[1]刘 杰,等.β-羟基-β-甲基丁酸改善神经系统危重症病人肌肉质量和神经功能的研究进展[J].肠外与肠内营养杂志,2024,(06):376-380.[doi:10.16151/j.1007-810x.2024.06.010]
 LIU Jie,LIN Ning,et al.Progress of beta-hydroxy-beta-methylbutyrate in improving muscle mass and neurological function in neurocritically ill patients[J].PARENTERAL & ENTERAL NUTRITION,2024,(06):376-380.[doi:10.16151/j.1007-810x.2024.06.010]
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β-羟基-β-甲基丁酸改善神经系统危重症病人肌肉质量和神经功能的研究进展()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2024年06期
页码:
376-380
栏目:
论著
出版日期:
2024-12-10

文章信息/Info

Title:
Progress of beta-hydroxy-beta-methylbutyrate in improving muscle mass and neurological function in neurocritically ill patients
作者:
刘 杰 1 2林 宁 1 2
1.西南交通大学医学院,四川成都 610031;2.西南交通大学附属医院/西部战区总医院营养科,四川成都 610083
Author(s):
LIU Jie1 2 LIN Ning1 2
1. College of Medicine, Southwest Jiaotong University, Chengdu 610031, Sichuan, China;2. The Affiliated Hospital of Southwest Jiaotong Unversity/Western Theater General Hospital of the Chinese people’s Liberation Armyu,Chengdu 610083, Sichuan, China
关键词:
β-羟基-β-甲基丁酸盐 神经危重症 肌肉质量 神经功能
Keywords:
β-Hydroxy-beta-methylbutyrate Neurological critical illnesses Muscle mass Neurological function
分类号:
R739.4,R459.3
DOI:
10.16151/j.1007-810x.2024.06.010
文献标志码:
A
摘要:
神经系统危重症病人出现肌肉质量减少、力量下降和神经功能损害是很常见的,肌肉萎缩和肌无力都会导致身体功能的损害,导致脱机时间延长、轻瘫或四肢瘫等临床特征,严重影响病人预后和生活质量。β-羟基-β-甲基丁酸盐(HMB)是人体必需的支链氨基酸亮氨酸的活性代谢产物,能促进蛋白质合成并减少其分解,作为一种外源性营养补充剂,近年来因其对肌肉代谢的改善作用而受到关注。本综述探讨了ICU内的神经系统重症病人不同阶段单独使用或联合使用HMB的营养补充剂对肌肉质量和神经功能的作用,为缓解神经系统危重症病人肌肉萎缩、改善神经功能提供新的治疗思路。
Abstract:
Muscle mass loss, strength loss and neurological impairment are common in patients with neurological critical illnesses. Muscle atrophy and muscle weakness can lead to impairment of body functions, resulting in clinical features such as prolonged deconditioning time, light paralysis or quadriplegia, which seriously affects the prognosis and quality of life of patients. Beta-Hydroxy-beta-methylbutyrate (HMB) is an active metabolite of the essential branched-chain amino acid leucine, which promotes protein synthesis and reduces its catabolism. As an exogenous nutritional supplement, HMB has attracted attention in recent years because of its improvement of muscle metabolism. In this review, we investigated the effects of nutritional supplements with HMB alone or in combination at different stages on muscle mass and neurological function in neurocritically ill patients in ICUs to provide new therapeutic ideas for alleviating muscle atrophy and improving neurological function in neurocritically ill patients.

参考文献/References:


[1] Burns KEA, Rizvi L, Cook DJ, et al. Ventilator weaning and discontinuation practices for critically ill patients[J]. JAMA,2021, 325(12): 1173-1184.
[2] Vanhorebeek I, Latronico N. Van den Berghe G. ICU-acquired weakness[J]. Intensive Care Med, 2020, 46(4): 637-653.
[3] Doherty N, Steen CD. Critical illness polyneuromyopathy(CIPNM); rehabilitation during critical illness. Therapeutic options in nursing to promote recovery: a review of the literature[J]. Intensive Crit Care Nurs, 2010, 26(6): 353-362.
[4] Dalton RE, Tripathi RS, Abel EE, et al. Polyneuropathy and myopathy in the elderly[J]. HSR Proc Intensive Care Cardiovasc Anesth, 2012, 4(1): 15-19.
