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Eser B, Dogan I, Kayadibi H. The relationship between cognitive impairment and fatty acids and carnitine in hemodialysis patients. Nefrologia 2024; 44:40-49. [PMID: 36517361 DOI: 10.1016/j.nefroe.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/20/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND/AIM The prevalence of cognitive impairment (CI) is high in hemodialysis patients. In this study, the relationship between CI and serum carnitine, plasma omega-3, omega-6 and omega-3/omega-6 fatty acid ratio was evaluated in hemodialysis patients. MATERIALS AND METHODS Sixty two patients [male: 40 (64.5%), mean age 51±13 years] were included in this cross-sectional study. Serum total and free-carnitine levels were determined by ELISA. Plasma omega-3 [eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)] and omega-6 [arachidonic acid (AA), dihomo gamma linoleic acid (DGLA)] levels were measured using LC-ESI-MS/MS. According to the Montreal Cognitive Assessment (MoCA) scores, ≤24 points were considered as CI. MoCA score ≤24 and >24 were determined as Group 1 and Group 2, respectively. RESULTS Group 1 had significantly higher AA+DGLA/EPA+DHA ratios and lower free-carnitine, DHA and EPA+DHA levels compared to Group 2 (P=0.008, P=0.040, P=0.032, P=0.032, respectively). Group 1 had a statistically lower education level (P<0.05). Negative correlation was found between MoCA scores and AA+DGLA/EPA+DHA ratios (rs=-0.284, P=0.026). Free-carnitine levels were positively correlated with EPA and EPA+DHA levels (rs=0.278, P=0.030 and rs=0.271, P=0.034, respectively), and negative correlated with AA+DGLA/EPA+DHA ratios (rs=-0.414, P=0.001). In multivariate logistic regression analysis, MoCA scores was associated with AA+DGLA/EPA+DHA ratio (P=0.009) and education level (P<0.001). CONCLUSION It was determined that high AA+DGLA/EPA+DHA ratio and low education level could be independent risk factors of the CI. It has been shown that free-carnitine level can have positive effects on plasma EPA+DHA and AA+DGLA distributions. Low omega-3 fatty acid levels may be associated with CI in hemodialysis patients, and low carnitine level may contribute partially to this process. In addition, cognitive education programs may have an effect on preventing CI in hemodialysis patients with low education levels.
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Affiliation(s)
- Baris Eser
- Hitit University Faculty of Medicine, Department of Nephrology, 19200 Corum, Turkey.
| | - Ibrahim Dogan
- Hitit University Faculty of Medicine, Department of Nephrology, 19200 Corum, Turkey
| | - Huseyin Kayadibi
- Eskisehir Osmangazi University Faculty of Medicine, Department of Medical Biochemistry, Eskisehir, Turkey
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Zamani M, Pahlavani N, Nikbaf-Shandiz M, Rasaei N, Ghaffarian-Ensaf R, Asbaghi O, Shiraseb F, Rastgoo S. The effects of L-carnitine supplementation on glycemic markers in adults: A systematic review and dose-response meta-analysis. Front Nutr 2023; 9:1082097. [PMID: 36704801 PMCID: PMC9871499 DOI: 10.3389/fnut.2022.1082097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Background and aims Hyperglycemia and insulin resistance are concerns today worldwide. Recently, L-carnitine supplementation has been suggested as an effective adjunctive therapy in glycemic control. Therefore, it seems important to investigate its effect on glycemic markers. Methods PubMed, Scopus, Web of Science, and the Cochrane databases were searched in October 2022 for prospective studies on the effects of L-carnitine supplementation on glycemic markers. Inclusion criteria included adult participants and taking oral L-carnitine supplements for at least seven days. The pooled weighted mean difference (WMD) was calculated using a random-effects model. Results We included the 41 randomized controlled trials (RCTs) (n = 2900) with 44 effect sizes in this study. In the pooled analysis; L-carnitine supplementation had a significant effect on fasting blood glucose (FBG) (mg/dl) [WMD = -3.22 mg/dl; 95% CI, -5.21 to -1.23; p = 0.002; I 2 = 88.6%, p < 0.001], hemoglobin A1c (HbA1c) (%) [WMD = -0.27%; 95% CI, -0.47 to -0.07; p = 0.007; I 2 = 90.1%, p < 0.001] and homeostasis model assessment-estimate insulin resistance (HOMA-IR) [WMD = -0.73; 95% CI, -1.21 to -0.25; p = 0.003; I 2 = 98.2%, p < 0.001] in the intervention compared to the control group. L-carnitine supplementation had a reducing effect on baseline FBG ≥100 mg/dl, trial duration ≥12 weeks, intervention dose ≥2 g/day, participants with overweight and obesity (baseline BMI 25-29.9 and >30 kg/m2), and diabetic patients. Also, L-carnitine significantly affected insulin (pmol/l), HOMA-IR (%), and HbA1c (%) in trial duration ≥12 weeks, intervention dose ≥2 g/day, and participants with obesity (baseline BMI >30 kg/m2). It also had a reducing effect on HOMA-IR in diabetic patients, non-diabetic patients, and just diabetic patients for insulin, and HbA1c. There was a significant nonlinear relationship between the duration of intervention and changes in FBG, HbA1c, and HOMA-IR. In addition, there was a significant nonlinear relationship between dose (≥2 g/day) and changes in insulin, as well as a significant linear relationship between the duration (weeks) (coefficients = -16.45, p = 0.004) of intervention and changes in HbA1C. Conclusions L-carnitine could reduce the levels of FBG, HbA1c, and HOMA-IR. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022358692.
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Affiliation(s)
- Mohammad Zamani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Naseh Pahlavani
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat-e Heydariyeh, Iran,Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | | | - Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran,*Correspondence: Farideh Shiraseb ✉
| | - Samira Rastgoo
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Department of Cellular and Molecular Nutrition, Faculty of Nutrition Science and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Samira Rastgoo ✉
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Al-Dhuayan IS. Biomedical role of L-carnitine in several organ systems, cellular tissues, and COVID-19. BRAZ J BIOL 2023; 82:e267633. [PMID: 36629544 DOI: 10.1590/1519-6984.267633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/20/2022] [Indexed: 01/11/2023] Open
Abstract
Carnitine is a conditionally necessary vitamin that aids in energy creation and fatty acid metabolism. Its bioavailability is higher in vegetarians than in meat-eaters. Deficits in carnitine transporters occur because of genetic mutations or in conjunction with other illnesses. Carnitine shortage can arise in health issues and diseases-including hypoglycaemia, heart disease, starvation, cirrhosis, and ageing-because of abnormalities in carnitine control. The physiologically active form of L-carnitine supports immunological function in diabetic patients. Carnitine has been demonstrated to be effective in the treatment of Alzheimer's disease, several painful neuropathies, and other conditions. It has been used as a dietary supplement for the treatment of heart disease, and it also aids in the treatment of obesity and reduces blood glucose levels. Therefore, L-carnitine shows the potential to eliminate the influences of fatigue in COVID-19, and its consumption is recommended in future clinical trials to estimate its efficacy and safety. This review focused on carnitine and its effect on tissues, covering the biosynthesis, metabolism, bioavailability, biological actions, and its effects on various body systems and COVID-19.
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Affiliation(s)
- I S Al-Dhuayan
- Imam Abdulrahman Bin Faisal University, College of Science, Department of Biology, Dammam, Saudi Arabia
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The Association of Serum L-Carnitine Concentrations with the Risk of Cancer in Chinese Adults with Hypertension. Nutrients 2022; 14:nu14234999. [PMID: 36501029 PMCID: PMC9738465 DOI: 10.3390/nu14234999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The effect of serum L-carnitine (LC) concentrations on cancer risk remains unclear. This study aims to explore the association between serum LC and the risk of incident cancer. METHODS This is a case-control study, including 574 patients with incident cancer and 574 controls matched in a 1:1 ratio by age, sex, and residence, nested within the China H-Type Hypertension Registry Study (CHHRS). Conditional logistic regression analysis was used to assess the association of serum LC and incident cancer risk. RESULTS When LC was assessed as quartiles, compared with patients with low LC (Q1), patients in the highest quartile (Q4) had a 33% (OR = 0.67, 95% CI: 0.46 to 0.99), 52% (OR = 0.48, 95% CI: 0.23 to 0.99), and 39% (OR = 0.61, 95% CI: 0.38 to 0.99) decreased risk of overall, digestive system, and non-digestive system cancer in the adjusted models, respectively. In subgroup analyses, an inverse association of LC with cancer risk was observed in individuals who were overweight (obese), who never drink, who never smoke, and who were female. In the mediation analysis, serum trimethylamine-N-oxide (TMAO) concentrations did not mediate the reversed association of LC with cancer risk. CONCLUSIONS This study showed that serum LC concentrations had a protective impact on overall, digestive system, and non-digestive system cancer risk.
