{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:18:07Z","timestamp":1777364287508,"version":"3.51.4"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T00:00:00Z","timestamp":1568851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bando Ricerca Sapienza","award":["2017\/201c"],"award-info":[{"award-number":["2017\/201c"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Sarcopenia is a frequent complication in liver transplant (LT) recipients. \u03b2-hydroxy-\u03b2-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.<\/jats:p>","DOI":"10.3390\/nu11092259","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T02:51:11Z","timestamp":1568947871000},"page":"2259","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["The Effect of 12 Weeks of \u03b2-Hydroxy-\u03b2-Methyl-Butyrate Supplementation after Liver Transplantation: A Pilot Randomized Controlled Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Barbara","family":"Lattanzi","sequence":"first","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Giusto","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlina","family":"Albanese","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Mennini","sequence":"additional","affiliation":[{"name":"Department of General Surgery \u201cParide Stefanini\u201d, Liver Transplantation Unit, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daria","family":"D\u2019Ambrosio","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7104-5826","authenticated-orcid":false,"given":"Alessio","family":"Farcomeni","sequence":"additional","affiliation":[{"name":"Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Ginanni Corradini","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of General Surgery \u201cParide Stefanini\u201d, Liver Transplantation Unit, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3173-9767","authenticated-orcid":false,"given":"Manuela","family":"Merli","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1002\/hep.26370","article-title":"The nutritional management of hepatic encephalopathy in patients with cirrhosis: International Society for Hepatic Encephalopathy and Nitrogen Metabolism Consensus","volume":"58","author":"Amodio","year":"2013","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2019). EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J. Hepatol., 70, 172\u2013193.","DOI":"10.1016\/j.jhep.2018.06.024"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.clnu.2018.12.022","article-title":"ESPEN guideline on clinical nutrition in liver disease","volume":"38","author":"Plauth","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Cruz-Jentoft, A.J., Bahat, G., Bauer, J., Boirie, Y., Bruy\u00e8re, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., and Sayer, A.A. (2019). Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing, in press.","DOI":"10.1093\/ageing\/afz046"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.cgh.2011.08.028","article-title":"Muscle wasting is associated with mortality in patients with cirrhosis","volume":"10","author":"Prado","year":"2012","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.jamcollsurg.2010.03.039","article-title":"Sarcopenia and mortality after liver transplantation","volume":"211","author":"Englesbe","year":"2010","journal-title":"J. Am. Coll. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s11011-012-9365-z","article-title":"Muscle depletion increases the risk of overt and minimal hepatic encephalopathy: Results of a prospective study","volume":"28","author":"Merli","year":"2013","journal-title":"Metab. Brain Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1111\/liv.13691","article-title":"A low muscle mass increases mortality in compensated cirrhotic patients with sepsis","volume":"38","author":"Lucidi","year":"2018","journal-title":"Liver Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/j.jhep.2017.11.030","article-title":"A model including sarcopenia surpasses the MELD score in predicting waiting list mortality in cirrhotic liver transplant candidates: A competing risk analysis in a national cohort","volume":"68","author":"Alferink","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1002\/lt.23978","article-title":"Severe muscle depletion predicts postoperative length of stay but is not associated with survival after liver transplantation","volume":"20","year":"2014","journal-title":"Liver Transpl."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1111\/j.1478-3231.2009.02135.x","article-title":"Nutritional status: Its influence on the outcome of patients undergoing liver transplantation","volume":"30","author":"Merli","year":"2010","journal-title":"Liver Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/00000658-200108000-00015","article-title":"Sequential changes in the metabolic response to orthotropic liver transplantation during the first year after surgery","volume":"234","author":"Plank","year":"2001","journal-title":"Ann. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"434","DOI":"10.21037\/hbsn.2017.08.05","article-title":"Sarcopenia plays a crucial role in liver transplantation","volume":"6","author":"Kaido","year":"2017","journal-title":"Hepatobiliary Surg. