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. 2024 Jun;28(6):100229.
doi: 10.1016/j.jnha.2024.100229. Epub 2024 Apr 9.

Relationship of endogenous plasma concentrations of β-hydroxy β-methyl butyrate (HMB) with frailty in community dwelling older adults with type-2 diabetes mellitus

Alejandro Álvarez-Bustos  1 , Jose A Carnicero  2 , Ricardo Rueda  3 , Suzette L Pereira  4 , Angela Santos-Fandila  3 , Jose M López-Pedrosa  3 , Begoña Molina-Baena  5 , Francisco José García-García  6 , Leocadio Rodríguez-Mañas  7
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Relationship of endogenous plasma concentrations of β-hydroxy β-methyl butyrate (HMB) with frailty in community dwelling older adults with type-2 diabetes mellitus

Alejandro Álvarez-Bustos et al. J Nutr Health Aging. 2024 Jun.

Abstract

Background: Supplementation with β-hydroxy β-methyl butyrate (HMB) appears to be effective in preserving muscle in older adults. However, the association between endogenously produced HMB with frailty has not been studied in people with chronic disease.

Objectives: The purpose of this study is to explore whether an association exists between endogenous HMB levels and frailty status in older adults with type-2 diabetes mellitus (T2DM).

Methods: Data were taken from the Toledo Study of Healthy Ageing, a community-dwelling aged (65 years+) cohort. Frailty was assessed at baseline and at 2.99 median years according to the Frailty Phenotype (FP) standardized to our population and the Frailty Trait Scale 12 (FTS12). The associations between HMB levels and frailty were assessed using three nested multivariate logistic regressions and segmented by sex. Glucose, HMB and glucose interaction, age and body composition were used as covariables.

Results: 255 participants (mean age 75.3 years, 52.94% men) were included. HMB levels showed an inverse cross-sectional association with frailty, which was modified when the interaction term HMB*glucose was included, remaining significant only for FTS12 [OR (95% CI): 0.436 (0.253, 0.751), p-value 0.003]. The association between HMB endogenous levels and FTS12 appears to be independent of sex, in which the association was maintained after adjusting for the covariates. However, there appears to be threshold points for glucose levels, above which the protective effect of HMB is lost: 145.4 mg/dl adjusted by gender for the whole sample and 149.6 mg/dl and 138.9 mg/dl for men and women, respectively. Endogenous HMB levels were not found to be associated with incident frailty.

Conclusions: Cross-sectional analysis revealed that endogenous HMB levels were inversely associated with frailty as assessed by the FTS12 in older people with T2DM. This association was found to be dependent on circulating fasted glucose levels.

Keywords: Community dwelling; Frailty; Older adults; Type-2 diabetes mellitus (T2DM); β-hydroxy β-methyl butyrate (HMB).

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Figures

Fig. 1
Fig. 1
Flow chart diagram.
Fig. 2
Fig. 2
Probability of being frail (according to Frailty Phenotype and Frailty Trait Scale) based on different values for glucose and HMB. FTS12: Frailty Trait Scale 12. FP: Frailty Phenotype.
See this image and copyright information in PMC

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References

    1. Álvarez-Bustos A., Carnicero-Carreño J.A., Davies B., Garcia-Garcia F.J., Rodríguez-Artalejo F., Rodríguez-Mañas L., et al. Role of sarcopenia in the frailty transitions in older adults: a population‐based cohort study. J Cachexia Sarcopenia Muscle. 2022;13:2352–2360. doi: 10.1002/jcsm.13055. - DOI - PMC - PubMed
    1. Davies B., Walter S., Rodríguez-Laso A., Carnicero Carreño J.A., García-García F.J., Álvarez-Bustos A., et al. Differential association of frailty and sarcopenia with mortality and disability: insight supporting clinical subtypes of frailty. J Am Med Dir Assoc. 2022;23:1712–1716.e3. doi: 10.1016/j.jamda.2022.03.013. - DOI - PubMed
    1. Álvarez-Bustos A., Rodríguez-Sánchez B., Carnicero-Carreño J.A., Sepúlveda-Loyola W., Garcia-Garcia F.J., Rodríguez-Mañas L. Healthcare cost expenditures associated to frailty and sarcopenia. BMC Geriatr. 2022;22:747. doi: 10.1186/S12877-022-03439-Z. - DOI - PMC - PubMed
    1. Hoogendijk E.O., Afilalo J., Ensrud K.E., Kowal P., Onder G., Fried L.P. Frailty: implications for clinical practice and public health. Lancet. 2019;394:1365–1375. doi: 10.1016/S0140-6736(19)31786-6. - DOI - PubMed
    1. Cesari M., Nobili A., Vitale G. Frailty and sarcopenia: from theory to clinical implementation and public health relevance. Eur J Intern Med. 2016;35:1–9. doi: 10.1016/J.EJIM.2016.07.021. - DOI - PubMed