Identification of key factors for malnutrition diagnosis in chronic gastrointestinal diseases using machine learning underscores the importance of GLIM criteria as well as additional parameters.

Introduction: Disease-related malnutrition is common but often underdiagnosed in patients with chronic gastrointestinal diseases, such as liver cirrhosis, short bowel and intestinal insufficiency, and chronic pancreatitis. To improve malnutrition diagnosis in these patients, an evaluation of the current Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria, and possibly the implementation of additional criteria, is needed. Aim: This study aimed to identify previously unknown and potentially specific features of malnutrition in patients with different chronic gastrointestinal diseases and to validate the relevance of the GLIM criteria for clinical practice using machine learning (ML). Methods: Between 10/2018 and 09/2021, Results: Supervised ML effectively classified malnourished versus non-malnourished patients and controls. Excluding the existing GLIM criteria and malnutrition risk reduced model performance (sensitivity -19%, specificity -8%, F1-score -10%), highlighting their significance. Besides some GLIM criteria (weight loss, reduced food intake, disease/inflammation), additional anthropometric (hip and upper arm circumference), body composition (phase angle, SMMI), and laboratory markers (albumin, pseudocholinesterase, prealbumin) were key features for malnutrition classification. Conclusion: ML analysis confirmed the clinical applicability of the current GLIM criteria and identified additional features that may improve malnutrition diagnosis and understanding of the pathophysiology of malnutrition in chronic gastrointestinal diseases.