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Objective <p>To investigate the effects of prebiotics combined with β-hydroxy-β-methylbutyrate (HMB) on muscle function, intestinal barrier integrity, and inflammation in elderly patients with sarcopenia.</p> Methods <p>A randomized controlled trial was conducted on 78 elderly sarcopenic patients recruited from Tongji University Affiliated Tenth People’s Hospital and Baoshan District Geriatric Care Hospital (Jan 2023 - Jan 2025). Participants were randomly assigned Group A (<i>n</i> = 32, standard diet + HMB-supplement), Group B (<i>n</i> = 31, standard diet + HMB + fructooligosaccharides), or Group C (<i>n</i> = 15, standard diet alone) for 30 days. Outcomes included muscle function (skeletal muscle mass index, grip strength, calf circumference), intestinal barrier markers (serum diamine oxidase, D-lactic acid, endotoxin), and inflammatory and nutritional markers (CRP, neutrophil/lymphocyte ratio, systemic immune inflammation index, albumin, prealbumin).</p> Results <p>Baseline indicators did not differ among groups (<i>P</i> &gt; 0.05). After intervention, skeletal muscle mass index and grip strength improved significantly in Groups A and B (<i>P</i> &lt; 0.05), with higher grip strengths to Group B than C (adj. <i>P</i> = 0.017). Calf circumference decreased in all groups (<i>P</i> &lt; 0.05), most in Group C (t = 4.461, <i>P</i> = 0.001). Group B exhibited lower diamine oxidase, D-lactic acid, and endotoxin levels than Groups A and C (<i>P</i> &lt; 0.05) and the greatest reductions in CRP, NLR, and SII (<i>P</i> &lt; 0.001). Albumin or prealbumin showed no significant changes (<i>P</i> &gt; 0.05).</p> Conclusion <p>HMB improves muscle function in sarcopenic elderly, prebiotics combined with HMB further enhance intestinal barrier repair and reduce inflammation, offering a promising gut-muscle-targeted nutritional strategy.</p>

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Preliminary clinical study on the synergistic effects of prebiotics and β-hydroxy-β-methylbutyrate in improving muscle function and intestinal barrier function in elderly patients with sarcopenia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月2日

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  • Jialu Zhuo,
  • Ting Han,
  • Ning Yang,
  • Zhihua Qu,
  • Zixiang Li,
  • Fangjing Hong

摘要

Objective

To investigate the effects of prebiotics combined with β-hydroxy-β-methylbutyrate (HMB) on muscle function, intestinal barrier integrity, and inflammation in elderly patients with sarcopenia.

Methods

A randomized controlled trial was conducted on 78 elderly sarcopenic patients recruited from Tongji University Affiliated Tenth People’s Hospital and Baoshan District Geriatric Care Hospital (Jan 2023 - Jan 2025). Participants were randomly assigned Group A (n = 32, standard diet + HMB-supplement), Group B (n = 31, standard diet + HMB + fructooligosaccharides), or Group C (n = 15, standard diet alone) for 30 days. Outcomes included muscle function (skeletal muscle mass index, grip strength, calf circumference), intestinal barrier markers (serum diamine oxidase, D-lactic acid, endotoxin), and inflammatory and nutritional markers (CRP, neutrophil/lymphocyte ratio, systemic immune inflammation index, albumin, prealbumin).

Results

Baseline indicators did not differ among groups (P > 0.05). After intervention, skeletal muscle mass index and grip strength improved significantly in Groups A and B (P < 0.05), with higher grip strengths to Group B than C (adj. P = 0.017). Calf circumference decreased in all groups (P < 0.05), most in Group C (t = 4.461, P = 0.001). Group B exhibited lower diamine oxidase, D-lactic acid, and endotoxin levels than Groups A and C (P < 0.05) and the greatest reductions in CRP, NLR, and SII (P < 0.001). Albumin or prealbumin showed no significant changes (P > 0.05).

Conclusion

HMB improves muscle function in sarcopenic elderly, prebiotics combined with HMB further enhance intestinal barrier repair and reduce inflammation, offering a promising gut-muscle-targeted nutritional strategy.