L-carnitine Supplementation Research Articles

The effects of L-carnitine supplementation on inflammatory and anti-inflammatory markers in adults: a systematic review and dose-response meta-analysis.

L-carnitine supplementation may be beneficial in improving inflammatory conditions and reducing the level of inflammatory cytokines. Therefore, according to the finding of randomized controlled trials (RCTs), the systematic review and meta-analysis aimed to investigate the effect of L-carnitine supplementation on inflammation in adults. To obtain acceptable articles up to October 2022, a thorough search was conducted in databases including PubMed, ISI Web of Science, the Cochrane Library, and Scopus. A random-effects model was used to estimate the weighted mean difference (WMD). We included the 48 RCTs (n = 3255) with 51 effect sizes in this study. L-carnitine supplementation had a significant effect on C-reactive protein (CRP) (p < 0.001), interleukin-6 (IL-6) (p = 0.001), tumor necrosis factor-α (TNF-α) (p = 0.002), malondialdehyde (MDA) (p = 0.001), total antioxidant capacity (TAC) (p = 0.029), alanine transaminase (ALT) (p < 0.001), and aspartate transaminase (AST) (p < 0.001) in intervention, compared to the placebo group. Subgroup analyses showed that L-carnitine supplementation had a lowering effect on CRP and TNF-α in trial duration ≥ 12 weeks in type 2 diabetes and BMI ≥ 25 kg/m2. L-carnitine supplementation reduced ALT levels in overweight and normal BMI subjects at any trial dose and trial duration ≥ 12 weeks and reduced AST levels in overweight subjects and trial dose ≥ 2 g/day. This meta-analysis revealed that L-carnitine supplementation effectively reduces the inflammatory state by increasing the level of TAC and decreasing the levels of CRP, IL-6, TNF-α and MDA in the serum.

Blood and liver telomere length, mitochondrial DNA copy number, and hepatic gene expression of mitochondrial dynamics in mid-lactation cows supplemented with l-carnitine under systemic inflammation

The current study was conducted to examine the effect of l-carnitine (LC) supplementation on telomere length and mitochondrial DNA copy number (mtDNAcn) per cell in mid-lactation cows challenged by lipopolysaccharide (LPS) in blood and liver. The mRNA abundance of 31 genes related to inflammation, oxidative stress, and the corresponding stress response mechanisms, the mitochondrial quality control and the protein import system, as well as the phosphatidylinositol 3-kinase/protein kinase B pathway, were assessed using microfluidics integrated fluidic circuit chips (96.96 dynamic arrays). In addition to comparing the responses in cows with or without LC, our objectives were to characterize the oxidative and inflammatory status by assessing the circulating concentration of lactoferrin (Lf), haptoglobin (Hp), fibrinogen, derivates of reactive oxygen metabolites (dROM), and arylesterase activity (AEA), and to extend the measurement of Lf and Hp to milk. Pluriparous Holstein cows were assigned to either a control group (CON, n = 26) or an LC-supplemented group (CAR; 25 g LC/cow per day; d 42 ante partum to d 126 postpartum (PP), n = 27). On d 111 PP, each cow was injected intravenously with LPS (Escherichia coli O111:B4, 0.5 µg/kg). The mRNA abundance was examined in liver biopsies of d -11 and +1 relative to LPS administration. Plasma and milk samples were frequently collected before and after the challenge. After LPS administration, circulating plasma fibrinogen and serum dROM concentrations increased, whereas AEA decreased. Moreover, serum P4 initially increased by 3 h after LPS administration and declined thereafter irrespective of grouping. The Lf concentrations increased in both groups after LPS administration, with the CAR group showing greater concentrations in serum and milk than the CON group. After LPS administration, telomere length in blood increased, whereas mtDNAcn per cell decreased; however, both remained unaffected in liver. For mitochondrial protein import genes, the hepatic mRNA abundance of the translocase of the mitochondrial inner membrane (TIM)-17B was increased in CAR cows. Moreover, TIM23 increased in both groups after LPS administration. Regarding the mRNA abundance of genes related to stress response mechanisms, 7 out of 14 genes showed group × time interactions, indicating a (local) protective effect due to the dietary LC supplementation against oxidative stress in mid-lactating dairy cows. For mtDNAcn and telomere length, the effects of the LPS-induced inflammation were more pronounced than the dietary supplementation of LC. Dietary LC supplementation affected the response to LPS primarily by altering mitochondrial dynamics. Regarding mRNA abundance of genes related to the mitochondrial protein import system, the inner mitochondrial membrane translocase (TIM complex) seemed to be more sensitive to dietary LC than the outer mitochondrial membrane translocase (TOM complex).

