Abstract

Sarcopenia is a frequent complication in liver transplant (LT) recipients. β-hydroxy-β-methyl-butyrate (HMB) has the potential to increase muscle-performance and tropism. Our study aims at evaluating the effect on muscle mass and functioning, and the safety of 12 weeks of HMB supplementation in patients after LT. This is a pilot, randomized study. Male patients undergoing LT were randomly assigned to the HMB or control group. A diet interview, anthropometry and body composition by dual energy X-ray absorptiometry (DEXA) were performed at enrollment (T0), after 12 weeks (T1) and after 12 months (T12). Twenty-two liver transplant male patients were enrolled in the study: 12 in the HMB group and 10 as the control group. At enrollment, demographic, clinical and nutritional data were similar. According to the appendicular skeletal muscle index, sarcopenia was present in 50% of patients. The appendix skeletal muscle mass index (ASMI) showed a significant increase at T1 and T12 in HMB patients, but not in controls. The mid-arm muscle-circumference and hand grip strength also increased at T1 and T12 versus T0 only in the HMB group. No side effects were reported in either group. The study showed a positive effect of HMB in the recovery of muscle mass and strength after LT. HMB supplement in patients after LT was safe and well tolerated.

Highlights

  • Malnutrition is an important burden in patients affected by liver cirrhosis with an incidence ranging from 20% to 90%, depending on the population studied and the diagnostic tools used for the diagnosis [1,2,3]

  • Sarcopenia is associated with an increased risk of mortality, higher prevalence of portal hypertension-related complications and infections, and longer hospital stays for cirrhotic patients [5,6,7,8]

  • Figureis4.aHand gripcomplication strength (HG)in modification in the recipients control andthat group during follow up

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Summary

Introduction

Malnutrition is an important burden in patients affected by liver cirrhosis with an incidence ranging from 20% to 90%, depending on the population studied and the diagnostic tools used for the diagnosis [1,2,3]. The main component of malnutrition in liver cirrhosis is represented by sarcopenia. The term sarcopenia was first developed to describe a condition of muscle atrophy associated with aging process (“primary sarcopenia”). Nutrients 2019, 11, 2259 independently of ageing (“secondary” sarcopenia) [4]. Sarcopenia is associated with an increased risk of mortality, higher prevalence of portal hypertension-related complications and infections, and longer hospital stays for cirrhotic patients [5,6,7,8]

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