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Chai X, Pan M, Wang J, Feng M, Wang Y, Zhang Q, Sun Y. Cordycepin exhibits anti-fatigue effect via activating TIGAR/SIRT1/PGC-1α signaling pathway. Biochem Biophys Res Commun 2022; 637:127-135. [DOI: 10.1016/j.bbrc.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 10/28/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
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Chen X, Gu M, Hong Y, Duan R, Zhou J. Association of Trimethylamine N-Oxide with Normal Aging and Neurocognitive Disorders: A Narrative Review. Brain Sci 2022; 12:brainsci12091203. [PMID: 36138939 PMCID: PMC9497232 DOI: 10.3390/brainsci12091203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/30/2022] [Accepted: 09/04/2022] [Indexed: 11/16/2022] Open
Abstract
Aging-related neurocognitive disorder (NCD) is a growing health concern. Trimethylamine-N-oxide (TMAO), a gut microbiota-derived metabolite from dietary precursors, might emerge as a promising biomarker of cognitive dysfunction within the context of brain aging and NCD. TMAO may increase among older adults, Alzheimer’s disease patients, and individuals with cognitive sequelae of stroke. Higher circulating TMAO would make them more vulnerable to age- and NCD-related cognitive decline, via mechanisms such as promoting neuroinflammation and oxidative stress, and reducing synaptic plasticity and function. However, these observations are contrary to the cognitive benefit reported for TMAO through its positive effects on blood–brain barrier integrity, as well as from the supplementation of TMAO precursors. Hence, current disputable evidence does not allow definite conclusions as to whether TMAO could serve as a critical target for cognitive health. This article provides a comprehensive overview of TMAO documented thus far on cognitive change due to aging and NCD.
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Xu Y, Lian Y, Li J, Zhang Y, Liu Y, Wang X, Ma J, Li F. KangPiLao decoction modulates cognitive and emotional disorders in rats with central fatigue through the GABA/Glu pathway. Front Pharmacol 2022; 13:939169. [PMID: 36120289 PMCID: PMC9478895 DOI: 10.3389/fphar.2022.939169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Central fatigue (CF) is a subjective sense of tiredness associated with cognitive and memory disorders, accompanied by reduced physical endurance and negative emotions, such as anxiety and depression. Disease progression and prognosis with regards to CF have been unfavorable and possibly contribute to dementia, schizophrenia, and other diseases. Additionally, effective treatments for CF are lacking. KangPiLao decoction (KPLD) has been widely applied in clinical treatment and is composed of six Chinese herbal medicines, some of which have confirmed anti-fatigue effects. While glutamic acid (Glu) is the main excitatory transmitter in the central nervous system (CNS), gamma-aminobutyric acid (GABA) is the major inhibitory transmitter. Both are involved in emotional, cognitive, and memory functions. This research was designed to explore how KPLD regulates cognitive and emotional disorders in rats with CF and to identify the relationship between the regulatory effect and the GABA/Glu pathway. Methods: The compounds comprising KPLD were analyzed using high-performance liquid chromatography-mass spectrometry. Sixty Wistar rats were randomly divided into six groups. The modified multiple platform method was used to induce CF. Cognitive, emotional, and fatigue states were evaluated by performing behavioral tests (Morris water maze [MWM], open-field test [OFT], and grip strength test). Histomorphology, western blotting, immunohistochemistry, and RT-qPCR were performed to investigate protein and mRNA expression levels in the hippocampus and prefrontal cortexes involved in the GABA/Glu pathway. Results: Rats with CF exhibited impaired spatial cognition and increased negative emotions in the MWM and OFT. KPLD enabled the improvement of these symptoms, especially in the high-concentration group. Western blotting and RT-qPCR demonstrated that the expression of GABAARα1, GABAARγ2, GABABR1, and GAD67 in rats with CF was higher, whereas GAT-1 and NMDAR2B were lower in the hippocampus and prefrontal cortex. KPLD decreased the expression of GABAARα1, GABABR1, GABAARγ2, and GAD67 in the hippocampus and prefrontal cortex and enhanced the expression of NR2B in the prefrontal cortex. Conclusion: KPLD significantly improved cognitive and emotional disorders in rats with CF by regulating the GABA/Glu pathway. Overall, KPLD may be a promising candidate for developing a drug for treating CF.
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Affiliation(s)
- Yifei Xu
- Beijing University of Chinese Medicine, Beijing, China
| | - Yajun Lian
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Li
- Beijing University of Chinese Medicine, Beijing, China
| | - Yifei Zhang
- Beijing University of Chinese Medicine, Beijing, China
| | - Yan Liu
- Beijing University of Chinese Medicine, Beijing, China
| | - Xuejiao Wang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Ma
- Beijing University of Chinese Medicine, Beijing, China
| | - Feng Li
- Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Feng Li,
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DiNicolantonio JJ, McCarty MF, Assanga SI, Lujan LL, O'Keefe JH. Ferulic acid and berberine, via Sirt1 and AMPK, may act as cell cleansing promoters of healthy longevity. Open Heart 2022; 9:openhrt-2021-001801. [PMID: 35301252 PMCID: PMC8932268 DOI: 10.1136/openhrt-2021-001801] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 03/08/2022] [Indexed: 12/11/2022] Open
Abstract
Ferulic acid, a bacterial metabolite of anthocyanins, seems likely to be a primary mediator of the health benefits associated with anthocyanin-rich diets, and has long been employed in Chinese cardiovascular medicine. In rodent studies, it has exerted wide-ranging antioxidant and anti-inflammatory effects, the molecular basis of which remains rather obscure. However, recent studies indicate that physiologically relevant concentrations of ferulic acid can boost expression of Sirt1 at mRNA and protein levels in a range of tissues. Sirt1, a class III deacetylase, functions to detect a paucity of oxidisable substrate, and in response works in various ways to promote cellular survival and healthful longevity. Sirt1 promotes ‘cell cleansing’ and cell survival by boosting autophagy, mitophagy, mitochondrial biogenesis, phase 2 induction of antioxidant enzymes via Nrf2, and DNA repair—while inhibiting NF-kB-driven inflammation, apoptosis, and cellular senescence, and boosting endothelial expression of the protective transcription factor kruppel-like factor 2. A deficit of the latter appears to mediate the endothelial toxicity of the SARS-CoV-2 spike protein. Ferulic acid also enhances the activation of AMP-activated kinase (AMPK) by increasing expression and activity of its activating kinase LKB1—whereas AMPK in turn amplifies Sirt1 activity by promoting induction of nicotinamide phosphoribosyltranferase, rate-limiting for generation of Sirt1’s obligate substrate NAD+. Curiously, AMPK acts by independent mechanisms to potentiate many of the effects mediated by Sirt1. Hence, it is proposed that ferulic acid may exert complementary or synergistic health-promoting effects when used in conjunction with clinically useful AMPK activators, such as the nutraceutical berberine. Additional nutraceuticals which might have potential for amplifying certain protective effects of ferulic acid/berberine are also discussed.
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Affiliation(s)
- James J DiNicolantonio
- Preventive Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA
| | | | - Simon Iloki Assanga
- Department of Research and Postgraduate in Food Science, University of Sonora, Hermosillo, Mexico
| | - Lidianys Lewis Lujan
- Department of Research and Postgraduate in Food Science, University of Sonora, Hermosillo, Mexico
| | - James H O'Keefe
- Charles and Barbara Duboc Cardio Health & Wellness Center, St Luke's Mid America Heart Institute, Kansas City, Missouri, USA
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Eser B, Dogan I, Kayadibi H. The relationship between cognitive impairment and fatty acids and carnitine in hemodialysis patients. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Che B, Chen H, Wang A, Peng H, Bu X, Zhang J, Ju Z, Xu T, He J, Zhong C, Zhang Y. Association Between Plasma L-Carnitine and Cognitive Impairment in Patients with Acute Ischemic Stroke. J Alzheimers Dis 2022; 86:259-270. [DOI: 10.3233/jad-215376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: L-carnitine has been shown to exert neuroprotective effects on cerebral ischemia, mainly by improving mitochondrial function and reducing inflammation. L-carnitine supplementation has also been promoted to enhance cognitive function. However, the relationship between L-carnitine and cognitive impairment after ischemic stroke has seldom been studied. Objective: We aimed to evaluate the association between plasma L-carnitine and poststroke cognitive impairment. Methods: The study sample population was drawn from the China Antihypertensive Trial in Acute Ischemic Stroke. Plasma L-carnitine were measured at baseline in 617 patients with ischemic stroke using ultrahigh-performance liquid chromatography-tandem mass spectrometry. Cognitive function was evaluated using the Montreal Cognitive Assessment at 3-month follow-up after ischemic stroke. Results: Plasma L-carnitine were inversely associated with cognitive impairment at 3 months after ischemic stroke, and the adjusted odds ratio (95% CI) for the highest versus lowest quartiles of L-carnitine was 0.60 (0.37, 0.98; p for trend = 0.04). Each 1-SD increase in log-transformed L-carnitine concentration was significantly associated with a 15% (95% CI: 1%, 29%) reduction in the risk of cognitive impairment after stroke. The addition of L-carnitine to the model including conventional risk factors significantly improved the risk reclassification for cognitive impairment (net reclassification improvement: 17.9%, integrated discrimination improvement: 0.8% ; both p < 0.05). Furthermore, joint effects of L-carnitine and inflammation markers were observed, and patients with higher L-carnitine and a lower inflammatory status simultaneously had the lowest risk of poststroke cognitive impairment. Conclusion: The present study provided prospective evidence on the inverse association between plasma L-carnitine and cognitive impairment after ischemic stroke.