Hand Grip Strength: A Tool of Nutritional Assessment in Prevalent Hemodialysis Patients

Abstract Background Malnutrition is a common problem in patients with end stage renal disease (ESRD) undergoing hemodialysis that is associated with increased morbidity and mortality. There are several clinical, nutritional, and biochemical parameters that may be indicative of PEW in patients using hemodialysis (HD). Handgrip strength is a simple, quick, non-invasive, inexpensive, rapid, and objective procedure. In addition, it has other advantages as a diagnostic/screening tool for nutritional assessment. However, HGS relies on the motivation of the subjects, and therefore it is imperative that researchers and clinicians are sufficiently trained in HGS assessment. L-Carnitine supplementation, levocarnitine is an amino acid derivative which is an essential cofactor of fatty acid metabolism, may improve several situations. Aim of the Work The aim of our study, a longitudinal observational study, is to assess HGS as an independent tool for assessment of the nutritional status in hemodialysis patients. This study can also show the significance of the commitment to high protein diet (1.2-1.4 g/ kg/ d) and receiving L-carnitine (10-20 mg/kg intravenously after each dialysis session) and its effect on the handgrip strength and other studied nutritional tools. Patients and Methods In our study, a longitudinal observational study, study duration was 3 months after washout period; our population is all End Stage Renal Disease patients in Kasr AlAiny Hemodialysis Unit, Cairo University. The unit provides hemodialysis and medical service for 104 patients from whom 50 were excluded and 54 patients were enrolled. Results the study showed comparison between both studied groups regarding the studied laboratory parameters and different nutrition assessment tools showed no statistically significant differences. The study showed Comparison between the effect of high protein diet and L Carnitine (pre and post) in patients of group B on the studied nutritional tools and laboratory parameters. Again HGS was the only tool that showed statistical significance. %BF(body fat) assessed by anthropometry was negativelycorrelated with HGS. Also they found lower HGSvalues in patients on HD with higher estimates of abdominal fatdeposition. Thus, it seems that low muscle mass can occurdespite fat accumulation, and one possible explication for thiswould be the proinflammatory phenotype presented by individualswith abdominal fat deposition. This confirms that subjects can have normal or higher BMI and have a depletionprocess, thus increasing the need for screening proceduresrelated to functional status. Conclusion In this study, we concluded that HGS was the only significant (p value: &amp;lt;.001), while all other nutrition assessment tools didn’t show any significant difference.The correlation between nPCR and HGS was statistically significant (p value:.001, r:.616). L-carnitine supplementation has no role over commitment to high protein diet only regarding improving the nutritional status and hemoglobin level in hemodialysis patients.

CRIOTOLERANCIA DE EMBRIONES BOVINOS CULTIVADOS INDIVIDUALMENTE EN UN MEDIO SUPLEMENTADO CON L-CARNITINA

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; L-carnitine is a lipid metabolism enhancer and a potent antioxidant that prevents oxidative damage and improves cryotolerance of bovine embryos. &lt;strong&gt;Objective:&lt;/strong&gt; To determine the effect of L-carnitine during oocyte maturation on developmental competence and cryotolerance of single bovine embryo cultured. &lt;strong&gt;Methodology:&lt;/strong&gt; Embryos were produced in vitro using abattoir-derived cumulus-oocyte complexes (COCs). In experiment 1, two individual maturation, fertilization and culture systems were used in 24-well plates with 20 µL drops of medium covered with mineral oil and 96-well plates with 30 µL drops of medium. In experiment 2, oocytes were randomly distributed into two groups and single matured in 96-well plates in medium supplemented or not with 0.6mg/mL L-carnitine. On day 7 post fertilization, blastocysts were vitrified on solid surface in Fiberplug. Non-vitrified blastocysts were used as control. Embryonic survival after devitrification was determined by blastocysts re-expansion and hatching rate at 24 and 48 hours of post-devitrification culture. Total cell number and apoptotic rate by TUNEL-DAPI staining were used as quality and cryotolerance indicator. In both cases, cleavage and blastocyst rates were evaluated at 48 hours and 7 days post fertilization, respectively. &lt;strong&gt;Results:&lt;/strong&gt; No significant differences were found for embryonic development between single culture systems. There was no effect of L-carnitine supplementation during maturation on embryo development, but embryo survival had increased (P &amp;lt; 0.05) at 24- and 48-hours post devitrification. &lt;strong&gt;Implications:&lt;/strong&gt; Treatment with L-carnitine had increased (P &amp;lt; 0.05) post-thaw re-expansion rates (86.8 ± 3.0 vs 70.0 ± 4.4) and it was similar to non-vitrified control (89.7 ± 2.6). Mean cell number and apoptotic cell index, were similar for all treatment groups. &lt;strong&gt;Conclusion:&lt;/strong&gt; L-carnitine supplementation during maturation, does not improve division rate and subsequent development of single cultured embryos, however increases cryotolerance post devitrification.&lt;/p&gt;