[5] Puthucheary ZA, Rawal J, McPhail M, et al. Acute skeletal muscle wasting in critical illness[J]. JAMA, 2013, 310(15): 1591-1600.
[6] Su Y, Yuki M, Otsuki M. Prevalence of stroke-related sarcopenia: a systematic review and meta-analysis[J]. J Stroke Cerebrovasc Dis, 2020, 29(9): 105092.
[7] Rieu I, Balage M, Sornet C, et al. Leucine supplementation improves muscle protein synthesis in elderly men independently of hyperaminoacidaemia[J]. J Physiol, 2006, 575(Pt 1): 305-315.
[8] Anthony JC, Anthony TG, Kimball SR, et al. Signaling pathways involved in translational control of protein synthesis in skeletal muscle by leucine[J]. J Nutr, 2001, 131(3): 856S-860S.
[9] Wilson GJ, Wilson JM, Manninen AH. Effects of beta-hydroxybeta-methylbutyrate (HMB) on exercise performance and body composition across varying levels of age, sex, and training experience: a review[J]. Nutr Metab (Lond), 2008, 5: 1.
[10] Ikeda K, Takahashi M, Aburaya S, et al. Produced β-hydroxybutyrate after β -hydroxy- β -methylbutyrate (HMB) administration may contribute HMB function in mice[J].Biochem Biophys Rep, 2021, 27: 101097.
[11] 田 林, 陈锦瑶. β-羟基-β-甲基丁酸钙安全性和有效性研究进展[J]. 食品安全质量检测学报, 2021, 12(16): 6565-6572.
[12] Kuriyan R, Lokesh DP, Selvam S, et al. The relationship of endogenous plasma concentrations of β -hydroxy β -methyl butyrate (HMB) to age and total appendicular lean mass in humans[J]. Exp Gerontol, 2016, 81: 13-18.
[13] Fitschen PJ, Wilson GJ, Wilson JM, et al. Efficacy of β-hydroxy-β-methylbutyrate supplementation in elderly and clinical populations[J]. Nutrition, 2013, 29(1): 29-36.
[14] Hsieh LC, Chien SL, Huang MS, et al. Anti-inflammatory and anticatabolic effects of short-term beta-hydroxy-betamethylbutyrate supplementation on chronic obstructive pulmonary disease patients in intensive care unit[J]. Asia Pac J Clin Nutr, 2006, 15(4): 544-550.
[15] Wilkinson DJ, Hossain T, Hill DS, et al. Effects of leucine and its metabolite β -hydroxy- β -methylbutyrate on human skeletal muscle protein metabolism[J]. J Physiol, 2013, 591(11): 2911-2923.
[16] Schwartz AL, Ciechanover A. The ubiquitin-proteasome pathway and pathogenesis of human diseases[J]. Annu Rev Med, 1999, 50:57-74.
[17] Zheng J, Li B, Yan YT, et al. β -hydroxy- β -methylbutyric acid promotes repair of sheep myoblast injury by inhibiting IL-17/NF-κB signaling[J]. Int J Mol Sci, 2022, 24(1): 444.
[18] Zhang Y, Yang M, Zhou P, et al. β -hydroxy- β -methylbutyrateInduced upregulation of miR-199a-3p contributes to slow-to-fast muscle fiber type conversion in mice and C2C12 cells[J]. J Agric Food Chem, 2020, 68(2): 530-540.
[19] Eley HL, Russell ST, Baxter JH, et al. Signaling pathways initiated by beta-hydroxy-beta-methylbutyrate to attenuate the depression of protein synthesis in skeletal muscle in response tocachectic stimuli[J]. Am J Physiol Endocrinol Metab, 2007, 293(4): E923-E931.
[20] Hole?ek M. Beta-hydroxy-beta-methylbutyrate supplementation and skeletal muscle in healthy and muscle-wasting conditions[J]. J Cachexia Sarcopenia Muscle, 2017, 8(4): 529-541.
[21] Patel P, Butani K, Kumar A, et al. Effects of fermented food consumption on non-communicable diseases[J]. Foods, 2023, 12(4): 687.