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Affiliation(s)
- Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Haichang Chen
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Xiaoqing Bu
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jintao Zhang
- Department of Neurology, The 88th Hospital of PLA, Shandong, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People’s Hospital of Tongliao City, Tongliao, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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Sawicka AK, Jaworska J, Brzeska B, Sabisz A, Samborowska E, Radkiewicz M, Szurowska E, Winklewski PJ, Szarmach A, Olek RA. L-Carnitine Combined with Leucine Supplementation Does Not Improve the Effectiveness of Progressive Resistance Training in Healthy Aged Women. J Nutr Health Aging 2022; 26:945-953. [PMID: 36259583 DOI: 10.1007/s12603-022-1848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To evaluate the effect of L-carnitine (LC) in combination with leucine supplementation on muscle strength and muscle hypertrophy in aged women participating in a resistance exercise training (RET) program. DESIGN/SETTING/PARTICIPANTS Thirty-seven out of sixty (38.3% dropout) healthy women aged 60-75 years (mean 67.6 ± 0.7 years) completed the intervention in one of three groups. One of the supplemented groups received 1 g of L-carnitine-L-tartrate in combination with 3 g of L-leucine per day (LC+L group; n = 12), and the second supplemented group received 4 g of L-leucine per day (L group; n = 13). The control group (CON group; n = 12) received no supplementation. INTERVENTION All three groups completed the same RET protocol involving exercise sessions twice per week for 24 weeks. MEASUREMENTS Before and after the experiment, participants performed isometric and isokinetic muscle strength testing on the Biodex dynamometer. The cross-sectional areas of the major knee extensors and total thigh muscles were assessed using magnetic resonance imaging. Fasting serum levels of insulin-like growth factor-1 (IGF-1), myostatin and decorin, and plasma levels of total carnitine (TC) and trimethylamine-N-oxide (TMAO) levels were measured. RESULTS The 24-week RET significantly increased muscle strength and muscle volume, but the group and time interactions were not significant for the muscle variables analyzed. Plasma total carnitine increased only in the LC+L group (p = 0.009). LC supplementation also caused a significant increase in plasma TMAO, which was higher after the intervention in the LC+L group than in the L (p < 0.001), and CON (p = 0.005) groups. The intervention did not change plasma TMAO concentration in the L (p = 0.959) and CON (p = 0.866) groups. After the intervention serum decorin level was higher than before in both supplemented groups combined (p = 0.012), still not significantly different to post intervention CON (p = 0.231). No changes in serum IGF-1 and myostatin concentrations and no links between the changes in blood markers and muscle function or muscle volume were observed. CONCLUSIONS LC combined with leucine or leucine alone does not appear to improve the effectiveness of RET.
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Affiliation(s)
- A K Sawicka
- Robert A. Olek, Department of Athletics, Strength, and Conditioning, Poznan University of Physical Education, Krolowej Jadwigi 27/39; 61-871 Poznan, Poland, e-mail: , ORCID: 0000-0002-3714-7386
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Sokolova L, Starykh E. Asthenic syndrome in general therapeutic practice. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:44-51. [DOI: 10.17116/jnevro202212204144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Vaziri-Harami R, Delkash P. Can l-carnitine reduce post-COVID-19 fatigue? Ann Med Surg (Lond) 2021; 73:103145. [PMID: 34925826 PMCID: PMC8667465 DOI: 10.1016/j.amsu.2021.103145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/16/2022] Open
Abstract
A significant number of patients infected with the new coronavirus suffer from chronic fatigue syndrome after COVID-19, and their symptoms may persist for months after the infection. Nevertheless, no particular treatment for post-disease fatigue has been found. At the same time, many clinical trials have shown the effectiveness of l-carnitine in relieving fatigue caused by the treatment of diseases such as cancer, MS, and many other diseases. Therefore, it can be considered as a potential option to eliminate the effects of fatigue caused by COVID-19, and its consumption is recommended in future clinical trials to evaluate its effectiveness and safety. The coronavirus disease is a viral infection that could induce different respiratory. A significant number of patients infected with the new coronavirus suffer from chronic fatigue. Clinical trials have shown the effectiveness of L-carnitine in relieving fatigue.
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Affiliation(s)
- Roya Vaziri-Harami
- Department of Psychiatry, School of Medicine, Behavioural Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Delkash
- Department of Adult Rheumatology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Vecchio M, Chiaramonte R, Testa G, Pavone V. Clinical Effects of L-Carnitine Supplementation on Physical Performance in Healthy Subjects, the Key to Success in Rehabilitation: A Systematic Review and Meta-Analysis from the Rehabilitation Point of View. J Funct Morphol Kinesiol 2021; 6:jfmk6040093. [PMID: 34842765 PMCID: PMC8628984 DOI: 10.3390/jfmk6040093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 10/01/2021] [Accepted: 10/31/2021] [Indexed: 11/16/2022] Open
Abstract
L-carnitine supplementation improves body strength, sports endurance and exercise capacity, as well as delaying the onset of fatigue. The aim of this study was to identify the correct dosage of supplementation to obtain improvements in physical performance and evaluate the changes related to L-carnitine supplementation in specific metabolic parameters, such as serum lactate, VO2, serum total and free carnitine at rest and after physical activities, in healthy subjects. The search was conducted on PubMed, EMBASE, Cochrane Library, Scopus and Web of Science and identified 6404 articles with the keywords: "carnitine" AND "exercises" OR "rehabilitation" OR "physical functional performance" OR "physical activity" OR "sports" OR "health" OR "healthy". A total of 30 publications met the inclusion criteria and were included in the systematic review. The meta-analysis did not show any significant differences in serum lactate values at rest and after exercise in healthy subjects who took L-carnitine supplementation (p > 0.05). On the contrary, L-carnitine administration significantly changed maximal oxygen consumption (VO2) at rest (p < 0.005), serum free and total carnitine at rest and after exercise (p < 0.001). The dosage of supplementation that obtained a significant change in serum total carnitine was 2 g/dL for 4 weeks at rest, 1 g/dL for 3 weeks after exercise, and in serum free carnitine was 2 g/dL for 3 weeks and 2 g/dL for 4 weeks at rest. Based on our study, serum total and free carnitine at rest and after exercise, and VO2 at rest could be used to clinically follow individuals during physical activity and rehabilitation programs. Moreover, the supplementation should have a correct dosage to have maximum effect. Other robust trials are needed to find the best dosage to obtain positive results in metabolic parameters and in physical performance.
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Affiliation(s)
- Michele Vecchio
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy
- Rehabilitation Unit, “AOU Policlinico Vittorio Emanuele”, 95123 Catania, Italy
- Correspondence: (M.V.); (R.C.); Tel.: +39-095-378-27-03 (M.V.); Fax: +39-095-731-53-84 (R.C.)
| | - Rita Chiaramonte
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy
- Correspondence: (M.V.); (R.C.); Tel.: +39-095-378-27-03 (M.V.); Fax: +39-095-731-53-84 (R.C.)
| | - Gianluca Testa
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico “Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.T.); (V.P.)
| | - Vito Pavone
- Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico “Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.T.); (V.P.)
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15
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Cenko E, Chen H, Gill TM, Glynn NW, Henderson RM, King AC, Pahor M, Qiu P, Rego A, Reid KF, Tudor-Locke C, Valiani V, You L, Manini TM. Ratings of Perceived Exertion During Walking: Predicting Major Mobility Disability and Effect of Structured Physical Activity in Mobility-Limited Older Adults. J Gerontol A Biol Sci Med Sci 2021; 76:e264-e271. [PMID: 33585918 DOI: 10.1093/gerona/glab036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study evaluated the association between ratings of perceived exertion (RPE) of walking and major mobility disability (MMD), as well as their transitions in response to a physical activity (PA) compared to a health education (HE) program. METHODS Older adults (n = 1633) who were at risk for mobility impairment were randomized to structured PA or HE programs. During a 400 m walk, participants rated exertion as "light" or "hard." An MMD event was defined as the inability to walk 400 m. MMD events and RPE values were assessed every 6 months for an average of 2.6 years. RESULTS Participants rating their exertion as "hard" had a nearly threefold higher risk of MMD compared with those rating their exertion as "light" (HR: 2.61, 95% CI: 2.19-3.11). The association was held after adjusting for disease conditions, depression, cognitive function, and walking speed (HR: 2.24, 95% CI: 1.87-2.69). The PA group was 25% more likely to transition from "light" to "hard" RPE than the HE group (HR: 1.25, 95% CI: 1.05-1.49). Additionally, the PA group was 27% (HR: 0.73, 95% CI: 0.55 - 0.97) less likely to transition from a "hard" RPE to inability to walk 400 m and was more likely to recover their ability to walk 400 m by transitioning to a "hard" RPE (HR: 2.10, 95% CI: 1.39-3.17) than the HE group. CONCLUSIONS Older adults rating "hard" effort during a standardized walk test were at increased risk of subsequent MMD. A structured PA program enabled walking recovery, but was more likely to increase transition from "light" to "hard" effort, which may reflect the greater capacity to perform the test.