Effect of a 3-month L-carnitine supplementation and resistance training program on circulating markers and bone mineral density in postmenopausal women: a randomized controlled trial

BackgroundHigher circulating levels of trimethylamine N-oxide (TMAO), which is a metabolite that can be produced by the gut microbiota from L-carnitine (LC), have been associated with bone mineral density (BMD). Because LC supplementation can improve bone density and microstructural properties in animal models, this study aimed to examine the effects of 12 weeks of LC supplementation on BMD and selected blood markers involved in bone metabolism of postmenopausal women participating in a resistance training (RT) program.MethodsTwenty-seven postmenopausal women, who had not been treated for osteoporosis, with a total T-score above − 3.0 and no diet differences completed 12 weeks of RT. The participants’ diets were supplemented with either 1 g of LC-L-tartrate and 3 g of leucine per day (LC group) or 4 g of leucine per day as a placebo (PLA group), in a double-blind fashion.ResultsAfter the intervention in the LC group, plasma total carnitine and serum decorin levels were higher than the corresponding preintervention values (p = 0.040 and p = 0.042, respectively). Moreover, plasma TMAO and serum SPARC levels were higher in the LC group than the corresponding postintervention values in the PLA group (p < 0.001 and p = 0.030, respectively). No changes in the BMD were observed after 3 months of the intervention.ConclusionsTwelve weeks of LC supplementation during RT program increased plasma TMAO levels and appeared to affect signaling molecules, as indicated by the increase in the resting SPARC and decorin levels, with no significant modification in the BMD.Trial registrationRetrospectively registered at the ClinicalTrials.gov (NCT05120011).

The effects of dietary L-carnitine supplementation in fish diet containing high corn gluten meal on immunity, lipid metabolism, and metabolomics in juvenile hybrid grouper (♀Epinephelus fuscoguttatus × ♂Epinephelus lanceolatus)

The effects of dietary L-carnitine supplementation in fish diet containing high corn gluten meal on immunity, lipid metabolism, and metabolomics in juvenile hybrid grouper (♀Epinephelus fuscoguttatus × ♂Epinephelus lanceolatus)

Dietary choline, but not L-carnitine, increases circulating lipid and lipoprotein concentrations, without affecting body composition, energy expenditure or respiratory quotient in lean and obese male cats during weight maintenance.

Due to the involvement in one-carbon metabolism and lipid mobilization, choline and L-carnitine supplementation have been recommended to minimize hepatic lipid accumulation and support fat oxidation, respectively. This study investigated the lipotropic benefits of choline or L-carnitine supplementation in lean and obese cats maintaining body weight (BW). Lean [n = 9; body condition score (BCS): 4-5/9] and obese (n = 9; BCS: 8-9/9) adult male neutered colony cats were used in a replicated 3 x 3 complete Latin square design. Treatments included choline (378 mg/kg BW0.67), L-carnitine (200 mg/kg BW) and control (no supplement). Treatments were supplemented to the food for 6 weeks each, with a 2-week washout between treatments. Cats were fed once daily to maintenance energy requirements, and BW and BCS were assessed weekly. Fasted blood collection, indirect calorimetry, and dual-energy X-ray absorptiometry occurred at the end of each treatment period. Serum was analyzed for cholesterol (CHOL), high-density lipoprotein CHOL (HDL-C), triglycerides (TAG), non-esterified fatty acids (NEFA), glucose, creatinine (CREAT), urea, alkaline phosphatase (ALP) and alanine aminotransferase (ALT). Very low-density lipoprotein CHOL (VLDL) and low-density lipoprotein CHOL (LDL-C) were calculated. Data were analyzed using proc GLIMMIX, with group and period as random effects, and treatment, body condition, and their interaction as fixed effects, followed by a Tukey's post-hoc test when significance occurred. Cats supplemented choline had lower food intake (P = 0.025). Treatment did not change BW, BCS and body composition (P > 0.05). Obese cats had greater ALP, TAG, and VLDL, and lower HDL-C compared to lean cats (P < 0.05). Choline resulted in greater CHOL, HDL-C, LDL-C and ALT (P < 0.05). L-carnitine resulted in lower CREAT (P = 0.010). Following the post-hoc test, differences between treatment means were not present for ALP (P = 0.042). No differences were found for glucose, urea or NEFA (P > 0.05). Obese cats had a lower fed respiratory quotient (RQ), regardless of treatment (P = 0.045). Treatment did not affect fed or fasted RQ and energy expenditure (P > 0.05). Choline appeared to increase circulating lipid and lipoprotein concentrations regardless of body condition, likely through enhanced lipid mobilization and hepatic elimination. Neither dietary choline or L-carnitine altered body composition or energy metabolism in the lean or obese cats, as compared to control.

