Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and meta-analysis of randomized controlled trials
BackgroundBeta-hydroxy-beta-methylbutyrate (HMB) is beneficial for restoring muscle mass. However, the evidence supporting its use in critically ill patients remains unclear. We conducted a systematic review and meta-analysis of HMB in this population to ascertain its effects.MethodsWe searched PubM...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1505797/full |
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| author | Yu Ren Ya-Bei Gao Da-Xing Yu Hui-Bin Huang |
| author_facet | Yu Ren Ya-Bei Gao Da-Xing Yu Hui-Bin Huang |
| author_sort | Yu Ren |
| collection | DOAJ |
| description | BackgroundBeta-hydroxy-beta-methylbutyrate (HMB) is beneficial for restoring muscle mass. However, the evidence supporting its use in critically ill patients remains unclear. We conducted a systematic review and meta-analysis of HMB in this population to ascertain its effects.MethodsWe searched PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and the Cochrane database for articles focusing on adult patients receiving HMB compared to controls. The primary outcome was mortality. To explore potential heterogeneity, we assessed study quality and performed subgroup analysis, sensitivity analysis, and quality of evidence.ResultsNine randomized controlled trials were included. There were some differences in the study design, HMB protocols, and muscle measurements among these trials. Overall, there were no significant differences in mortality between the HMB and the control groups (risk ratio = 0.96; 95% CI, 0.44–2.08; P = 0.92). This finding was confirmed by the subgroup and sensitivity analyzes. Patients in the HMB group had similar durations of MV [mean difference (MD), –0.40; 95% CI, –0.91 to 0.12; P = 0.13], ICU stay (MD, –0.61 days; 95% CI, –3.59 to 2.38; P = 0.69), and hospital stay (MD, 1.52 days; 95% CI, –1.18 to 4.22; P = 0.27). In addition, HMB did not affect changes in body weight (P = 0.53), body mass index (P = 0.56), or quadriceps thickness (P = 0.74). The outcomes of changes in skeletal muscle area (P = 0.95) and muscle loss (P = 0.16) were similar between the two groups.ConclusionBeta-hydroxy-beta-methylbutyrate (HMB) did not improve the mortality or other clinical outcomes in critically ill patients. This may be because of the different HMB strategies used in the included trials. Our findings provide insights into future research designs that explore the clinical efficacy of HMB in this patient population. |
| format | Article |
| id | doaj-art-acc4ac9010a84fca94e9c9e36b5054d7 |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj-art-acc4ac9010a84fca94e9c9e36b5054d72025-01-23T05:10:10ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011210.3389/fnut.2025.15057971505797Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and meta-analysis of randomized controlled trialsYu Ren0Ya-Bei Gao1Da-Xing Yu2Hui-Bin Huang3Department of Emergency, Fuxing Hospital of Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Beijing Fengtai Hospital of Traditional Chinese and Western Medicine, Beijing, ChinaDepartment of Critical Care Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaDepartment of Critical Care Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaBackgroundBeta-hydroxy-beta-methylbutyrate (HMB) is beneficial for restoring muscle mass. However, the evidence supporting its use in critically ill patients remains unclear. We conducted a systematic review and meta-analysis of HMB in this population to ascertain its effects.MethodsWe searched PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and the Cochrane database for articles focusing on adult patients receiving HMB compared to controls. The primary outcome was mortality. To explore potential heterogeneity, we assessed study quality and performed subgroup analysis, sensitivity analysis, and quality of evidence.ResultsNine randomized controlled trials were included. There were some differences in the study design, HMB protocols, and muscle measurements among these trials. Overall, there were no significant differences in mortality between the HMB and the control groups (risk ratio = 0.96; 95% CI, 0.44–2.08; P = 0.92). This finding was confirmed by the subgroup and sensitivity analyzes. Patients in the HMB group had similar durations of MV [mean difference (MD), –0.40; 95% CI, –0.91 to 0.12; P = 0.13], ICU stay (MD, –0.61 days; 95% CI, –3.59 to 2.38; P = 0.69), and hospital stay (MD, 1.52 days; 95% CI, –1.18 to 4.22; P = 0.27). In addition, HMB did not affect changes in body weight (P = 0.53), body mass index (P = 0.56), or quadriceps thickness (P = 0.74). The outcomes of changes in skeletal muscle area (P = 0.95) and muscle loss (P = 0.16) were similar between the two groups.ConclusionBeta-hydroxy-beta-methylbutyrate (HMB) did not improve the mortality or other clinical outcomes in critically ill patients. This may be because of the different HMB strategies used in the included trials. Our findings provide insights into future research designs that explore the clinical efficacy of HMB in this patient population.https://www.frontiersin.org/articles/10.3389/fnut.2025.1505797/fullbeta-hydroxy-beta-methyl butyratecritical illnessmuscle massmortalitymeta-analysis |
| spellingShingle | Yu Ren Ya-Bei Gao Da-Xing Yu Hui-Bin Huang Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and meta-analysis of randomized controlled trials Frontiers in Nutrition beta-hydroxy-beta-methyl butyrate critical illness muscle mass mortality meta-analysis |
| title | Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | beta hydroxy beta methyl butyrate supplementation in critically ill patients a systematic review and meta analysis of randomized controlled trials |
| topic | beta-hydroxy-beta-methyl butyrate critical illness muscle mass mortality meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1505797/full |
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