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Affiliation(s)
- Erta Cenko
- Department of Epidemiology, University of Florida, Gainesville, USA
| | - Haiying Chen
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Thomas M Gill
- Department of Internal Medicine, Division of Geriatric Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Nancy W Glynn
- Department of Epidemiology, University of Pittsburgh, Pennsylvania, USA
| | - Rebecca M Henderson
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Abby C King
- Department of Health Research and Policy, Stanford University, California, USA
| | - Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville, USA
| | - Peihua Qiu
- Department of Biostatistics, University of Florida, Gainesville, USA
| | - Alvito Rego
- Division of General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois, USA
| | - Kieran F Reid
- Nutrition, Exercise Physiology and Sarcopenia Lab, Tufts University, Boston, Massachusetts, USA
| | | | - Vincenzo Valiani
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Italy
| | - Lu You
- Department of Biostatistics, University of Florida, Gainesville, USA
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, USA
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Statsenko ME, Turkina SV. [Possibilities of sequential levocarnitin and acetylcarnitin treatment in correcting cognitive deficiency in patients with cardiovascular diseases]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:45-51. [PMID: 34184477 DOI: 10.17116/jnevro202112105145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of sequential therapy with levocarnitine and acetylcarnitine in patients with cardiovascular pathology (arterial hypertension and/or coronary heart disease) and moderate cognitive deficits. MATERIAL AND METHODS The study included 120 patients aged 54-67 years. The main group of patients (n=60) in addition to the basic treatment of the underlying disease received l-carnitine (Elkar solution for intravenous and intramuscular injection of 100 mg/ml, the company «PIK-FARMA»)/jet during 10 days in a dose of 1000 mg/day, with following transition to oral administration of acetyl-l-carnitine (Carnitin, the company «PIK-FARMA»), 500 mg (2 cap Sula) 2 times a day for 2 months. The comparison group (n=60) received basic therapy for major diseases. The total duration of follow-up was 70 days. RESULTS The results obtained indicate that in such comorbid patients, the use of levocarnitine and acetylcarnitine reduces the severity of cognitive deficits. An important aspect of their pathogenetic effect on the severity of cognitive deficits may be the possibility of correcting endothelial dysfunction. The use of levocarnitine and acetylcarnitine in patients with cardiovascular pathology has demonstrated good tolerability and safety.
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Affiliation(s)
- M E Statsenko
- Volgograd State Medical University, Volgograd, Russia
| | - S V Turkina
- Volgograd State Medical University, Volgograd, Russia
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17
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Knoop V, Cloots B, Costenoble A, Debain A, Vella Azzopardi R, Vermeiren S, Jansen B, Scafoglieri A, Bautmans I. Fatigue and the prediction of negative health outcomes: A systematic review with meta-analysis. Ageing Res Rev 2021; 67:101261. [PMID: 33548508 DOI: 10.1016/j.arr.2021.101261] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/23/2020] [Accepted: 01/24/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Fatigue is a common complaint among older adults. Evidence grows that fatigue is linked to several negative health outcomes. A general overview of fatigue and its relationship with negative health outcomes still lacks in the existing literature. This brings complications for healthcare professionals and researchers to identify fatigue-related health risks. Therefore, this study gives an overview of the prospective predictive value of the main negative health outcomes for fatigue in community-dwelling older adults. METHODS PubMed, Web of Knowledge and PsycINFO were systematically screened for prospective studies regarding the relationship between fatigue and negative health outcomes resulting in 4595 articles (last search 5th March 2020). Meta-analyses were conducted in RevMan using Odds ratios (ORs), Hazard ratios (HRs) and relative risk ratios (RR) that were extracted from the included studies. Subgroup-analyses were performed based on (1) gender (male/female), (2) length of follow-up and (3) fatigue level (low, medium and high). RESULTS In total, thirty articles were included for this systematic review and meta-analysis encompassing 152 711 participants (age range 40-98 years), providing information on the relationship between fatigue and health outcomes. The results showed that fatigue is related to an increased risk for the occurrence of all studied health outcomes (range OR 1.299-3.094; HR/RR 1.038-1.471); for example, mortality OR 2.14 [1.74-2.63]; HR/RR 1.44 [1.28-1.62]), the development of disabilities in basic activities of daily living (OR 3.22 [2.05-5.38]), or the occurrence of physical decline (OR 1.42 [1.29-1.57]). CONCLUSION Overall fatigue increases the risk for developing negative health outcomes. The analyses presented in this study show that fatigue related physical decline occurs earlier than hospitalization, diseases and mortality, suggesting the importance of early interventions.
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Affiliation(s)
- V Knoop
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - B Cloots
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - A Costenoble
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - A Debain
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium
| | - R Vella Azzopardi
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium
| | - S Vermeiren
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - B Jansen
- Department of Electronics and Informatics ETRO, Vrije Universiteit Brussel (VUB), Elsene, Belgium; Imec, Leuven, Belgium
| | - A Scafoglieri
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Supporting Clinical Science Department and Research Department of Experimental Anatomy (EXAN), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - I Bautmans
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium.
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Takashima H, Maruyama T, Abe M. Significance of Levocarnitine Treatment in Dialysis Patients. Nutrients 2021; 13:1219. [PMID: 33917145 PMCID: PMC8067828 DOI: 10.3390/nu13041219] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/01/2021] [Accepted: 04/04/2021] [Indexed: 01/04/2023] Open
Abstract
Carnitine is a naturally occurring amino acid derivative that is involved in the transport of long-chain fatty acids to the mitochondrial matrix. There, these substrates undergo β-oxidation, producing energy. The major sources of carnitine are dietary intake, although carnitine is also endogenously synthesized in the liver and kidney. However, in patients on dialysis, serum carnitine levels progressively fall due to restricted dietary intake and deprivation of endogenous synthesis in the kidney. Furthermore, serum-free carnitine is removed by hemodialysis treatment because the molecular weight of carnitine is small (161 Da) and its protein binding rates are very low. Therefore, the dialysis procedure is a major cause of carnitine deficiency in patients undergoing hemodialysis. This deficiency may contribute to several clinical disorders in such patients. Symptoms of dialysis-related carnitine deficiency include erythropoiesis-stimulating agent-resistant anemia, myopathy, muscle weakness, and intradialytic muscle cramps and hypotension. However, levocarnitine administration might replenish the free carnitine and help to increase carnitine levels in muscle. This article reviews the previous research into levocarnitine therapy in patients on maintenance dialysis for the treatment of renal anemia, cardiac dysfunction, dyslipidemia, and muscle and dialytic symptoms, and it examines the efficacy of the therapeutic approach and related issues.
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Affiliation(s)
| | | | - Masanori Abe
- Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo 173-8610, Japan; (H.T.); (T.M.)
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19
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Martin-Cantero A, Reijnierse EM, Gill BMT, Maier AB. Factors influencing the efficacy of nutritional interventions on muscle mass in older adults: a systematic review and meta-analysis. Nutr Rev 2021; 79:315-330. [PMID: 33031516 PMCID: PMC7876433 DOI: 10.1093/nutrit/nuaa064] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CONTEXT Nutritional interventions stimulate muscle protein synthesis in older adults. To optimize muscle mass preservation and gains, several factors, including type, dose, frequency, timing, duration, and adherence have to be considered. OBJECTIVE This systematic review and meta-analysis aimed to summarize these factors influencing the efficacy of nutritional interventions on muscle mass in older adults. DATA SOURCES A systematic search was performed using the electronic databases MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus from inception date to November 22, 2017, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria included randomized controlled trials, mean or median age ≥65 years, and reporting muscle mass at baseline and postintervention. Exclusion criteria included genetically inherited diseases, anabolic drugs or hormone therapies, neuromuscular electrical stimulation, chronic kidney disease, kidney failure, neuromuscular disorders, and cancer. DATA EXTRACTION Extracted data included study characteristics (ie, population, sample size, age, sex), muscle mass measurements (ie, method, measure, unit), effect of the intervention vs the control group, and nutritional intervention factors (ie, type, composition, dose, duration, frequency, timing, and adherence). DATA ANALYSIS Standardized mean differences and 95%CIs were calculated from baseline to postintervention. A meta-analysis was performed using a random-effects model and grouped by the type of intervention. CONCLUSIONS Twenty-nine studies were included, encompassing 2255 participants (mean age, 78.1 years; SD, 2.22). Amino acids, creatine, β-hydroxy-β-methylbutyrate, and protein with amino acids supplementation significantly improved muscle mass. No effect was found for protein supplementation alone, protein and other components, and polyunsaturated fatty acids. High interstudy variability was observed regarding the dose, duration, and frequency, coupled with inconsistency in reporting timing and adherence. Overall, several nutritional interventions could be effective to improve muscle mass measures in older adults. Because of the substantial variability of the intervention factors among studies, the optimum profile is yet to be established. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42018111306.