Nutritional interventions for exercise-induced muscle damage: an umbrella review of systematic reviews and meta-analyses of randomized trials.

Several meta-analyses have been conducted on the effect of nutritional interventions on various factors related to muscle damage. However, the strength of the evidence and its clinical significance are unclear. This umbrella review aimed to provide an evidence-based overview of nutritional interventions for exercise-induced muscle damage (EIMD). PubMed, Scopus, and ISI Web of Science were systematically searched up to May 2022. Systematic reviews and meta-analyses of randomized controlled trials investigating nutritional interventions' effects on recovery following EIMD were included. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Fifty-three randomized controlled trial meta-analyses were included, evaluating 24 nutritional interventions on 10 different outcomes. The results revealed a significant effect of hydroxymethylbutyrate (HMB) supplementation and l-carnitine supplementation for reducing postexercise creatine kinase; HMB supplementation for reducing lactate dehydrogenase; branched-chain amino acids and leaf extract supplementation for reducing the delayed onset of muscle soreness; and l-carnitine, curcumin, ginseng, polyphenols, and anthocyanins for reducing muscle soreness, all with moderate certainty of evidence. Supplementation with HMB, l-carnitine, branched-chain amino acids, curcumin, ginseng, leaf extract, polyphenols, and anthocyanins showed favorable effects on some EIMD-related outcomes. PROSPERO registration no. CRD42022352565.

Desempenho zootécnico, grau de esteatose e potencial genotóxico de lambaris Astyanax lacustris alimentados com diferentes níveis de L-carnitina

ABSTRACT L-carnitine perform a major role in transporting long-chain fatty acids into the mitochondria, where they are oxidized. It has been used in animal diets to decrease fat and increase muscle protein. The aim of this study was to evaluate the zootechnical performance, degree of steatosis in the liver, and genotoxic potential in Astyanax lacustris fed with different levels of L-carnitine (LC). Yellowtail tetra juveniles (n = 140) were distributed in 20 tanks of 70 L, with seven fish in each, in a water recirculation system with controlled temperature (27±0.1⁰C). The treatments with different levels of L-carnitine supplementation were: 0 (control), 250, 500, 750, and 1000 mg of LC per kg of food. The diets were provided twice a day for 60 days. The results showed that the different levels of LC did not affect (P&gt;0.05) weight gain, survival, viscerosomatic index, and the liver hepatocytes showed a normal appearance. However, the use of LC supplementation showed genotoxic potential with a significant difference (P&lt;0.05) for cell alterations when compared to the control at concentrations above 500mg kg-1.

Effect of exogenous l-carnitine on aortic stiffness in dyslipidemic adolescents: Design of a quadruple-blind, randomized, controlled interventional trial

BackgroundAtherosclerotic cardiovascular disease (ASCVD) risk factors including vascular remodeling leading to hypertension and dyslipidemia are prevalent among children and adolescents. Conflicting observational and Mendelian randomization data suggest endogenous carnitine may affect arterial stiffness and lipid traits. Because of this, we developed a study to evaluate the causal role for carnitine in arterial stiffness at a point when the lifecourse trajectory to hypertension can be modified. MethodsThis study is a mechanistic, double-blinded, randomized control trial (RCT) in 166 adolescents with dyslipidemia for the effect of 6 months of maximum dose 3 g daily oral l-carnitine supplementation (CS+) versus placebo (CS-) on aortic stiffness measured as carotid-femoral pulse wave velocity (CFPWV) and pulse pressure (PP); lipid concentrations (total cholesterol, HDL-C, triglycerides, and LDL-C) and serum fatty acid oxidation biomarkers by metabolomic analysis. ConclusionsThe simultaneous evaluation of endogenous carnitine genetic effects and exogenous l-carnitine supplementation may facilitate future therapies for youth with cardiometabolic derangement to arrest atherosclerotic changes.

