Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

Acorus tatarinowii is the dried rhizome of the Araceae plant Acorus tatarinowii Schott.Acorus tata-rinowii was first recorded in Shennong's Classic of Mate-ria Medica.It was used for the treatment of epilepsy,amnesia,insomnia,tinnitus,deafness,silent diarrhea,and other diseases.Alzheimer's disease(AD),also known as senile dementia,is a degenerative disease of the central nervous system.It is mainly manifested as neuropsychiatric symptoms such as progressive memory impairment,cognitive dysfunction,personality changes and language disorders.Acorus tatarinowii mainly con-tains phenylpropylene,lignans,alkaloids,sugars,organic acids and amino acids,among which volatile compo-nents such as β-asarone are the main active compo-nents.The main mechanism of action of Acorus tatari-nowii in the prevention and treatment of AD is as follows:① Improve memory ability.Increasing the expression of brain-derived neurotrophic factor(BDNF),extracellular signal-regulated kinase(ERK)and adenosine cyclic phosphate response element binding protein(CREB)can improve cognitive dysfunction.Studies have shown that Acorus tatarinowii can increase the expression of BDNF,ERK,CREB and tyrosine receptor kinase B in the hippo-campus of mice to varying degrees.It can significantly improve the memory ability of memory-impaired mice,so as to achieve the purpose of prevention and treatment of AD.② Anti-oxidative stress.Studies have shown that Acorus tatarinowii can reduce the production of malondi-aldehyde in skeletal muscle,increase superoxide dis-mutase activity and total antioxidant capacity,and repair the balance of oxidative stress.③ Acetylcholinesterase inhibition.The loss of consciousness caused by deficiency of kidney essence in AD patients is related to the patho-logical changes of the cholinergic nervous system.The results showed that Acorus tatarinowii could significantly increase the contents of glutamate and acetylcholine in the cerebral cortex of AD model mice,and decrease the activity of acetylcholinesterase,to achieve the anti-AD effect.④ Anti-inflammatory and neuroprotective effects.The damage of neurons in the brain of AD patients is related to the excessive inflammatory immune response of nerve cells including microglia and astrocytes.The results showed that Acorus tatarinowii can inhibit the autophagy of microglia in rats with cerebral hemorrhage,and has neuroprotective effect,to achieve the effect of anti-AD.In this study,the effects of Acorus tatarinowii on AD were reviewed to further clarify its pharmacological ef-fects,and to provide a basis for clinical application and research.