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Affiliation(s)
- Aitana Martin-Cantero
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin M T Gill
- Department of Clinical Nutrition, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Plasma acylcarnitines and risk of lower-extremity functional impairment in older adults: a nested case-control study. Sci Rep 2021; 11:3350. [PMID: 33558555 PMCID: PMC7870673 DOI: 10.1038/s41598-021-82912-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 01/27/2021] [Indexed: 01/06/2023] Open
Abstract
Elevated concentrations of acylcarnitines have been associated with higher risk of obesity, type 2 diabetes and cardiovascular disease. The aim of the present study was to assess the association between L-carnitine and acylcarnitine profiles, and 2-year risk of incident lower-extremity functional impairment (LEFI). This case–control study is nested in the Seniors-ENRICA cohort of community-dwelling older adults, which included 43 incident cases of LEFI and 86 age- and sex- matched controls. LEFI was assessed with the Short Physical Performance Battery. Plasma L-carnitine and 28 acylcarnitine species were measured. After adjusting for potential confounders, medium-chain acylcarnitines levels were associated with 2-year incidence of LEFI [odds ratio per 1-SD increase: 1.69; 95% confidence interval: 1.08, 2.64; p = 0.02]. Similar results were observed for long-chain acylcarnitines [odds ratio per 1-SD increase: 1.70; 95% confidence interval: 1.03, 2.80; p = 0.04]. Stratified analyses showed a stronger association between medium- and long-chain acylcarnitines and incidence of LEFI among those with body mass index and energy intake below the median value. In conclusion, higher plasma concentrations of medium- and long-chain acylcarnitines were associated with higher risk of LEFI. Given the role of these molecules on mitochondrial transport of fatty acids, our results suggest that bioenergetics dysbalance contributes to LEFI.
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21
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Abe K, Fujita M, Hayashi M, Takahashi A, Ohira H. The Efficacy of Levocarnitine Treatment in Relieving Fatigue in Patients with Cirrhosis but without Overt Hepatic Encephalopathy. Intern Med 2021; 60:3533-3542. [PMID: 34776465 PMCID: PMC8666222 DOI: 10.2169/internalmedicine.7175-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective In the present study, we prospectively examined the efficacy of levocarnitine in relieving symptoms of fatigue in patients with cirrhosis but without overt hepatic encephalopathy. Methods Twenty-one cirrhotic patients who were able to undergo fatigue symptom evaluations at our institution were enrolled. A total of 12 cirrhotic patients underwent levocarnitine treatment (1,200-1,800 mg/day), while 9 did not undergo levocarnitine treatment. As primary endpoints, we investigated whether or not levocarnitine treatment exerted any beneficial effects by assessing the symptoms of fatigue [8-item Short-Form Health Survey (SF-8) and Fisk Fatigue Severity Score (FFSS)] at baseline and three months after treatment. Furthermore, as exploratory secondary endpoints, we investigated whether or not levocarnitine treatment exerted ameliorative effects on oxidative stress by assessing the serum thioredoxin (TRX) and urinary 8-hydroxydeoxyguanosine (8-OHdG) levels. Results The median age of the patients was 73 years old. Three men and 18 women were categorized by their Child-Pugh class (A and B in 14 and 7 patients, respectively). There were no significant differences in the clinical laboratory values between the two groups. The FFSS and SF-8 scores were significantly improved in the patients with cirrhosis who underwent levocarnitine treatment (p<0.01) but not in those who did not undergo levocarnitine treatment. Furthermore, three months after levocarnitine treatment, the serum carnitine concentrations were significantly increased, and the serum thioredoxin levels were decreased in the patients with cirrhosis who underwent levocarnitine treatment (p<0.05). Conclusion These results suggest that levocarnitine treatment may relieve symptoms of fatigue in cirrhotic patients by reducing oxidative stress.
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Affiliation(s)
- Kazumichi Abe
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Masashi Fujita
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Manabu Hayashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Japan
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22
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Carnitine Serum Levels in Frail Older Subjects. Nutrients 2020; 12:nu12123887. [PMID: 33352627 PMCID: PMC7766818 DOI: 10.3390/nu12123887] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/03/2020] [Accepted: 12/16/2020] [Indexed: 11/16/2022] Open
Abstract
Frailty is an expression that reconciles and condenses loss of autonomy, both physical and cognitive decline and a wide spectrum of adverse outcomes due to aging. The decrease in physical and cognitive activity is associated with altered mitochondrial function, and energy loss and consequently morbidity and mortality. In this cross-sectional study, we evaluated the carnitine levels in frailty status. The mean serum concentrations of total carnitine (TC) were lower in frail elderly subjects than in prefrail ones (p = 0.0006), higher in frail vs. robust subjects (p < 0.0001), and higher in prefrail vs. robust subjects (p < 0.0001). The mean serum concentrations of free carnitine (FC) were lower in frail elderly subjects than in prefrail ones (p < 0.0001), lower in frail vs. robust subjects (p < 0.0001) and lower in prefrail vs. robust subjects (p = 0.0009). The mean serum concentrations of acylcarnitine (AC) were higher in frail elderly subjects than in prefrail ones (p = 0.054) and were higher in pre-frail vs. robust subjects (p = 0.0022). The mean urine concentrations of TC were lower in frail elderly subjects than in prefrail ones (p < 0.05) and lower in frail vs. robust subjects (p < 0.0001). The mean urine concentrations of free carnitine were lower in frail elderly vs. robust subjects (p < 0.05). The mean urine concentrations of acyl carnitines were lower in frail elderly subjects than those in both prefrail (p < 0.0001) and robust subjects (p < 0.0001). Conclusion: high levels of carnitine may have a favorable effect on the functional status and may treat the frailty status in older subjects.
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McGrattan A, van Aller C, Narytnyk A, Reidpath D, Keage H, Mohan D, Su TT, Stephan B, Robinson L, Siervo M. Nutritional interventions for the prevention of cognitive impairment and dementia in developing economies in East-Asia: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2020; 62:1838-1855. [DOI: 10.1080/10408398.2020.1848785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Andrea McGrattan
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Carla van Aller
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Alla Narytnyk
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Daniel Reidpath
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Selangor, Malaysia
| | - Hannah Keage
- Cognitive Ageing and Impairment Neurosciences, Unit of Justice and Society, University of South Australia, Adelaide, Australia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Selangor, Malaysia
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Selangor, Malaysia
| | - Blossom Stephan
- School of Medicine, The University of Nottingham, Nottingham, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Nottingham, UK
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Sawicka AK, Renzi G, Olek RA. The bright and the dark sides of L-carnitine supplementation: a systematic review. J Int Soc Sports Nutr 2020; 17:49. [PMID: 32958033 PMCID: PMC7507632 DOI: 10.1186/s12970-020-00377-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 09/04/2020] [Indexed: 12/16/2022] Open
Abstract
Background L-carnitine (LC) is used as a supplement by recreationally-active, competitive and highly trained athletes. This systematic review aims to evaluate the effect of prolonged LC supplementation on metabolism and metabolic modifications. Methods A literature search was conducted in the MEDLINE (via PubMed) and Web of Science databases from the inception up February 2020. Eligibility criteria included studies on healthy human subjects, treated for at least 12 weeks with LC administered orally, with no drugs or any other multi-ingredient supplements co-ingestion. Results The initial search retrieved 1024 articles, and a total of 11 studies were finally included after applying inclusion and exclusion criteria. All the selected studies were conducted with healthy human subjects, with supplemented dose ranging from 1 g to 4 g per day for either 12 or 24 weeks. LC supplementation, in combination with carbohydrates (CHO) effectively elevated total carnitine content in skeletal muscle. Twenty-four-weeks of LC supplementation did not affect muscle strength in healthy aged women, but significantly increased muscle mass, improved physical effort tolerance and cognitive function in centenarians. LC supplementation was also noted to induce an increase of fasting plasma trimethylamine-N-oxide (TMAO) levels, which was not associated with modification of determined inflammatory nor oxidative stress markers. Conclusion Prolonged LC supplementation in specific conditions may affect physical performance. On the other hand, LC supplementation elevates fasting plasma TMAO, compound supposed to be pro-atherogenic. Therefore, additional studies focusing on long-term supplementation and its longitudinal effect on the cardiovascular system are needed.
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Affiliation(s)
- Angelika K Sawicka
- Department of Human Physiology, Faculty of Health Sciences, Medical University of Gdansk, 80-210, Gdansk, Poland
| | | | - Robert A Olek
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Krolowej Jadwigi 27/39, 61-871, Poznan, Poland.
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25
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Fujita M, Abe K, Hayashi M, Takahashi A, Ohira H. Skeletal muscle volume loss among liver cirrhosis patients receiving levocarnitine predicts poor prognosis. Medicine (Baltimore) 2020; 99:e21061. [PMID: 32664122 PMCID: PMC7360248 DOI: 10.1097/md.0000000000021061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Sarcopenia has a negative impact on the prognosis of patients with liver cirrhosis (LC). We investigated the significance of skeletal muscle volume and its changes in LC patients taking levocarnitine (L-carnitine).We retrospectively analyzed 51 LC patients taking L-carnitine from December 2012 to March 2019. Skeletal mass index was calculated as the left-right sum of the major × minor axis of psoas muscle at the third lumbar vertebra, divided by height squared (psoas muscle index [PMI]). Patients were classified into 2 groups (low and normal PMI) depending on PMI < 6.0 and < 3.4 cm/m for men and women, respectively. Changes in PMI per month during L-carnitine administration (ΔPMI/m) were calculated, and we classified the patients into 2 groups (severe and mild muscle atrophy) depending on ΔPMI/m below the lower quartile. We assessed overall survival (OS).At the start of L-carnitine administration, there were no significant differences in OS between groups with low and normal PMI. Multivariate analysis showed that ΔPMI/m (hazard ratio [HR], 0.007; P = .005) and L-carnitine administration period (HR, 0.956; P = .021) were significantly associated with OS. Patients with severe muscle atrophy had a significantly lower OS than those with mild muscle atrophy. There was the positive correlation relationship between ΔPMI/m and L-carnitine administration period.Among LC patients taking L-carnitine, progressive muscle volume loss was a predictor of poor prognosis. L-carnitine administration for longer may be able to prevent muscle volume loss and lead to a better prognosis in LC patients.