Evaluation of Treatment Modalities for Pure Asthenospermia Regarding Changes in Seminal Fluid Parameters

Background: Asthenospermia is one of the most common findings in the seminal fluid analysis of patients with infertility. In spite of a full diagnostic workup, the causes of Asthenospermia are not always clear; accordingly, there are a lot of controversies about the best treatment for such a condition. Aim of the study: To evaluate the validity of two treatment modalities for patients with pure Asthenospermia, one surgical (varicocelectomy) and the other medical (L-carnitine supplementation), by following changes in seminal fluid parameters. Patients and methods: A prospective study was conducted at AL-Yarmouk Teaching Hospital/Urology Department from 23rd August 2021 to 18th April 2022. One hundred eighteen infertile male patients were included. Patients were divided in two groups: Surgical arm (71 patients with different grades of varicoceles) and the medical arm (47 patients with no overt clinical varicoceles). For all patients, a full assessment had been done, including at least two seminal fluid analyses as a baseline (to document the presence of pure Asthenospermia). Surgical arm patients were treated with subinguinal varicocelectomy, and medical arm patients were treated with oral supplementation of L-carnitine 1 gm/day. Patients in both groups were followed for 6-12 months by repeated seminal fluid analyses to check the changes in sperm motility. Adverse effects of the treatment were also checked during follow-up visits. Results and Discussion: Surgical arm patients included were 26,23, and 12 patients with varicocele grades 1,2, and 3, respectively, and ten patients with subclinical varicoceles. Medical arm patients included were 32 patients with no varicoceles and 15 patients with subclinical varicoceles. Changes in seminal fluid parameters (total Sperms motility status) after treatment were statistically significant in the varicocelectomy group, and improvement in the seminal fluid parameters was directly related to the grade of the varicoceles with no significant improvement in the patients with subclinical varicoceles. In the medical arm, we achieved an improvement in sperm motility status, but it was not statistically significant. Conclusion: Patients with pure Asthenospermia and clinically detected varicoceles are best treated by varicocelectomy, and the more grade varicoceles, the better results are achieved. L-carnitine supplementation for patients with pure Asthenospermia proved to be beneficial and safe, but when given alone, it was not enough to raise sperm motility status to normal values.

L-carnitine reverses methotrexate-induced nephrotoxicity in experimental rat model: Insight on SIRT1/PGC-1α/Nrf2/HO-1 axis.

Methotrexate (MTX) is a chemotherapeutic agent used for treating several types of cancer as well as psoriasis and rheumatoid arthritis, but its use is limited due to its nephrotoxicity. The purpose of this research work was to observe ameliorative effects of L-carnitine (LC) toward renal toxicity caused by MTX and mechanisms responsible for these effects. Thirty-two male Sprague-Dawley rats were divided into four groups (eight rats/group), control group (received saline), MTX group (20 mg/kg/i.p. once), LC group (500 mg/kg/i.p. for 5days), and MTX + LC group (received a single MTX dose 20 mg/kg/i.p. followed by LC 500 mg/kg/i.p. for 5days). Histopathological examinations, lipid oxidation marker, malondialdehyde (MDA), and the antioxidant superoxide dismutase (SOD) as well as inflammatory (tumor necrosis factor-α [TNF-α] and interleukin-6 [IL-6]) and apoptotic markers (Bax, Bcl2, and caspase-3) were used to assess renal toxicity. Moreover, the protein levels of silent information regulator 1 (SIRT1) and its downstream signaling targets, peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), and nuclear factor erythroid 2-related factor 2 (Nrf2) in addition to heme oxygenase-1 (HO-1) were measured. LC significantly protected against MTX-induced nephrotoxicity. It ameliorated MTX-induced renal histopathological changes and diminished MTX-induced renal oxidative stress, renal inflammation, and apoptosis. LC also upregulated the expression of SIRT1 and PGC-1 as well as Nrf2 and HO-1. By controlling the expression of renal SIRT1/PGC-1/Nrf2/HO-1, LC displayed antioxidant, anti-inflammatory, and anti-apoptotic activities. Hence, using LC supplements may help prevent negative MTX side effects.

