Editorial, J Clin Nutr Metab Vol: 2 Issue: 1
The Potential Role of Β-Hydroxy-Β-Methylbutyrate in Preventing Muscle Loss in Chronic Diseases
Department of Sport Performance, National Taiwan University of Sport, Taiwan
*Corresponding Author : Chen-Kang Chang
Department of Sport Performance, National Taiwan University of Sport, 16, Sec 1, Shuan-Shih RD, Taichung 404, Taiwan
Tel: (04) 22213108-2235
Received: December 02, 2017 Accepted: January 10, 2018 Published: January 17, 2018
Citation: Chang CK (2018) The Potential Role of Β-Hydroxy-Β-Methylbutyrate in Preventing Muscle Loss in Chronic Diseases. J Clin Nutr Metab 2:1.
Loss of lean body mass is apparent in many chronic diseases, such as cancer, chronic obstructive pulmonary disease, and heart failure. The loss is a combined consequence of clinical conditions, loss of appetite, and lack of physical activity. In addition, even short-term hospitalization would increase the risk for loss of lean body mass. It has been shown that this malnutrition state significantly increased the length of hospitalization, readmission rate, and mortality.
Keywords: Cardiac cachexia; Heart failure; Lean body mass, β− hydroxy--β-methylbutyrate (HMB)
Loss of lean body mass is apparent in many chronic diseases, such as cancer, chronic obstructive pulmonary disease, and heart failure. The loss is a combined consequence of clinical conditions, loss of appetite, and lack of physical activity. In addition, even short-term hospitalization would increase the risk for loss of lean body mass [1,2]. It has been shown that this malnutrition state significantly increased the length of hospitalization, readmission rate, and mortality [2,3]. With the high incidence of loss of lean body mass, even in the presence of enteral and/or parental nutrition support, dietary supplements that could prevent muscle loss under stressful conditions may be helpful in these patients.
β-hydroxy-β-methylbutyrate (HMB), a leucine metabolite, is a popular supplement in exercising populations. HMB has been shown to be effective in augmenting the gain in lean body mass in young and old subjects, in combination with resistance training [4-6]. HMB can increase muscle protein synthesis by activating mammalian target of rapamycin (mTOR) . HMB can also attenuate muscle protein breakdown by inhibiting ubiquitin-mediated autophagy [8-10]. Its anti-catabolic effect has drawn interest from clinical settings. We have shown that a short-term HMB supplementation had anticatabolic effect and improved pulmonary function in chronic obstructive pulmonary disease patients in an intensive care unit setting . HMB supplementation also improved nitrogen balance in critically injured  and hospitalized elderly patients . Moreover, supplementation of HMB, arginine, and glutamine increased fat-free mass in advanced cancer  and Human immunodeficiency virus (HIV)-infected patients .
A recent meta-analysis has revealed that HMB can preserve muscle mass in generally healthy older adults . With the growing evidence of its anti-catabolic effect in various chronic diseases, HMB supplementation should receive more attention in both clinical settings and scientific research.
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