β-羟基-β-甲基丁酸酯或富含β-羟基-β-甲基丁酸酯的营养补充剂对肌肉减少症患者的影响：一项系统评价和荟萃分析。
The effects of β-hydroxy-β-methylbutyrate or HMB-rich nutritional supplements on sarcopenia patients: a systematic review and meta-analysis.
作者信息
Su Hai, Zhou Haojing, Gong Yichen, Xiang Sicheng, Shao Weijie, Zhao Xinzheng, Ling Hao, Chen Guoqian, Tong Peijian, Li Ju
机构信息
The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
出版信息
Front Med (Lausanne). 2024 Jul 12;11:1348212. doi: 10.3389/fmed.2024.1348212. eCollection 2024.
BACKGROUND
Sarcopenia is a progressive, systemic skeletal muscle disorder. Resistance exercise and physical activity have been proven effective in its treatment, but consensus on pharmacological interventions has not yet been reached in clinical practice. β-Hydroxy-β-methylbutyrate (HMB) is a nutritional supplement that has demonstrated favorable effects on muscle protein turnover, potentially contributing to beneficial impacts on sarcopenia.
AIM
To assess the potential positive effects of HMB or HMB-containing supplements on individuals with sarcopenia, a systematic review and meta-analysis was conducted.
METHODS
A systematic review and meta-analysis were conducted on randomized controlled trials (RCTs) examining the treatment of sarcopenia with HMB. Two assessors independently conducted screening, data extraction, and bias risk assessment. Outcome data were synthesized through a random-effects model in meta-analysis, using the mean difference (MD) as the effect measure.
RESULTS
A meta-analysis was conducted on six studies. HMB or HMB-rich nutritional supplements showed a statistically significant difference in Hand Grip Strength (HGS) for sarcopenia patients [MD = 1.26, 95%CI (0.41, 2.21), = 0.004], while there was no statistically significant difference in Gait Speed (GS) [MD = 0.04, 95%CI (-0.01, 0.08), = 0.09], Fat Mass (FM) [MD = -0.18, 95%CI (-0.38, 0.01), = 0.07], Fat-Free Mass (FFM) [MD = 0.09, 95%CI (-0.23, 0.42), = 0.58], and Skeletal Muscle Index (SMI) [MD = 0.01, 95%CI (-0.00, 0.01), = 0.13].
CONCLUSION
HMB or HMB-rich nutritional supplements are beneficial for muscle strength in sarcopenia patients. However, there is limited evidence demonstrating significant effects on both muscle strength and physical performance in sarcopenia individuals. HMB may be considered as a treatment option for sarcopenia patients.
SYSTEMATIC REVIEW REGISTRATION
CRD42024512119.
背景
肌肉减少症是一种进行性的全身性骨骼肌疾病。抗阻运动和体育活动已被证明对其治疗有效，但在临床实践中，对于药物干预尚未达成共识。β-羟基-β-甲基丁酸酯（HMB）是一种营养补充剂，已证明对肌肉蛋白质周转有积极影响，可能对肌肉减少症产生有益作用。
目的
为评估HMB或含HMB的补充剂对肌肉减少症患者的潜在积极影响，进行了一项系统评价和荟萃分析。
方法
对使用HMB治疗肌肉减少症的随机对照试验（RCT）进行系统评价和荟萃分析。两名评估者独立进行筛选、数据提取和偏倚风险评估。在荟萃分析中，通过随机效应模型合成结局数据，以平均差（MD）作为效应量度。
结果
对六项研究进行了荟萃分析。HMB或富含HMB的营养补充剂在肌肉减少症患者的握力（HGS）方面显示出统计学上的显著差异[MD = 1.26，95%CI（0.41，2.21），P = 0.004]，而在步速（GS）[MD = 0.04，95%CI（-0.01，0.08），P = 0.09]、脂肪量（FM）[MD = -0.18，95%CI（-0.38，0.01），P = 0.07]、去脂体重（FFM）[MD = 0.09，95%CI（-0.23，0.42），P = 0.58]和骨骼肌指数（SMI）[MD = 0.01，95%CI（-0.00，0.01），P = 0.13]方面没有统计学上的显著差异。
结论
HMB或富含HMB的营养补充剂对肌肉减少症患者的肌肉力量有益。然而，仅有有限的证据表明对肌肉减少症患者的肌肉力量和身体表现有显著影响。HMB可被视为肌肉减少症患者的一种治疗选择。
系统评价注册
CRD42024512119。
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