Randomized Clinical Trial: Effects of β-Hydroxy-β-Methylbutyrate (HMB)-Enriched vs. HMB-Free Oral Nutritional Supplementation in Malnourished Cirrhotic Patients
What this study found
Improvements in liver function scores were observed in both groups, with increases in fat mass but no changes in fat-free mass. HMB supplementation did show an upward trend in handgrip strength and a decrease in minimal hepatic encephalopathy, though changes in liver enzyme levels were noted.
- Study & population
- 43 malnourished patients with liver cirrhosis were randomized to receive twice a day either an oral nutritional supplement enriched with 1.5g calcium HMB or a similar supplement without HMB for 12 weeks.
- Intervention
- A randomized clinical trial investigated the effects of β-Hydroxy-β-Methylbutyrate (HMB)-enriched vs.
- Key limitation
- High dropout rate in the HMB group due to gastrointestinal effects and the small sample size may limit the findings.
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Open PDFOriginal abstract
β-Hydroxy-β-methylbutyrate (HMB) supplementation increases muscle and strength mass in some muscle-wasting disorders. Malnutrition and sarcopenia are often present in liver cirrhosis. We aimed to investigate the effects of oral HMB supplementation on changes in body composition and liver status in patients with cirrhosis and malnutrition. In a randomized, controlled, double-blind trial, 43 individuals were randomized to receive twice a day and for 12 weeks an oral nutritional supplement (ONS) enriched with 1.5 g of calcium HMB per bottle or another supplement with similar composition devoid of HMB. Inclusion criteria were liver cirrhosis with at least one previous decompensation and clinical malnutrition. Liver function, plasma biochemistry analyses, and physical condition assessment were carried out at baseline, then after six and 12 weeks of supplementation. A total of 34 patients completed the clinical trial. An improvement in liver function and an increase in fat mass index were observed in both groups. None of the two ONS changed the fat-free mass. However, we observed an upward trend in handgrip strength and a downward trend in minimal hepatic encephalopathy in the HMB group. At the end of the trial and regardless of the supplement administered, fat mass content increased with no change in fat-free mass, while liver function scores and nutritional analytic markers also improved.