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Talenezhad N, Mohammadi M, Ramezani-Jolfaie N, Mozaffari-Khosravi H, Salehi-Abargouei A. Effects of l-carnitine supplementation on weight loss and body composition: A systematic review and meta-analysis of 37 randomized controlled clinical trials with dose-response analysis. Clin Nutr ESPEN 2020; 37:9-23. [DOI: 10.1016/j.clnesp.2020.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/31/2020] [Accepted: 03/10/2020] [Indexed: 02/06/2023]
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27
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Reply - Letter to the Editor - Meta-analysis of L-carnitine supplementation on lipid profile and glycemic control: inadequate search strategy and other methodological issues. Clin Nutr 2020; 39:1977. [PMID: 32386859 DOI: 10.1016/j.clnu.2020.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 11/24/2022]
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28
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Raeisi-Dehkordi H, Muka T. Meta-analysis of l-carnitine supplementation on lipid profile and glycemic control: Inadequate search strategy and other methodological issues. Clin Nutr 2020; 39:1975-1976. [PMID: 32386858 DOI: 10.1016/j.clnu.2020.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Hamidreza Raeisi-Dehkordi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
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Novel Insights on Intake of Fish and Prevention of Sarcopenia: All Reasons for an Adequate Consumption. Nutrients 2020; 12:nu12020307. [PMID: 31991560 PMCID: PMC7071242 DOI: 10.3390/nu12020307] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 12/17/2022] Open
Abstract
Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength and it is diagnosed by measurements of muscle mass, muscle strength, and physical performance. Sarcopenia affects quality of life and is associated with several adverse health effects. Muscle decline is aggravated by a sedentary lifestyle and can be prevented through proper nutrition, together with adequate physical activity. Fish contains biologically active compounds, such as omega-3 polyunsaturated fatty acids, proteins, vitamin D, magnesium, and carnitine, which are able to intervene positively on muscle metabolism. This narrative literature review was performed to evaluate evidence regarding the actual benefit of fish consumption in the prevention of sarcopenia and the positive action on the muscle mass of the biological compounds present in fish. The results demonstrated that fish consumption has a protective and anti-inflammatory function on skeletal muscle and that its biologically active compounds help to maintain good muscle performance, preventing sarcopenia. Considering the nutritional and health benefits, elderly with sarcopenia should consume at least three servings per week of fish in order to have a minimum intake of 4-4.59 g daily of omega 3, and reaching the 50% RDA in Vitamin E and D. High biological value of proteins in 150 g of fish and its high available magnesium (20% of RDA in 150 g of fish) are an added value that could suggest fish as a "functional food" in order to prevent and treat sarcopenia.
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Askarpour M, Djafarian K, Ghaedi E, Sadeghi O, Sheikhi A, Shab-Bidar S. Effect of L-Carnitine Supplementation on Liver Enzymes: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Med Res 2020; 51:82-94. [DOI: 10.1016/j.arcmed.2019.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/02/2019] [Accepted: 12/06/2019] [Indexed: 02/06/2023]
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Askarpour M, Hadi A, Miraghajani M, Symonds ME, Sheikhi A, Ghaedi E. Beneficial effects of l-carnitine supplementation for weight management in overweight and obese adults: An updated systematic review and dose-response meta-analysis of randomized controlled trials. Pharmacol Res 2020; 151:104554. [DOI: 10.1016/j.phrs.2019.104554] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/07/2019] [Accepted: 11/16/2019] [Indexed: 10/25/2022]
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Askarpour M, Hadi A, Symonds ME, Miraghajani M, Sheikhi A, Ghaedi E. Efficacy of l-carnitine supplementation for management of blood lipids: A systematic review and dose-response meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2019; 29:1151-1167. [PMID: 31561944 DOI: 10.1016/j.numecd.2019.07.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/04/2019] [Accepted: 07/16/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIM l-carnitine has an important role in fatty acid metabolism and could therefore act as an adjuvant agent in the improvement of dyslipidemia. The purpose of present systematic review and meta-analysis was to critically assess the efficacy of l-carnitine supplementation on lipid profiles. METHODS AND RESULTS We performed a systematic search of all available randomized controlled trials (RCTs) in the following databases: Scopus, PubMed, ISI Web of Science, The Cochrane Library. Mean difference (MD) of any effect was calculated using a random-effects model. In total, there were 55 eligible RCTs included with 58 arms, and meta-analysis revealed that l-carnitine supplementation significantly reduced total cholesterol (TC) (56 arms-MD: -8.53 mg/dl, 95% CI: -13.46, -3.6, I2: 93%), low-density lipoprotein-cholesterol (LDL-C) (47 arms-MD: -5.48 mg/dl, 95% CI: -8.49, -2.47, I2: 94.5) and triglyceride (TG) (56 arms-MD: -9.44 mg/dl, 95% CI: -16.02, -2.87, I2: 91.8). It also increased high density lipoprotein-cholesterol (HDL-C) (51 arms-MD:1.64 mg/dl, 95% CI:0.54, 2.75, I2: 92.2). l-carnitine supplementation reduced TC in non-linear fashion based on dosage (r = 21.11). Meta-regression analysis indicated a linear relationship between dose of l-carnitine and absolute change in TC (p = 0.029) and LDL-C (p = 0.013). Subgroup analyses showed that l-carnitine supplementation did not change TC, LDL-C and TG in patients under hemodialysis treatment. Intravenous l-carnitine and lower doses (>2 g/day) had no effect on TC, LDL-C and triglycerides. CONCLUSION l-carnitine supplementation at doses above 2 g/d has favorable effects on patients' lipid profiles, but is modulated on participant health and route of administration.
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Affiliation(s)
- Moein Askarpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran; Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Michael E Symonds
- The Early Life Research Unit, Academic Division of Child Health, Obstetrics and Gynaecology, and Nottingham Digestive Disease Centre and Biomedical Research Centre, The School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Maryam Miraghajani
- The Early Life Research Unit, Academic Division of Child Health, Obstetrics and Gynaecology, and Nottingham Digestive Disease Centre and Biomedical Research Centre, The School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK; Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sheikhi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Ghaedi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Kelek SE, Afşar E, Akçay G, Danışman B, Aslan M. Effect of chronic L-carnitine supplementation on carnitine levels, oxidative stress and apoptotic markers in peripheral organs of adult Wistar rats. Food Chem Toxicol 2019; 134:110851. [PMID: 31568849 DOI: 10.1016/j.fct.2019.110851] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 12/13/2022]
Abstract
This study investigated the effects of L-carnitine supplementation on carnitine levels, oxidative stress and apoptotic markers in the stomach, kidney, liver and testis tissues in adult rats. Rats were randomized to control and L-carnitine supplemented (LCAR) groups. Control group received distilled water for 7 months by intragastric gavage and the LCAR group was given 50 mg/kg/day L-carnitine via intragastric intubation for the same period. L-carnitine concentrations and caspase-3 activity were measured by fluorometric methods while cleaved caspase-3 was determined by Western blot analysis. Bcl-2 associated X protein (Bax) and B-cell lymphoma/leukemia-2 (Bcl-2) were quantified by enzyme immunoassay and Western blot analysis. Oxygen/nitrogen species (ROS/RNS) and total antioxidant capacity (TAC) were analyzed by colorimetric assay. Tissue L-carnitine concentrations were significantly increased in the LCAR group compared to controls. Anti-apoptotic Bcl-2 levels were significantly increased while pro-apoptotic Bax was significantly decreased in LCAR group rats compared to controls. Tissue caspase-3 was significantly alleviated in the LCAR group compared to controls. L-carnitine supplementation increased TAC and decreased ROS/RNS generation in the kidney, liver, stomach and testis tissues compared to controls. Obtained data suggests that L-carnitine supplementation can potentially be used to lessen both oxidative and apoptotic progression in peripheral organs.
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Affiliation(s)
- Sevim Ercan Kelek
- Vocational School of Health Services, Akdeniz University, Antalya, 07070, Turkey.
| | - Ebru Afşar
- Department of Medical Biochemistry, Akdeniz University Medical School, Antalya, 07070, Turkey.
| | - Güven Akçay
- Department of Biophysics, Akdeniz University Medical School, Antalya, 07070, Turkey.
| | - Betül Danışman
- Department of Biophysics, Akdeniz University Medical School, Antalya, 07070, Turkey.
| | - Mutay Aslan
- Department of Medical Biochemistry, Akdeniz University Medical School, Antalya, 07070, Turkey.
