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Article

Multi-Axis Reprogramming of Muscle–Metabolic Crosstalk by HiLo Platinum™ Restores Strength in Prediabetes via Mitochondrial Activation and Gut Microbiome Remodeling

by
Jeremy Nicolas Sibarani
1,†,
Muhammad Iqhrammullah
2,†,
Amal Arifi Hidayat
3,4,5,
Ricky Indra Alfaray
4,5,
Fahrul Nurkolis
1,5,6,* and
Antonello Santini
7,*
1
Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia
2
Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh 23245, Indonesia
3
Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia
4
Helicobacter Pylori and Microbiota Study Group, Institute of Tropical Disease, Universitas Airlangga, Surabaya 60131, Indonesia
5
Medical Research Center of Indonesia, Surabaya 60281, Indonesia
6
Institute for Research and Community Service, State Islamic University of Sunan Kalijaga (UIN Sunan Kalijaga), Yogyakarta 55281, Indonesia
7
Department of Pharmacy, University of Napoli Federico II, Via Domenico Montesano, 49, 80131 Napoli, Italy
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Mol. Sci. 2026, 27(9), 4014; https://doi.org/10.3390/ijms27094014
Submission received: 17 April 2026 / Revised: 24 April 2026 / Accepted: 28 April 2026 / Published: 30 April 2026

Abstract

Prediabetes is increasingly recognized as a risk factor for sarcopenia, driven by chronic low-grade inflammation, insulin resistance, and impaired anabolic signaling. Nutritional interventions containing whey protein, hydroxymethylbutyrate (HMB), glucosamine, and micronutrients may offer a multi-target strategy to counteract muscle deterioration. This study aimed to evaluate the efficacy of HiLo Platinum™ supplementation in attenuating muscle strength decline in a prediabetic rat model, with integrated analysis of metabolic biomarkers and gut microbiome profiles. A randomized preclinical trial was conducted using male Sprague Dawley rats assigned to four groups: normal diet (ND), prediabetic control induced by cholesterol- and fat-enriched diet with fructose (CFEDF), and two treatment groups receiving low-dose (0.63 g/kg BW) or high-dose (1.26 g/kg BW) HiLo Platinum™. The intervention lasted six weeks. Muscle strength was assessed via a four-limb grip strength test (reverse hang time and holding impulse). Biomarkers related to inflammation, mitochondrial function, and anabolic signaling (TNF-α, IL-10, PGC-1α, IGF-1, SIRT-1, AMPK, mTOR, and myostatin), lipid profile, and blood glucose were analyzed. Gut microbiome composition and diversity were evaluated using taxonomic profiling and multivariate analyses. HiLo Platinum™ supplementation significantly improved muscle strength, evidenced by increased reverse hang time and holding impulse (p < 0.001). Both doses reduced blood glucose and improved lipid profiles, including increased HDL and decreased LDL, triglycerides, and total cholesterol. Anti-inflammatory effects were observed with reduced TNF-α and elevated IL-10 levels. Mitochondrial and metabolic regulators (PGC-1α, SIRT-1, AMPK) and anabolic mediators (IGF-1) were significantly upregulated, while mTOR levels decreased. Gut microbiome analysis revealed increased genus richness (Chao1 index) and distinct microbial shifts associated with improved metabolic and inflammatory markers. HiLo Platinum™ effectively mitigates prediabetes-induced muscle strength decline through integrated modulation of inflammatory pathways, mitochondrial function, metabolic homeostasis, and gut microbiome composition. These findings support its potential as a nutritional therapeutic strategy for preventing sarcopenia in prediabetic conditions, although further studies are needed to evaluate long-term effects and implications on muscle hypertrophy.
Keywords: prediabetes; sarcopenia; whey protein; hydroxymethylbutyrate (HMB); glucosamine; muscle strength; gut microbiome; PGC-1α; SIRT-1; nutritional intervention prediabetes; sarcopenia; whey protein; hydroxymethylbutyrate (HMB); glucosamine; muscle strength; gut microbiome; PGC-1α; SIRT-1; nutritional intervention
Graphical Abstract

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MDPI and ACS Style

Sibarani, J.N.; Iqhrammullah, M.; Hidayat, A.A.; Alfaray, R.I.; Nurkolis, F.; Santini, A. Multi-Axis Reprogramming of Muscle–Metabolic Crosstalk by HiLo Platinum™ Restores Strength in Prediabetes via Mitochondrial Activation and Gut Microbiome Remodeling. Int. J. Mol. Sci. 2026, 27, 4014. https://doi.org/10.3390/ijms27094014

AMA Style

Sibarani JN, Iqhrammullah M, Hidayat AA, Alfaray RI, Nurkolis F, Santini A. Multi-Axis Reprogramming of Muscle–Metabolic Crosstalk by HiLo Platinum™ Restores Strength in Prediabetes via Mitochondrial Activation and Gut Microbiome Remodeling. International Journal of Molecular Sciences. 2026; 27(9):4014. https://doi.org/10.3390/ijms27094014

Chicago/Turabian Style

Sibarani, Jeremy Nicolas, Muhammad Iqhrammullah, Amal Arifi Hidayat, Ricky Indra Alfaray, Fahrul Nurkolis, and Antonello Santini. 2026. "Multi-Axis Reprogramming of Muscle–Metabolic Crosstalk by HiLo Platinum™ Restores Strength in Prediabetes via Mitochondrial Activation and Gut Microbiome Remodeling" International Journal of Molecular Sciences 27, no. 9: 4014. https://doi.org/10.3390/ijms27094014

APA Style

Sibarani, J. N., Iqhrammullah, M., Hidayat, A. A., Alfaray, R. I., Nurkolis, F., & Santini, A. (2026). Multi-Axis Reprogramming of Muscle–Metabolic Crosstalk by HiLo Platinum™ Restores Strength in Prediabetes via Mitochondrial Activation and Gut Microbiome Remodeling. International Journal of Molecular Sciences, 27(9), 4014. https://doi.org/10.3390/ijms27094014

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