#4655 IMPACT OF MAGNESIUM ASPARTATE AND L-CARNITINE ON INFLAMMATION, INSULIN RESISTANCE AND ATHEROSCLEROSIS PROGRESSION IN DIABETIC HEMODIALYSIS PATIENTS

Abstract Background and Aims The development of new pathogenetic treatment programs to reduce cardiovascular risk in diabetic patients with end-stage kidney disease is an important task of modern nephrology. In these conditions, considering the essential role of magnesium and L-carnitine deficiency in the mechanisms (via endothelial and metabolic disorders) of cardiovascular diseases, we evaluated the effect of the combined use of magnesium aspartate and L-carnitine on inflammation, insulin resistance and the atherosclerosis progression of carotid arteries in type 2 diabetic hemodialysis (HD) patients. Method 42 type 2 diabetic HD patients were included in this prospective cohort study (male, 26; age, 59.5 ± 0.7 years; HD duration, 31.2 ± 4.6 month; diabetes mellitus duration, 174.6 ± 7.8 month). Depending on the treatment programme, patients were divided into two groups: the 1st (main) group (n = 22) in addition to basic treatment (hypoglycemic, antihypertensive therapy, correction of anemia, hyperparathyroidism, hyperphosphatemia) was treated by combination of magnesium aspartate (0.5 g/day orally) and L-carnitine (1 g/day parenterally after each HD session (three times weekly); the 2nd (comparison) group (n = 20) was only on the standard therapy. Complex treatment lasted 12-months; administration of L-carnitine was performed continuously throughout the year, while magnesium aspartate – by three 2-months’ courses per year. Serum content of tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP) and fibrinogen as inflammatory biomarkers were determined. The homoeostasis model of assessment-insulin resistance (HOMA-IR) as an index of insulin resistance was estimated. Common carotid artery intima-media thickness (CСА IMT) as an index of the atherosclerosis severity was measured by ultrasound. Data are expressed as means ± SEM. Wilcoxon T-test was used for comparison of the dependent variables, Mann-Whitney U-test – for independent ones. Results In diabetic HD patients undergoing complex treatment with a combination of magnesium aspartate and L-carnitine after 12 months of observation CCA IMT did not change (0.88 ± 0.05 vs. 0.88 ± 0.05 mm; Z = 0.09, p = 0.925), while a significant increase (by 9.1%) in the CCA IMT was determined in subjects, who were on basic therapy (0.98 ± 0.04 vs. 1.07 ± 0.04 mm; Z = 2.27, p = 0.023). In addition, after 12 months of treatment, the indicated index between 1st and 2nd groups differed (p = 0.006). By the end of follow-up, the TNF-α, CRP and fibrinogen contents in patients who were on modified therapy were 44.7, 56.4 and 78.2% from baseline, a similar indices in patients receiving standard treatment – 70.7, 77.3 and 88.8% respectively, and after one year the main group and the comparison group on the serum concentrations of TNF-α (p = 0.089), CRP (p = 0.030) and fibrinogen (p = 0.026) differed. Magnesium aspartate and L-carnitine supplementation significantly improve HOMA-IR, and after 12 months of observation, the indicated index in the 2nd group exceeded (p = 0.003) that in the 1st one (Table 1). Conclusion (1) The combined use of magnesium aspartate and L-carnitine, in addition to the basic 12-month treatment, prevents the atherosclerosis progression of CCA, provides an effective reduction of the activity of chronic inflammation, improves insulin resistance in type 2 diabetic HD patients. (2) Long-term modified treatment may reduce the cardiovascular risk in these subjects.

A report of a pedigree with compound heterozygous mutations in the SLC22A5 gene.

To investigate the clinical characteristics and disease outcomes of a pedigree with compound heterozygous mutations in the SLC22A5 gene. Serum acylcarnitine profiles of patients were analyzed using tandem mass spectrometry. DNA samples isolated from patients and their first-degree relatives were subjected to high-throughput sequencing, and mutations were validated using Sanger sequencing. The proband, a 4-month-old girl, presented with seizure episodes and mild cardiac hypertrophy and was diagnosed with primary carnitine deficiency (PCD), with carnitine levels of 5.165 mol/L. Her brother, a 6-year-and 4-month-old boy, was also diagnosed with PCD with serum-free carnitine levels of 1.014 mol/L (reference values 10-60 mol/L). Compound heterozygous mutations (c.760C > T [p.R254X] and c.825G > A [p.W275X]) were detected in the SLC22A5 gene in both patients and were inherited from the mother and father, respectively. Oral L-carnitine significantly improved or resolved the clinical symptoms. Children with compound mutations in SLC22A5 may present different clinical manifestations, particularly at different ages. Early clinical manifestations have a greater impact on the organs and may cause irreversible damage. PCD can cause epilepsy and dilated cardiomyopathy. Tandem mass spectrometry and high-throughput sequencing are recommended to confirm the diagnosis. Early L-carnitine supplementation can improve symptoms and reverse organ damage in some children. Tandem mass spectrometry should be used to screen for newborns with a family history of PCD.

