Béta-hidroxi-béta-metilbutirát tartalmú táplálékkiegészítő hatása az izomtömeg-paraméterekre elhízott, anyagcserezavarral társult steatoticus májbetegségben szenvedő cukorbetegekben

INTRODUCTION: Sarcopenic obesity is closely related to the occurrence of metabolically associated fatty liver disease (MASLD), but the factors that influence the effectiveness of dietary supplements in increasing muscle mass have not yet been clarified. OBJECTIVE: In our study, we examined the effects of a diabetes-specific dietary supplement containing beta-hydroxy-beta-methylbutyrate (HMB) on total body muscle mass after a treatment lasting for 6 months, and measured by densitometry in patients with type 2 diabetes who were treated for sarcopenic obesity and also met the criteria of MASLD. Then, we looked for linear correlations between the degree of muscle mass change and age, as well as the lean mass index, and various metabolic parameters such as hemoglobin A1c, C-peptide, and triglyceride levels. Our goal was also to determine the predictive value of these parameters in forecasting of the effectiveness of the dietary supplement. METHOD: Our cross-sectional study included 48 patients with type 2 diabetes (aged 55-84 years, 40 female and 8 male, average age 72.48 ± 8.26 years). As a control group, we chose 20 persons of similar age with no serious comorbidities, who had neither diabetes nor MASLD. We confirmed liver steatosis using transient elastography. After identifying the relationships between the degree of muscle mass change and other examined parameters using simple linear regression, we evaluated the predictive value of individual parameters for the extent of muscle mass change with logistic regression. RESULTS: The average pre-treatment values of patients' parameters were: body mass index: 27.80 ± 4.63, hemoglobin A1c: 6.27 ± 0.73, degree of steatosis: 289 ± 42 dB/m, appendicular muscle mass index: 6213 ± 786 g/m², android fat ratio: 47.59 ± 9.80%, total fat ratio: 41.82 ± 9.31%. After a 6-month treatment, we observed an increase in muscle mass in 28 patients. Of those, the increase reached up to 5% of the original muscle mass in 16 patients, it was above 5% in 8 patients, and it exceeded 10% of the original mass in 4 patients. We observed a slight decrease in muscle mass in 20 patients, with the decrease reaching up to 5% of the original muscle mass in all of them. We found a significant positive linear relationship between the degree of muscle mass increase and other baseline parameters in terms of C-peptide (r = 0.42, p = 0.03) and alkaline phosphatase (r = 0.51, p = 0.01), and a negative relationship in terms of age (r= -0.39, p = 0.05) and triglycerides (r = -0.41, p = 0.04). We did not find a significant relationship with any body composition parameter. Based on the logistic regression analysis, the predictors of muscle mass change were as follows: age appeared as a negative predictor (OR = 0.87, CI: 0.77-0.99, p = 0.04), and triglycerides appeared as a borderline negative predictor (OR = 0.21, CI 0.04-1.03, p = 0.05). CONCLUSION: Taking HMB-containing dietary supplements led to an increase or maintenance of muscle mass in a significant portion of patients; however, the changes in muscle mass did not reach the level of statistical significance, although individual responses to the intervention varied, with higher age and higher triglyceride levels having a negative impact. So, in this regard, the conclusion of the study can be considered as negative. Interpretation of these results is limited by the small number of participants and the cross-sectional nature of the study, hence larger prospective studies are needed to confirm them. Orv Hetil. 2026; 167(38): 1507-1515.