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Askarpour M, Hadi A, Dehghani Kari Bozorg A, Sadeghi O, Sheikhi A, Kazemi M, Ghaedi E. Effects of l-carnitine supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials. J Hum Hypertens 2019; 33:725-734. [DOI: 10.1038/s41371-019-0248-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/21/2019] [Accepted: 07/29/2019] [Indexed: 12/19/2022]
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35
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McCarty MF, Iloki-Assanga S, Lujany LML. Nutraceutical targeting of TLR4 signaling has potential for prevention of cancer cachexia. Med Hypotheses 2019; 132:109326. [PMID: 31421423 DOI: 10.1016/j.mehy.2019.109326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/23/2019] [Indexed: 12/25/2022]
Abstract
The mechanisms underlying cancer cachexia - the proximate cause of at least 20% of cancer-related deaths - have until recently remained rather obscure. New research, however, clarifies that cancers evoking cachexia release microvesicles rich in heat shock proteins 70 and 90, and that these extracellular heat shock proteins induce cachexia by serving as agonists for toll-like receptor 4 (TLR4) in skeletal muscle, macrophages, and adipocytes. Hence, safe nutraceutical measures which can down-regulate TLR4 signaling can be expected to aid prevention and control of cancer cachexia. There is reason to suspect that phycocyanobilin, ferulic acid, glycine, long-chain omega-3s, green tea catechins, β-hydroxy-β-methylbutyrate, carnitine, and high-dose biotin may have some utility in this regard.
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Fathizadeh H, Milajerdi A, Reiner Ž, Kolahdooz F, Asemi Z. The effects of L-carnitine supplementation on glycemic control: a systematic review and meta-analysis of randomized controlled trials. EXCLI JOURNAL 2019; 18:631-643. [PMID: 31611746 PMCID: PMC6785772 DOI: 10.17179/excli2019-1447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/03/2019] [Indexed: 12/12/2022]
Abstract
The findings of trials investigating the effect of L-carnitine administration on glycemic control are controversial. This meta-analysis of randomized controlled trials (RCTs) was performed to explore the effects of L-carnitine intake on glycemic control. Two authors independently searched electronic databases including MEDLINE, EMBASE, Cochrane Library, Web of Science, PubMed and Google scholar from 1990 until February 2019, in order to find relevant RCTs. 37 studies with 44 effect sizes met the inclusion criteria and were eligible for the meta-analysis. L-carnitine supplementation resulted in a significant reduction in fasting plasma glucose (FPG) (WMD: -4.57; 95 % CI: -6.88, -2.25), insulin (WMD: -1.21; 95 % CI: -1.85, -0.57), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD: -0.67; 95 % CI: -0.90, -0.44) and HbA1C concentrations (WMD: -0.30; 95 % CI: -0.47, -0.13). L-Carnitine supplementation significantly reduced FPG, insulin, HOMA-IR, and HbA1c levels.
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Affiliation(s)
- Hadis Fathizadeh
- Department of Microbiology, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Milajerdi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Željko Reiner
- Department of Internal Medicine, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Fariba Kolahdooz
- Indigenous and Global Health Research, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Hiramatsu A, Aikata H, Uchikawa S, Ohya K, Kodama K, Nishida Y, Daijo K, Osawa M, Teraoka Y, Honda F, Inagaki Y, Morio K, Morio R, Fujino H, Nakahara T, Murakami E, Yamauchi M, Kawaoka T, Miki D, Tsuge M, Imamura M, Tanaka J, Chayama K. Levocarnitine Use Is Associated With Improvement in Sarcopenia in Patients With Liver Cirrhosis. Hepatol Commun 2019; 3:348-355. [PMID: 30859147 PMCID: PMC6396356 DOI: 10.1002/hep4.1309] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 12/31/2018] [Indexed: 12/27/2022] Open
Abstract
Although the effect of levocarnitine (L-carnitine) on hyperammonemia has been reported in patients with liver cirrhosis (LC), its effect on sarcopenia remains to be elucidated. We assessed the effects of L-carnitine on sarcopenia in patients with LC. We retrospectively evaluated 52 patients with LC who were treated with L-carnitine for more than 3 months between February 2013 and June 2017. Computed tomography was used to measure the cross-sectional area of the skeletal muscles at the level of the third lumbar vertebra. The relative change in skeletal muscle index (SMI) per year (ΔSMI/year) was computed in each patient. We evaluated the relationship between ΔSMI/year and various parameters, such as age, sex, liver functional reserve, and dose of L-carnitine. The median ΔSMI/year for all patients was -0.22%. The ΔSMI/year values in Child-Pugh classes A, B, and C were not significantly different among the three groups. There was no significant relationship between ΔSMI/year and sex, age, body mass index, and sarcopenia. Multivariate analysis showed that only a high dose of L-carnitine (odds ratio [OR], 4.812; 95% confidence interval [CI], 1.233-18.784; P = 0.024) was associated with increased muscle mass. The L-carnitine high-dose group included a significantly larger number of patients with increased muscle mass compared with the low-dose group (OR, 3.568; 95% CI, 1.138-11.185; P = 0.027). Administration of L-carnitine led to a significant and gradual reduction in serum ammonia levels. Conclusion: L-carnitine seems to suppress the progression of sarcopenia dose dependently, and this was noted to be associated with the improvement of hyperammonemia in patients with LC.
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Affiliation(s)
- Akira Hiramatsu
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Shinsuke Uchikawa
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Kazuki Ohya
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Kenichiro Kodama
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Yuno Nishida
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Kana Daijo
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Mitsutaka Osawa
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Yuji Teraoka
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Fumi Honda
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Yuki Inagaki
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Kei Morio
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Reona Morio
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan
| | - Hatsue Fujino
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Takashi Nakahara
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Eisuke Murakami
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Masami Yamauchi
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Tomokazu Kawaoka
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Daiki Miki
- Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Masataka Tsuge
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan.,Natural Science Center for Basic Research and Development Hiroshima University Hiroshima Japan
| | - Michio Imamura
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.,Liver Research Project Center Hiroshima University Hiroshima Japan
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Ben-Shachar D, Ene HM. Mitochondrial Targeted Therapies: Where Do We Stand in Mental Disorders? Biol Psychiatry 2018; 83:770-779. [PMID: 28965983 DOI: 10.1016/j.biopsych.2017.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/26/2017] [Accepted: 08/06/2017] [Indexed: 12/20/2022]
Abstract
The neurobiology of psychiatric disorders is still unclear, although changes in multiple neuronal systems, specifically the dopaminergic, glutamatergic, and gamma-aminobutyric acidergic systems as well as abnormalities in synaptic plasticity and neural connectivity, are currently suggested to underlie their pathophysiology. A growing body of evidence suggests multifaceted mitochondrial dysfunction in mental disorders, which is in line with their role in neuronal activity, growth, development, and plasticity. In this review, we describe the main endeavors toward development of treatments that will enhance mitochondrial function and their transition into clinical use in congenital mitochondrial diseases and chronic disorders such as types 1 and 2 diabetes, cardiovascular disorders, and cancer. In addition, we discuss the relevance of mitochondrial targeted treatments to mental disorders and their potential to become a novel therapeutic strategy that will improve the efficiency of the current treatments.
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Affiliation(s)
- Dorit Ben-Shachar
- Laboratory of Psychobiology, Department of Psychiatry, Rambam Health Care Campus and B. Rappaport Faculty of Medicine, Rappaport Family Institute for Research in Medical Sciences, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Hila M Ene
- Laboratory of Psychobiology, Department of Psychiatry, Rambam Health Care Campus and B. Rappaport Faculty of Medicine, Rappaport Family Institute for Research in Medical Sciences, Technion-Israel Institute of Technology, Haifa, Israel
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Abstract
Given its pivotal role in fatty acid oxidation and energy metabolism, l-carnitine has been investigated as ergogenic aid for enhancing exercise capacity in the healthy athletic population. Early research indicates its beneficial effects on acute physical performance, such as increased maximum oxygen consumption and higher power output. Later studies point to the positive impact of dietary supplementation with l-carnitine on the recovery process after exercise. It is demonstrated that l-carnitine alleviates muscle injury and reduces markers of cellular damage and free radical formation accompanied by attenuation of muscle soreness. The supplementation-based increase in serum and muscle l-carnitine contents is suggested to enhance blood flow and oxygen supply to the muscle tissue via improved endothelial function thereby reducing hypoxia-induced cellular and biochemical disruptions. Studies in older adults further showed that l-carnitine intake can lead to increased muscle mass accompanied by a decrease in body weight and reduced physical and mental fatigue. Based on current animal studies, a role of l-carnitine in the prevention of age-associated muscle protein degradation and regulation of mitochondrial homeostasis is suggested.
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Affiliation(s)
- Roger Fielding
- Tufts University, 136 Harrison Avenue, Boston, MA 02111, USA.
| | - Linda Riede
- analyze & realize GmbH, Waldseeweg 6, 13467 Berlin, Germany.
| | - James P Lugo
- Lonza Inc., 90 Boroline Road, Allendale, NJ 07401, USA.