[22] Picca A, Ponziani FR, Calvani R, et al. Gut microbial, inflammatory and metabolic signatures in older people with physical frailty and sarcopenia: results from the BIOSPHERE study[J]. Nutrients, 2019, 12(1): 65.
[23] Zheng P, Zeng B, Zhou C, et al. Gut microbiome remodeling induces depressive-like behaviors through a pathway mediated by the host’s metabolism[J]. Mol Psychiatry, 2016, 21(6): 786-796.
[24] Picca A, Fanelli F, Calvani R, et al. Gut dysbiosis and muscle aging: searching for novel targets against sarcopenia[J]. Mediators Inflamm, 2018, 2018: 7026198.
[25] Bindels LB, Delzenne NM. Muscle wasting: the gut microbiota as a new therapeutic target?[J]. Int J Biochem Cell Biol, 2013, 45(10): 2186-2190.
[26] Locantore P, Del Gatto V, Gelli S, et al. The interplay between immune system and microbiota in osteoporosis[J]. Mediators Inflamm, 2020, 2020: 3686749.
[27] 石培洁, 冯 健, 胡 健, 等. 基于“肠-肌轴”的营养干预在ICU获得性衰弱治疗的研究进展[J]. 肠外与肠内营养, 2023, 30(4):249-253.
[28] 唐玉秀, 韦 瑶, 金 钧. 肠-肺轴以及粪菌移植在脓毒症中的作用[J]. 肠外与肠内营养, 2023, 30(3): 179-184.
[29] Duan YH, Zhong YZ, Xiao H, et al. Gut microbiota mediates the protective effects of dietary β-hydroxy-β-methylbutyrate (HMB) against obesity induced by high-fat diets[J]. FASEB J, 2019, 33(9): 10019-10033.
[30] Frampton J, Murphy KG, Frost G, et al. Short-chain fatty acids as potential regulators of skeletal muscle metabolism and function[J]. Nat Metab, 2020, 2(9): 840-848.
[31] Tang G, Du Y, Guan HC, et al. Butyrate ameliorates skeletal muscle atrophy in diabetic nephropathy by enhancing gut barrier function and FFA2-mediated PI3K/Akt/mTOR signals[J]. Br JPharmacol, 2022, 179(1): 159-178.
[32] Chen FY, Li Q, Chen Y, et al. Association of the gut microbiota and fecal short-chain fatty acids with skeletal muscle mass and strength in children[J]. FASEB J, 2022, 36(1): e22109.
[33] Cryan JF, O’Riordan KJ, Cowan CSM, et al. The microbiota-gut-brain axis[J]. Physiol Rev, 2019, 99(4): 1877-2013.
[34] 冯莉娟, 李子纯, 刘小伟. 肠道菌群-肠-脑轴的研究进展[J]. 中华消化杂志, 2022, 42(2): 134-136.
[35] Kumar A, Pramanik J, Goyal N, et al. Gut microbiota in anxiety and depression: unveiling the relationships and management options[J]. Pharmaceuticals (Basel), 2023, 16(4): 565.
[36] Vendrik KEW, Ooijevaar RE, de Jong PRC, et al. Fecal microbiota transplantation in neurological disorders[J]. Front Cell Infect Microbiol, 2020, 10: 98.
[37] Miramonti AA, Stout JR, Fukuda DH, et al. Effects of 4 weeks of High-Intensity interval training and β -hydroxy- β -methylbutyric free acid supplementation on the onset of neuromuscular fatigue[J]. J Strength Cond Res, 2016, 30(3): 626-634.
[38] Salto R, Vílchez JD, Girón MD, et al. β -hydroxy- β-methylbutyrate (HMB) promotes neurite outgrowth in neuro2a cells[J]. PLoS One, 2015, 10(8): e0135614.
[39] Kougias DG, Nolan SO, Koss WA, et al. Beta-hydroxy-betamethylbutyrate ameliorates aging effects in the dendritic tree of pyramidal neurons in the medial prefrontal cortex of both maleand female rats[J]. Neurobiol Aging, 2016, 40: 78-85.
[40] Paidi RK, Raha S, Roy A, et al. Muscle-building supplement β-hydroxy β -methylbutyrate binds to PPARα to improve hippocampal functions in mice[J]. Cell Rep, 2023, 42(7): 112717.