The effect of dietary L-carnitine and fat on performance, carcass traits and blood components in broiler chickens

Abstract The poultry industry has traditionally been selecting animals for improved performance without consideration for the effect on fat deposition. Dietary L-carnitine can alter lipid metabolism; nevertheless, when combined with fat, the effects are not clear. This study shows the effect of different dietary levels of L-carnitine (0, 200 and 400 mg/kg) and fat (0, 2.5 and 5%) on growth performance and slaughter traits of commercial broilers (Ross 308; n=270). The groups received the following dietary treatments: 1) 0 mg/kg L-carnitine + 0% fat, 2) 200 mg/kg L-carnitine + 0% fat, 3) 400 mg/kg L-carnitine + 0% fat, 4) 0 mg/kg L-carnitine + 2.5% fat, 5) 200 mg/kg L-carnitine + 2.5% fat, 6) 400 mg/kg L-carnitine + 2.5% fat, 7) 0 mg/kg L-carnitine + 5.0% fat, 8) 200 mg/kg L-carnitine + 5.0% fat, and 9) 400 mg/kg L-carnitine + 5.0% fat. Feed conversion ratio, growth performance, blood biochemical parameters, carcass traits and body composition were measured and analyzed. Levels of fat with L-carnitine had significant effects on the European Performance Efficiency Factor, wings weight, intestine length and weight, spleen and liver weight, full abdomen carcass and abdominal fat weight, as well as serum triglyceride levels. Dietary L-carnitine supplementation improved growth performance of broilers, thus it may be a promising solution to reduce fat storage in broilers and improve the quality of carcasses intended for human consumption.

L-carnitine supplementation in female infertility – is it working?

Introduction and objective: Infertility is estimated to affect around 15% of couples in reproductive age. Due to delayed decision about childbearing and unhealthy lifestyle it is increasing problem in many western countries. For that reason, people seek out supplements to enhance their fertility. L-carnitine is primarily known as a supplement often used by athletes to enhance exercise performance, but some reports suggest that L-carnitine may also have a positive effect on sperm and oocytes quality. The aim of this study was to summarize the published reports about L-carnitine impact on female fertility. Brief description of the state knowledge The primary mechanism of action of L-carnitine involves its role in the transport of long-chain fatty acids into the mitochondria of cells, where they are then metabolized in a process called beta-oxidation to produce energy. L-carnitine also have antioxidant properties, helping to protect cells from oxidative stress. It has also been suggested to play a role in modulating signaling pathways involved in metabolism, inflammation, and cellular growth and differentiation. Due to wide range of possible mechanisms of action L-carnitine is considered as a potential supplement for fertility. Summary The presented literature review suggests that L-carnitine has a promising effect on improving female fertility, especially when it comes to clomiphene citrate-resistant patients with polycystic ovary syndrome and in vitro fertilization. However, further studies are needed to confirm its role and exclude possible side effects of its use before it is routinely recommended for this indication.

Effects of L-Carnitine Intake on Exercise-Induced Muscle Damage and Oxidative Stress: A Narrative Scoping Review.

Exercise-induced muscle damage results in decreased physical performance that is accompanied by an inflammatory response in muscle tissue. The inflammation process occurs with the infiltration of phagocytes (neutrophils and macrophages) that play a key role in the repair and regeneration of muscle tissue. In this context, high intensity or long-lasting exercise results in the breakdown of cell structures. The removal of cellular debris is performed by infiltrated phagocytes, but with the release of free radicals as collateral products. L-carnitine is a key metabolite in cellular energy metabolism, but at the same time, it exerts antioxidant actions in the neuromuscular system. L-carnitine eliminates reactive oxygen and nitrogen species that, in excess, alter DNA, lipids and proteins, disturbing cell function. Supplementation using L-carnitine results in an increase in serum L-carnitine levels that correlates positively with the decrease in cell alterations induced by oxidative stress situations, such as hypoxia. The present narrative scoping review focuses on the critical evaluation of the efficacy of L-carnitine supplementation on exercise-induced muscle damage, particularly in postexercise inflammatory and oxidative damage. Although both concepts appear associated, only in two studies were evaluated together. In addition, other studies explored the effect of L-carnitine in perception of fatigue and delayed onset of muscle soreness. In view of the studies analyzed and considering the role of L-carnitine in muscle bioenergetics and its antioxidant potential, this supplement could help in postexercise recovery. However, further studies are needed to conclusively clarify the mechanisms underlying these protective effects.

Immune-mediated polyneuropathy in cats: Clinical description, electrodiagnostic assessment, and treatment.