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1111\/jgh.12524","article-title":"Post-liver transplantation sarcopenia in cirrhosis: A prospective evaluation","volume":"29","author":"Tsien","year":"2014","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e142","DOI":"10.1016\/j.eclnm.2011.02.003","article-title":"Improvement of nutritional status in malnourished cirrhotic patients one year after liver transplantation","volume":"6","author":"Merli","year":"2011","journal-title":"e-SPEN Eur. e-J. Clin. Nutr. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10682","DOI":"10.3748\/wjg.v20.i31.10682","article-title":"Changes in nutritional status after liver transplantation","volume":"20","author":"Giusto","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_17","first-page":"CD007605","article-title":"Nutritional interventions for liver-transplanted patients","volume":"15","author":"Langer","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1177\/0148607190014004386","article-title":"Nutritional support after liver transplantation: A randomized prospective study","volume":"14","author":"Reilly","year":"1990","journal-title":"Jpen. J. Parenter. Enter. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1177\/0148607195019006437","article-title":"Early enteral nutrition support in patients undergoing liver transplantation","volume":"19","author":"Hasse","year":"1995","journal-title":"Jpen. J. Parenter. Enter. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/00000658-199208000-00008","article-title":"Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis","volume":"216","author":"Moore","year":"1992","journal-title":"Ann. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/S0140-6736(94)92824-X","article-title":"Comparison of enteral feeding and total parenteral nutrition after liver transplantation","volume":"344","author":"Wicks","year":"1994","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1002\/hep.27433","article-title":"Perioperative immunonutrition in patients undergoing liver transplantation: A randomized double-blind trial","volume":"61","author":"Plank","year":"2015","journal-title":"Hepatology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/jcsm.12208","article-title":"Beta-hydroxy-beta-methylbutyrate supplementation and skeletal muscle in healthy and muscle-wasting conditions","volume":"8","author":"Holecek","year":"2017","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/MEG.0000000000000274","article-title":"Sarcopenia in liver cirrhosis: The role of computed tomography scan for the assessment of muscle mass compared with dual-energy X-ray absorptiometry and anthropometry","volume":"27","author":"Giusto","year":"2015","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.jamda.2013.02.010","article-title":"Prevalence of sarcopenia based on different diagnostic criteria using DEXA and appendicular skeletal muscle mass reference values in an Italian population aged 20 to 80","volume":"14","author":"Coin","year":"2013","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/S0973-6883(11)60237-5","article-title":"Nutritional status and Liver Transplantation","volume":"1","author":"Merli","year":"2011","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s40520-016-0709-0","article-title":"Nutrition, frailty, and sarcopenia","volume":"29","author":"Kiesswetter","year":"2017","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1743-7075-5-1","article-title":"Effects of beta-hydroxy-beta-methylbutyrate (HMB) on exercise performance and body composition across varying levels of age, sex, and training experience: A review","volume":"5","author":"Wilson","year":"2008","journal-title":"Nutr. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"15603","DOI":"10.1073\/pnas.95.26.15603","article-title":"Viral mediated expression of IGF-I blocks the aging-related loss of skeletal muscle function","volume":"95","author":"Shoturma","year":"1998","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1096\/fj.02-0289fje","article-title":"Persistent IGF-1 overexpression in skeletal muscle transiently enhances DNA accretion and growth","volume":"17","author":"Fiorotto","year":"2003","journal-title":"FASEB J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1158\/0008-5472.277.65.1","article-title":"Attenuation of proteasome-induced proteolysis in skeletal muscle by {beta}-hydroxy-{beta}-methylbutyrate in cancer-induced muscle loss","volume":"65","author":"Smith","year":"2005","journal-title":"Cancer Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.bbrc.2012.06.029","article-title":"\u03b2-Hydroxy-\u03b2-methylbutyrate (HMB) prevents dexamethasone-induced myotube atrophy","volume":"423","author":"Aversa","year":"2012","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1093\/ajcn\/nqy373","article-title":"beta-hydroxy-beta-methylbutyrate and its impact on skeletal muscle mass and physical function in clinical practice: A systematic review and meta-analysis","volume":"109","author":"Bear","year":"2019","journal-title":"Am. J. Clin. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/9\/2259\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:22:05Z","timestamp":1760188925000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/9\/2259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,19]]},"references-count":33,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9]]}},"alternative-id":["nu11092259"],"URL":"https:\/\/doi.org\/10.3390\/nu11092259","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,19]]}}}