[41] Hankosky ER, Sherrill LK, Ruvola LA, et al. Effects of β-hydroxy- β -methyl butyrate on working memory and cognitive flexibility in an animal model of aging[J]. Nutr Neurosci, 2017,20(7): 379-387.
[42] Nissen S, Sharp RL, Panton L, et al. Beta-hydroxy-betamethylbutyrate (HMB) supplementation in humans is safe and may decrease cardiovascular risk factors[J]. J Nutr, 2000, 130(8):1937-1945.
[43] Alway SE, Pereira SL, Edens NK, et al. β -Hydroxy- β-methylbutyrate (HMB) enhances the proliferation of satellite cells in fast muscles of aged rats during recovery from disuse atrophy[J]. Exp Gerontol, 2013, 48(9): 973-984.
[44] Sarto F, Franchi MV, McPhee JS, et al. Neuromuscular impairment at different stages of human sarcopenia[J]. J Cachexia Sarcopenia Muscle, 2024, 15(5): 1797-1810.
[45] Supinski GS, Netzel PF, Westgate PM, et al. A randomized controlled trial to determine whether beta-hydroxy-betamethylbutyrate and/or eicosapentaenoic acid improves diaphragm and quadriceps strength in critically Ill mechanically ventilated patients[J]. Crit Care, 2021, 25(1): 308.
[46] Wu TT, Li CX, Zhuang YN, et al. Resistance training combined with β-hydroxy β-methylbutyrate for patients with critical illness: a four-arm, mixed-methods, feasibility randomised controlled trial [J]. Intensive Crit Care Nurs, 2024, 82: 103616.
[47] Wu TT, Chen QL, Lin XX, et al. Effects of a multilevel intervention of resistance training with or without beta-hydroxybeta-methylbutyrate in medical ICU patients during entire hospitalisation: a four-arm multicentre randomised controlled trial[J]. Crit Care, 2023, 27(1): 493.
[48] Deutz NE, Matheson EM, Matarese LE, et al. Readmission and mortality in malnourished, older, hospitalized adults treated with a specialized oral nutritional supplement: a randomized clinical trial[J]. Clin Nutr, 2016, 35(1): 18-26.
[49] Landi F, Calvani R, Picca A, et al. Beta-hydroxy-betamethylbutyrate and sarcopenia: from biological plausibility to clinical evidence[J]. Curr Opin Clin Nutr Metab Care, 2019, 22 (1): 37-43.
[50] Liu SM, Zhang L, Li SQ. Advances in nutritional supplementation for sarcopenia management[J]. Front Nutr, 2023,10: 1189522.
[51] Wilson JM, Fitschen PJ, Campbell B, et al. International society of sports nutrition position stand: beta-hydroxy-betamethylbutyrate (HMB)[J]. J Int Soc Sports Nutr, 2013, 10(1): 6.
[52] Wandrag L, Brett SJ, Frost G, et al. Impact of supplementation with amino acids or their metabolites on muscle wasting in patients with critical illness or other muscle wasting illness: a systematic review[J]. J Hum Nutr Diet, 2015, 28(4): 313-330.
[53] Viana MV, Becce F, Pantet O, et al. Impact of β -hydroxy- β-methylbutyrate (HMB) on muscle loss and protein metabolism in critically ill patients: a RCT[J]. Clin Nutr, 2021, 40(8): 4878-4887.
[54] Wittholz K, Fetterplace K, Karahalios A, et al. Beta-hydroxy-betamethylbutyrate supplementation and functional outcomes in multitrauma patients: a pilot randomized controlled trial[J]. JPENJ Parenter Enteral Nutr, 2023, 47(8): 983-992.

备注/Memo

备注/Memo:
基金项目 :西部战区总医院院级联合攻关项目(KY2019006);四川省干部保健科研项目(川干研 2021-1303);四川省自然科学基金(2022NSFSC1422)作者简介 :刘 杰,医师,医学学士,主要从事危重症和肿瘤病人的营养治疗方向的研究。E-mail:lxj163187@163.com通讯作者 :林 宁,E-mail:helenmedic@yeah.net
更新日期/Last Update: 1900-01-01