---
title: "HMB-containing nutritional support and lean mass in T2DM with sarcopenic obesity and MASLD"
id: "pubmed-42763880"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42763880"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42763880/"
doi: "10.1556/650.2026.33671"
published_at: "2026-09-20T00:00:00.000Z"
evidence_level: "English Abstract"
license: "CC-BY-NC-4.0 / Informational Use"
---
# HMB-containing nutritional support and lean mass in T2DM with sarcopenic obesity and MASLD
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42763880
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42763880/)
- **DOI:** [10.1556/650.2026.33671](https://doi.org/10.1556%2F650.2026.33671)
- **Published At:** 2026-09-20T00:00:00.000Z
- **Evidence Rating:** English Abstract
## Executive GIST (TL;DR)
- Study evaluated a diabetes-specific dietary supplement containing **beta-hydroxy-beta-methylbutyrate (HMB)** for 6 months in patients with type 2 diabetes, sarcopenic obesity, and metabolically associated fatty liver disease (MASLD). 48 patients (mean age 72.48 ± 8.26 years; 40 female, 8 male) were included; 20 age-similar controls without diabetes or MASLD were used for comparison. - Body composition and total body muscle mass were measured by densitometry; liver steatosis was confirmed with transient elastography. Baseline group means included BMI 27.80 ± 4.63, HbA1c 6.27 ± 0.73, steatosis 289 ± 42 dB/m, appendicular muscle mass index 6213 ± 786 g/m², android fat ratio 47.59 ± 9.80%, and total fat ratio 41.82 ± 9.31%. - After 6 months of HMB-containing supplementation, 28 of 48 patients showed an increase in muscle mass; of these, 16 increased up to 5%, 8 increased >5%, and 4 increased >10% of baseline muscle mass. The remaining 20 patients had a modest decrease in muscle mass (all ≤5%). - Simple linear regression identified significant positive correlations between muscle mass change and baseline **C-peptide** (r = 0.42, p = 0.03) and alkaline phosphatase (r = 0.51, p = 0.01). Significant negative correlations were observed with **age** (r = -0.39, p = 0.05) and **triglycerides** (r = -0.41, p = 0.04). No significant relationships were found with body composition parameters. - Logistic regression showed **age** as a negative predictor of muscle mass change (OR = 0.87, 95% CI 0.77–0.99, p = 0.04). **Triglycerides** was a borderline negative predictor (OR = 0.21, 95% CI 0.04–1.03, p = 0.05). - Overall, HMB supplementation led to muscle mass increase or maintenance in a substantial subset but changes did not reach statistical significance for the cohort as a whole. Higher age and higher triglyceride levels were associated with poorer responses. - Authors conclude the study is effectively negative because group-level changes were not statistically significant. They note key limitations: small sample size and cross-sectional design, and recommend larger prospective studies to confirm findings.
## Clinical Analysis & Structured Key Points
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Print 2026 Sep 20. # [Observation of the impact of nutritional support with beta-hydroxy-beta-methylbutyrate on lean mass parameters of body composition in patients with obesity, type 2 diabetes mellitus and metabolically associated fatty liver disease] [Article in Hungarian] [Emil Fraenkel](https://pubmed.ncbi.nlm.nih.gov/?term=Fraenkel+E&cauthor_id=42763880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42763880/#full-view-affiliation-1 "1 I. Interná Klinika UNLP a LF UPJŠ Košice Košice, Trieda SNP 1, 040 66. Szlovákia."), [Tomáš Koky](https://pubmed.ncbi.nlm.nih.gov/?term=Koky+T&cauthor_id=42763880)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42763880/#full-view-affiliation-2 "2 II. Interná Klinika UNLP a LF UPJŠ Košice Košice Szlovákia."), [Ivica Lazúrová](https://pubmed.ncbi.nlm.nih.gov/?term=Laz%C3%BArov%C3%A1+I&cauthor_id=42763880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42763880/#full-view-affiliation-1 "1 I. Interná Klinika UNLP a LF UPJŠ Košice Košice, Trieda SNP 1, 040 66. Szlovákia.") Affiliations Expand ### Affiliations * 1 1 I. Interná Klinika UNLP a LF UPJŠ Košice Košice, Trieda SNP 1, 040 66. Szlovákia. * 2 2 II. Interná Klinika UNLP a LF UPJŠ Košice Košice Szlovákia. * PMID: **42763880** * DOI: [ 10.1556/650.2026.33671 ](https://doi.org/10.1556/650.2026.33671) Item in Clipboard # [Observation of the impact of nutritional support with beta-hydroxy-beta-methylbutyrate on lean mass parameters of body composition in patients with obesity, type 2 diabetes mellitus and metabolically associated fatty liver disease] [Article in Hungarian] Emil Fraenkel et al. Orv Hetil. 2026. Show details Display options Display options Format Abstract PubMed PMID Orv Hetil Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Orv+Hetil%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Orv+Hetil%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42763880/) . 