The effect of P-hydroxy P-methylbutyrate (HMB) with nutritional counselling on anthropometric muscle mass markers, strength, functionality, and quality of life in patients on the waiting list for liver transplantation: A double-blind study

Objective: Patients on the waiting list for liver transplantation (LTx) usually lose muscle mass. Supplementa-tion with P-hydroxy P-methylbutyrate (HMB) may have a promising effect on this clinical condition. This study aimed to evaluate the effects of HMB on muscle mass, strength, functionality, and quality of life in patients on the LTx waiting list.Methods: A double-blind, randomized study was conducted of 3g supplementation of HMB or 3g supplemen-tation of maltodextrin (active control) with nutritional counselling for 12 wk in patients >18 y, evaluated at five points or timepoints. Body composition and anthropometric data (resistance, reactance, phase angle, weight, body mass index, arm circumference [AC], arm muscle area, and adductor pollicis muscle thickness) were collected, and muscle strength was assessed through dynamometry and muscle function by the frailty index (FI). Quality of life was assessed.Results: A total of 47 patients were enrolled (HMB: 23 and active control: 24). There was a significant differ-ence in both groups for AC (P = 0.03), dynamometry (P = 0.02), and FI (P = 0.01). There was an increase in dynamometry between weeks 0 and 12 in both groups (HMB [Adynamometry: 10.1% & PLUSMN; 16.4%; P < 0.05] and active control [Adynamometry: 23.0% & PLUSMN; 70.3%; P < 0.05]). The AC increased in both groups between weeks 0 and 4 (HMB [AAC: 0.9% & PLUSMN; 2.8%; P < 0.05] and active control [AAC: 1.6% & PLUSMN; 3.6%; P < 0.05]) and between weeks 0 and 12 (HMB [AAC: 3.2% & PLUSMN; 6.7%; P < 0.05] and active control [AAC: 2.1% & PLUSMN; 6.6%; P < 0.05]). The FI decreased in both groups, between weeks 0 and 4 (HMB [AFI:-4.2% & PLUSMN; 6.9%; P < 0.05) and active control [AFI:-3.2% & PLUSMN; 9.6%; P < 0.05]) and between weeks 0 and 12 (HMB AFI:-4.4% & PLUSMN; 11.2%; P < 0.05] and active control [AFI:-5.5% & PLUSMN; 11.3%; P < 0.05]). The other variables did not change (P > 0.05).Conclusions: Nutritional counselling with supplementation with HMB or active control in patients on the LTx waiting list improved AC, dynamometry, and the FI in both groups.& COPY; 2023 Elsevier Inc. All rights reserved.