Impact of β-hydroxy-β-methylbutyrate (HMB) on muscle loss and protein metabolism in critically ill patients: A RCT
| Autor: | G. Bagnoud, Sabine Schmidt, J.J. Thaden, Gabriella A. M. Ten Have, Nicolaas E. P. Deutz, Olivier Pantet, Mette M. Berger, Fabio Becce, Mariëlle P.K.J. Engelen, Aline Voidey, Marina Verçoza Viana |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Organ Dysfunction Scores Critical Illness Protein metabolism Critical Care and Intensive Care Medicine Placebo Gastroenterology law.invention Quadriceps Muscle chemistry.chemical_compound Enteral Nutrition Randomized controlled trial Double-Blind Method law Internal medicine medicine Clinical endpoint Electric Impedance Valerates Humans Prospective Studies Amino Acids Muscle Skeletal Wasting Aged Ultrasonography Nutrition and Dietetics business.industry Skeletal muscle Middle Aged Intensive care unit Protein catabolism Intensive Care Units Muscular Atrophy medicine.anatomical_structure chemistry Dietary Supplements Body Composition Female medicine.symptom business |
| Zdroj: | Clinical nutrition (Edinburgh, Scotland). 40(8) |
| ISSN: | 1532-1983 |
| Popis: | Muscle wasting deteriorates life quality after critical illness and increases mortality. Wasting starts upon admission to intensive care unit (ICU). We aimed to determine whether β-hydroxy-β-methylbutyrate (HMB), a metabolite of leucine, can attenuate this process.Prospective randomized, placebo-controlled double blind trial.ICU patients depending on mechanical ventilation on day 3 having a functional gastrointestinal tract. They were randomized to HMB (3 g/day) or placebo (maltodextrin) from day 4 on for 30 days.magnitude of loss of skeletal muscle area (SMA) of the quadriceps femoris measured by ultrasound at days 4 and 15.body composition, change in protein metabolism assessed by amino acids tracer pulse, and global health at 60 days. Data are mean [95% CI]. Statistics by ANCOVA with correction for confounders sex, age and/or BMI.Thirty patients completed the trial, aged 65 [59, 71] years, SAPS2 score 48 [43, 52] and SOFA 8.5 [7.4, 9.7]. The loss of total SMA was 11% between days 4 and 15 (p 0.001), but not different between the groups (p = 0.86). In the HMB group, net protein breakdown (Δ Estimate HMB-Placebo: -153 [-242, -63]; p = 0.0021) and production of several amino acid was significantly reduced, while phase angle increased more (0.66 [0.09, 1.24]; p = 0.0247), and SF-12 global health improved more (Δ Estimate HMB-Placebo: 27.39 [1.594, 53.19], p = 0.04).HMB treatment did not significantly reduce muscle wasting over 10 days of observation (primary endpoint), but resulted in significantly improved amino acid metabolism, reduced net protein breakdown, a higher phase angle and better global health. CLINICALTRIALS.NCT03628365. |
| Databáze: | OpenAIRE |
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