2026 Sep 20;167(38):1507-1515. doi: 10.1556/650.2026.33671. Print 2026 Sep 20. ### Authors [Emil Fraenkel](https://pubmed.ncbi.nlm.nih.gov/?term=Fraenkel+E&cauthor_id=42763880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42763880/#short-view-affiliation-1 "1 I. Interná Klinika UNLP a LF UPJŠ Košice Košice, Trieda SNP 1, 040 66. Szlovákia."), [Tomáš Koky](https://pubmed.ncbi.nlm.nih.gov/?term=Koky+T&cauthor_id=42763880)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42763880/#short-view-affiliation-2 "2 II. Interná Klinika UNLP a LF UPJŠ Košice Košice Szlovákia."), [Ivica Lazúrová](https://pubmed.ncbi.nlm.nih.gov/?term=Laz%C3%BArov%C3%A1+I&cauthor_id=42763880)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42763880/#short-view-affiliation-1 "1 I. Interná Klinika UNLP a LF UPJŠ Košice Košice, Trieda SNP 1, 040 66. Szlovákia.") ### Affiliations * 1 1 I. Interná Klinika UNLP a LF UPJŠ Košice Košice, Trieda SNP 1, 040 66. Szlovákia. * 2 2 II. Interná Klinika UNLP a LF UPJŠ Košice Košice Szlovákia. * PMID: **42763880** * DOI: [ 10.1556/650.2026.33671 ](https://doi.org/10.1556/650.2026.33671) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract in [ English, ](https://pubmed.ncbi.nlm.nih.gov/42763880/#eng-abstract) [ Hungarian ](https://pubmed.ncbi.nlm.nih.gov/42763880/#hun-abstract) **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. Bevezetés: A sarcopeniás elhízás szorosan összefügg a metabolikus diszfunkcióval társult steatoticus májbetegség (MASLD) előfordulásával, de azok a tényezők, amelyek befolyásolják az étrend-kiegészítés hatékonyságát az izomtömeg növelés során, eddig nem tisztázottak. Célkitűzés: Munkánkban azt vizsgáltuk, hogy a cukorbetegség-specifikus, béta-hidroxi-béta-metil-butirátot (HMB) tartalmazó étrend-kiegészítő 6 hónapig tartó adása milyen hatással van a teljestest-denzitometriával mért izomtömegre 2-es típusú cukorbetegséggel kezelt, sarcopeniás, elhízott és egyidejűleg a MASLD kritériumainak megfelelő betegekben; ezt követően kerestük az izomtömeg-változás mértéke és az életkor, a végtagi izomtömegindex, az egyes metabolikus paraméterek, így a hemoglobin-A1c-, a C-peptid- és a trigliceridszint közötti lineáris kapcsolatokat. További célunk e paraméterek prediktív értékének meghatározása volt a táplálékkiegészítés hatékonyságának előrejelzésében. Módszer: Keresztmetszeti vizsgálatunkba 2-es típusú diabeteses 48 beteget vontunk be (55–84 éves betegek, közülük 40 nő, 8 férfi, átlagéletkoruk 72,48 ± 8,26 év). Kontrollcsoportként 20 hasonló korú, komoly társbetegségtől mentes személyt választottunk, akiknek nem volt sem diabetesük, sem MASLD-juk. A steatosist tranziens elasztográfiával igazoltuk. Miután az izomtömeg-változás mértéke és a többi vizsgált paraméter közötti kapcsolatot egyszerű lineáris regresszióval azonosítottuk, logisztikus regressziós vizsgálattal elemeztük az egyes paraméterek prediktív értékét az izomtömeg-növekedés mértékére vonatkozóan. Eredmények: A betegek paramétereinek kezelés előtti átlagértékei: testtömegindex: 27,80 ± 4,63, hemoglobin-A1c: 6,27 ± 0,73, a steatosis mértéke: 289 ± 42 db/m, végtagi izomtömegindex: 6213 ± 786 g/m2, android zsír aránya: 47,59 ± 9,80%, teljes zsír aránya: 41,82 ± 9,31%. A 6 hónapig tartó kezelést követően 28 betegnél izomtömeg-növekedést figyeltünk meg, közülük 16 betegnél a növekedés az eredeti izomtömeg 5%-áig terjedt ki, 8 betegnél 5% feletti volt, 4 betegnél pedig az eredeti tömeg 10%-a feletti. 20 betegnél enyhe izomtömeg-csökkenést észleltünk, valamennyiük esetében ez a csökkenés az eredeti izomtömeg 5%-áig terjedt ki. Az izomtömeg növekedésének mértéke és a többi kiindulási paraméter között szignifikáns mértékű pozitív lineáris kapcsolatot találtunk a C-peptid (r = 0,42, p = 0,03), az alkalikus foszfatáz (r = 0,51, p = 0,01) és negatív kapcsolatot az életkor (r = –0,39, p = 0,05) és a trigliceridek (r = –0,41, p = 0,04) esetében. A testösszetétel paramétereinek egyikénél sem találtunk szignifikáns kapcsolatot. Az izomtömeg változásának prediktorai a logisztikus regressziós analízis alapján a következők voltak: az életkor negatív prediktorként (OR = 0,87, CI: 0,77–0,99, p = 0,04), a trigliceridszint a statisztikai szignifikancia határán negatív prediktorként (OR = 0,21, CI: 0,04–1,03, p = 0,05) jelent meg. Következtetés: A HMB-tartalmú étrend-kiegészítés a betegek jelentős részénél az izomtömeg növekedéséhez vagy annak megőrzéséhez vezetett, az izomtömegben tapasztalt változások azonban nem érték el a statisztikai szignifikancia szintjét, miközben az intervencióra adott válasz egyéni volt, és azt negatívan befolyásolta a magasabb életkor és a magasabb trigliceridszint. Így e tekintetben a vizsgálat negatív eredményűnek tartható. Ezen eredmények értelmezését korlátozza az alacsony betegszám és a vizsgálat keresztmetszeti jellege, ezért azok megerősítésére nagyobb prospektív vizsgálatok szükségesek. Orv Hetil. 2026; 167(38): 1507–1515. **Keywords:** beta-hydroxy-beta-methylbutyrate; béta-hidroxi-béta-metil-butirát; diabetes mellitus; liver steatosis; metabolic syndrome; metabolikus szindróma; májsteatosis; sarcopenia. 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> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.