Abstract
L-carnitine transports fatty acids into the mitochondria for oxidation and also buffers excess acetyl-CoA away from the mitochondria. Thus, L-carnitine may play a key role in maintaining liver function, by its effect on lipid metabolism. The importance of L-carnitine in liver health is supported by the observation that patients with primary carnitine deficiency (PCD) can present with fatty liver disease, which could be due to low levels of intrahepatic and serum levels of L-carnitine. Furthermore, studies suggest that supplementation with L-carnitine may reduce liver fat and the liver enzymes alanine aminotransferase (ALT) and aspartate transaminase (AST) in patients with Non-Alcoholic Fatty Liver Disease (NAFLD). L-carnitine has also been shown to improve insulin sensitivity and elevate pyruvate dehydrogenase (PDH) flux. Studies that show reduced intrahepatic fat and reduced liver enzymes after L-carnitine supplementation suggest that L-carnitine might be a promising supplement to improve or delay the progression of NAFLD.
Highlights
One-third of the world’s Western population suffers from Non-Alcoholic Fatty Liver Disease (NAFLD) [1]
The aim of this review is to provide an overview of the published literature on the effects of L-carnitine supplementation in patients with NAFLD
Even though L-carnitine binds to all chain-lengths of fatty acids, it is only the most abundant form of long-chain fatty acids that are dependent on L-carnitine for transportation to the mitochondria [32]
Summary
One-third of the world’s Western population suffers from Non-Alcoholic Fatty Liver Disease (NAFLD) [1]. NAFLD develops when liver fat content exceeds 5% [2], and consists of a spectrum of pathologies ranging from simple steatosis (>5% liver fat) to Non-Alcoholic Steatohepatitis (NASH; fat + inflammation), fibrosis and cirrhosis. Liver fibrosis is a strong predictor of long-term mortality in patients with NAFLD [3,4]. Relative lack of L-carnitine may lead to reduced fatty acid oxidation and triglyceride accumulation, resulting in NAFLD. Supplementation with L-carnitine may be a potential therapeutic option for lowering the risk of NAFLD by promoting fatty acid oxidation. Studies show that L-carnitine is reduced in patients with liver disease, diabetes and cardiovascular disease [6,7,8] and supplementation with.
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