成分数量。我们的目的是比较四种营养评分、营养不良-炎症评分 (MIS)、透析营养客观评分、老年营养指数 (GNRI) 和营养风险指数与维持性血液透析患者营养不良的 GLIM 标准的同时有效性。这项前瞻性观察研究对 318 名平均年龄为 68.7 ± 13 岁的维持性血液透析门诊患者（37% 为女性）进行。1 年和 21 个月的中位透析年份。根据 GLIM 标准，这些患者中有 45.9% 被诊断为营养不良。测量了营养评分、膳食摄入量和身体成分参数。在多变量逻辑回归模型中，所有营养评分都与营养不良密切相关。在区分营养风险时，GNRI 的 ROC AUC 最大( 0.70, 95% CI: 0.65-0.75; P < .001)。与 GNRI 和透析营养客观评分相比，营养风险指数和 MIS 显示出高特异性但敏感性较低。与 MIS 相比，GNRI 具有更好的同时效度（更高的敏感性和可接受的特异性），但在 GLIM 标准的某些病因和表型成分（特别是饮食摄入和干重减少）方面不如 MIS。总之，在所测试的营养评分中，GNRI 是识别 GLIM 标准诊断的营养不良最敏感的评分，但 MIS 更具体，在预测 GLIM 标准的各个组成部分方面更佳。