Suspected immune-mediated polyneuropathy has been increasingly reported in cats, especially in the last decade, but the condition remains poorly understood. Refine the clinical description and review the classification of this condition based on electrodiagnostic investigation and evaluate the benefit of corticosteroid treatment and L-carnitine supplementation. Fifty-five cats presented with signs of muscular weakness and electrodiagnostic findings consistent with polyneuropathy of unknown origin. Retrospective, multicenter study. Data from the medical records were reviewed. The owners were contacted by phone for follow-up at the time of the study. The male-to-female ratio was 2.2. The median age of onset was 10 months, with 91% of affected cats being <3 years of age. Fourteen breeds were represented in the study. The electrodiagnostic findings supported purely motor axonal polyneuropathy. Histological findings from nerve biopsies were consistent with immune-mediated neuropathy in 87% of the tested cats. The overall prognosis for recovery was good to excellent, as all but 1 cat achieved clinical recovery, with 12% having mild sequelae and 28% having multiple episodes during their lifetime. The outcome was similar in cats with no treatment when compared with cats receiving corticosteroids or L-carnitine supplementation. Immune-mediated motor axonal polyneuropathy should be considered in young cats with muscle weakness. This condition may be similar to acute motor axonal neuropathy in Guillain-Barré syndrome patients. Based on our results, diagnostic criteria have been proposed.

The Effect of L-carnitine Supplementation on Liver Function, Folate and Vitamin B12 Levels in Patients with Type 2 Diabetes Mellitus: A Randomized, Double-Blind, Clinical Trial

Background: Carnitine is necessary for allowing the long-chain fatty acids to pass the inner mitochondrial membrane to induce β -oxidation. Lack of carnitine and abnormalities of mitochondria play an important role in forming fatty deposition in the liver, and hence, developing steatohepatitis. Carnitine and acylcarnitine identified in human erythrocytes and intra-erythrocyte acetylcarnitine have a significant relationship with the plasma levels.&#x0D; Methods: The present study was conducted to investigate the possible effects of L-carnitine on liver function, folate and vitamin B12 levels in patients with type 2 diabetes mellitus (T2DM). In this study, 70 patients with T2DM were randomly assigned to either a L-carnitine (CG) and a placebo group (PG). For 12 weeks, the first group received 1000 mg/d oral L-carnitine, whereas the second group received 1000 mg/day wheat starch as placebo. The alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), folate, Vitamin B12, complete blood count (CBC) including blood cells and indicators related to anemia were assessed at baseline.&#x0D; Results: 64 patients managed to complete the study (32 in each group). The results indicated that consumption of L-carnitine compared with placebo had no significant effect on liver enzymes, folate, vitamin B12, and CBC with differential.&#x0D; Conclusions: Daily intake of 1000 mg L-carnitine for 12 weeks had no effect on liver function and anemia indicators including CBC, folate, and vitamins B12.

Efficacy and safety of carnitine supplementation on NAFLD: a systematic review and meta-analysis

Background and objectiveThe efficacy and safety of L-carnitine supplementation on non-alcoholic fatty liver disease (NAFLD) are unclear. This systematic review and meta-analysis aimed to assess the efficacy and safety of L-carnitine supplementation on NAFLD.MethodsWe searched in four databases (PubMed, Embase, Cochrane Library, and Web of Science) from inception to 1 November 2022 (updated on March 20, 2023) for potentially relevant records without language restrictions. We collected information on the first author, publication year, country, setting, study design, population characteristics, duration of follow-up, outcome variables of interest, and sources of funding. We used a modified Cochrane risk of bias tool to assess the risk of bias, used GRADE to assess the certainty of evidence, and used the Credibility of Effect Modification Analyses (ICEMAN) tool to assess the credibility of any apparent subgroup effect.ResultsThis systematic review and meta-analysis included eight eligible randomized controlled trials (RCTs). Compared to placebo, low certainty evidence show that L-carnitine supplementation significantly changes (reduced) more in AST levels and ALT levels (MD: − 26.38, 95%CI: − 45.46 to − 7.30), and moderate certainty evidence show that L-carnitine supplementation significantly changes (reduced) more in HDL cholesterol levels (MD: 1.14, 95%CI: 0.21 to 2.07) and triglyceride levels (MD: − 6.92, 95%CI: − 13.82 to − 0.03). Moderate credibility of ICEMAN results shows that L-carnitine supplementation has no difference in changes of AST and ALT levels in younger ones (MD: 0.5, 95%CI: − 0.70 to 1.70) but has significant changes (reduced) in adults (MD: − 20.3, 95%CI: − 28.62 to − 12.28) compared to placebo.ConclusionL-carnitine supplementation may improve liver function and regulate triglyceride metabolism in patients with NAFLD, and with no significant adverse effects.