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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1505797
This article is part of the Research Topic The Relationship between Nutrition and Frailty/Multimorbidity: Prevention and Clinical Nutritional Management View all articles

Beta-hydroxy-beta-methyl butyrate supplementation in critically ill patients: a systematic review and metaanalysis of randomized controlled trials

Provisionally accepted
Ren Yu Ren Yu 1Gao Ya-Bei Gao Ya-Bei 2Da-Xing Yu Da-Xing Yu 3Hui-Bin Huang Hui-Bin Huang 3*
  • 1 Fuxing Hospital, Capital Medical University, Beijing, China
  • 2 Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing, China
  • 3 Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China

The final, formatted version of the article will be published soon.

    Background: Beta-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.We 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.Results: Nine 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 analyses. 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.Conclusions: 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.

    Keywords: beta-hydroxy-beta-methyl butyrate, Critical Illness, muscle mass, Mortality, Meta-analysis

    Received: 03 Oct 2024; Accepted: 07 Jan 2025.

    Copyright: © 2025 Yu, Ya-Bei, Yu and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hui-Bin Huang, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China

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