Abstract

Carnitine is an essential metabolite whose function is to transport activated long-chain fatty acids across the mitochondrial membrane. It is consumed in the diet and is synthesized from lysine and methionine to meet body needs. Hepatic fat deposition has been reported in experimental animals and patients receiving total parenteral nutrition (TPN) fluids devoid of preformed carnitine. In the present experiment, nitrogen balance, hepatic fat deposition and serum and tissue carnitine were determined in rats receiving a hypercaloric TPN regimen containing 0, 10, 50, and 100 mg dl-carnitine per 100 g body weight for 14 days. Rats fed a stock diet served as controls. Increased nitrogen balance was observed in TPN rats receiving the highest dose of carnitine supplementation. Hepatic fat deposition induced by the hypercaloric infusion was ameliorated but not eliminated by infusing carnitine. Serum, liver and skeletal muscle carnitine concentrations were maintained, whereas that of heart decreased in TPN rats without carnitine supplementation. Between 90 and 100% of the administered l-carnitine was excreted. It is suggested that the observed effects of carnitine on nitrogen balance and hepatic fat deposition are due to as yet undefined pharmacological properties. The significant decrease of carnitine in cardiac muscle resulting from TPN in a patient population already stressed and traumatized and the metabolic and physiological effects of this decrease deserve further exploration.total parenteral nutrition carnitine fatty infiltration nitrogen balance

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