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Sawicka AK, Hartmane D, Lipinska P, Wojtowicz E, Lysiak-Szydlowska W, Olek RA. l-Carnitine Supplementation in Older Women. A Pilot Study on Aging Skeletal Muscle Mass and Function. Nutrients 2018; 10:nu10020255. [PMID: 29473908 PMCID: PMC5852831 DOI: 10.3390/nu10020255] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/02/2018] [Accepted: 02/17/2018] [Indexed: 12/21/2022] Open
Abstract
Skeletal muscle wasting, associated with aging, may be regulated by the inflammatory cytokines as well as by insulin-like growth factor 1 (IGF-1). l-carnitine possesses anti-inflammatory properties and increases plasma IGF-1 concentration, leading to the regulation of the genes responsible for protein catabolism and anabolism. The purpose of the present study was to evaluate the effect of a 24-week l-carnitine supplementation on serum inflammatory markers, IGF-1, body composition and skeletal muscle strength in healthy human subjects over 65 years of age. Women between 65 and 70 years of age were supplemented for 24 weeks with either 1500 mg l-carnitine-l-tartrate or an isonitrogenous placebo per day in a double-blind fashion. Before and after the supplementation protocol, body mass and composition, as well as knee extensor and flexor muscle strength were determined. In the blood samples, free carnitine, interleukin-6, tumor necrosis factor-α, C-reactive protein and IGF-1 were determined. A marked increase in free plasma carnitine concentration was observed due to l-carnitine supplementation. No substantial changes in other parameters were noted. In the current study, supplementation for 24 weeks affected neither the skeletal muscle strength nor circulating markers in healthy women over 65 years of age. Positive and negative aspects of l-carnitine supplementation need to be clarified.
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Affiliation(s)
- Angelika K Sawicka
- Department of Bioenergetics and Nutrition, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland.
| | - Dace Hartmane
- Latvian Institute of Organic Synthesis, LV-1006 Riga, Latvia.
| | - Patrycja Lipinska
- Institute of Physical Culture, Kazimierz Wielki University, 85-091 Bydgoszcz, Poland.
| | - Ewa Wojtowicz
- Department of Anatomy and Anthropology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland.
| | | | - Robert A Olek
- Department of Bioenergetics and Nutrition, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland.
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Redmer J. Adrenal Fatigue. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Barger JL, Vann JM, Cray NL, Pugh TD, Mastaloudis A, Hester SN, Wood SM, Newton MA, Weindruch R, Prolla TA. Identification of tissue-specific transcriptional markers of caloric restriction in the mouse and their use to evaluate caloric restriction mimetics. Aging Cell 2017; 16:750-760. [PMID: 28556428 PMCID: PMC5506434 DOI: 10.1111/acel.12608] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2017] [Indexed: 12/28/2022] Open
Abstract
Caloric restriction (CR) without malnutrition has been shown to retard several aspects of the aging process and to extend lifespan in different species. There is strong interest in the identification of CR mimetics (CRMs), compounds that mimic the beneficial effects of CR on lifespan and healthspan without restriction of energy intake. Identification of CRMs in mammals is currently inefficient due to the lack of screening tools. We have performed whole‐genome transcriptional profiling of CR in seven mouse strains (C3H/HeJ, CBA/J, DBA/2J, B6C3F1/J, 129S1/SvImJ, C57BL/6J, and BALB/cJ) in white adipose tissue (WAT), gastrocnemius muscle, heart, and brain neocortex. This analysis has identified tissue‐specific panels of genes that change in expression in multiple mouse strains with CR. We validated a subset of genes with qPCR and used these to evaluate the potential CRMs bezafibrate, pioglitazone, metformin, resveratrol, quercetin, 2,4‐dinitrophenol, and L‐carnitine when fed to C57BL/6J 2‐month‐old mice for 3 months. Compounds were also evaluated for their ability to modulate previously characterized biomarkers of CR, including mitochondrial enzymes citrate synthase and SIRT3, plasma inflammatory cytokines TNF‐α and IFN‐γ, glycated hemoglobin (HbA1c) levels and adipocyte size. Pioglitazone, a PPAR‐γ agonist, and L‐carnitine, an amino acid involved in lipid metabolism, displayed the strongest effects on both the novel transcriptional markers of CR and the additional CR biomarkers tested. Our findings provide panels of tissue‐specific transcriptional markers of CR that can be used to identify novel CRMs, and also represent the first comparative molecular analysis of several potential CRMs in multiple tissues in mammals.
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Affiliation(s)
| | | | | | | | | | - Shelly N. Hester
- Center for Anti-Aging Research; NSE Products, Inc.; Provo UT USA
| | - Steven M. Wood
- Center for Anti-Aging Research; NSE Products, Inc.; Provo UT USA
| | - Michael A. Newton
- Departments of Statistics and of Biostatistics and Medical Informatics; University of Wisconsin; Madison WI USA
| | - Richard Weindruch
- LifeGen Technologies LLC; Madison WI USA
- Department of Medicine; SMPH; University of Wisconsin; Madison WI USA
- Geriatric Research, Education and Clinical Center; William S. Middleton Memorial Veterans Hospital; Madison WI USA
| | - Tomas A. Prolla
- LifeGen Technologies LLC; Madison WI USA
- Departments of Genetics and Medical Genetics; University of Wisconsin; Madison WI USA
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Zhao HP, Zhang Y, Liu Z, Chen JY, Zhang SY, Yang XD, Zhou HL. Acute toxicity and anti-fatigue activity of polysaccharide-rich extract from corn silk. Biomed Pharmacother 2017; 90:686-693. [DOI: 10.1016/j.biopha.2017.04.045] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/09/2017] [Accepted: 04/10/2017] [Indexed: 01/24/2023] Open
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Ayache SS, Chalah MA. Fatigue in multiple sclerosis – Insights into evaluation and management. Neurophysiol Clin 2017; 47:139-171. [DOI: 10.1016/j.neucli.2017.02.004] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 02/15/2017] [Indexed: 12/20/2022] Open
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Chen N, Yang M, Zhou M, Xiao J, Guo J, He L. L-carnitine for cognitive enhancement in people without cognitive impairment. Cochrane Database Syst Rev 2017; 3:CD009374. [PMID: 28349514 PMCID: PMC6464592 DOI: 10.1002/14651858.cd009374.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Safe interventions to enhance cognitive function in cognitively healthy people would be very valuable for several reasons, including a better quality of life and professional success. While L-carnitine has been reported to enhance cognitive function in some conditions, its efficacy is disputed. The evidence of its efficacy for cognitively healthy people has not previously been systematically reviewed. OBJECTIVES To assess the efficacy and safety of L-carnitine for the enhancement of cognitive function in people without cognitive impairment. SEARCH METHODS We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's Specialized Register, on 4 November 2016. We used the search terms 'L-carnitine' or 'acetyl-L-carnitine' or 'propionyl-L-carnitine' or 'ALC' or 'PLC' or 'ALCAR' or 'ALPAR'. We ran additional separate searches in several other sources to ensure that we retrieved the most up-to-date results. We also reviewed the bibliographies of the randomised controlled trials identified and contacted the authors and known experts in the field and pharmaceutical companies to identify additional published or unpublished data. SELECTION CRITERIA Eligible trials were randomised controlled trials (RCTs) or quasi-RCTs, parallel-group or cross-over, that compared L-carnitine or its derivatives, acetyl-L-carnitine or propionyl-L-carnitine, at any dose and for any length of treatment, with placebo or no treatment in cognitively healthy people of any age and either gender. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two review authors independently selected trials and evaluated the methodological quality, then extracted and analysed data from the included trials. MAIN RESULTS Only two RCTs were eligible. One was a cross-over trial with 18 participants. The other randomised 400 participants to one of four treatments, of which two (L-carnitine and placebo) were relevant to this review, but the exact numbers of participants in these two treatment groups was not reported. All participants were young adults. Methodological details were poorly reported, and we considered the risk of bias in both studies to be unclear. The trials assessed different cognitive outcomes. We could extract cognitive data on approximately 200 participants from one trial. We found no evidence that L-carnitine has any effect on reaction time, vigilance, immediate memory, or delayed recall after three days of treatment. This trial report stated that there was a small number of adverse effects, none of which were serious. The small cross-over trial also reported no effect of L-carnitine on cognition, but did not provide data; no information was provided on adverse effects. We considered the available evidence to be of very low quality for all reported outcomes. AUTHORS' CONCLUSIONS Due to the limited number of included trials, short-term treatment, and inadequate reporting, we were unable to draw any conclusions about the efficacy or safety of L-carnitine for cognitive enhancement in healthy adults. Well-designed, randomised, placebo-controlled trials of L-carnitine for cognition enhancement in cognitively healthy people, with large samples and relatively long-term follow-up, are still needed.
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Affiliation(s)
- Ning Chen
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - Mi Yang
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - Muke Zhou
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - Jing Xiao
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - Jian Guo
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37, Guo Xue XiangChengduSichuanChina610041
| | - Li He
- West China Hospital, Sichuan UniversityDepartment of NeurologyNo. 37, Guo Xue XiangChengduSichuanChina610041
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Badrasawi M, Shahar S, Zahara AM, Nor Fadilah R, Singh DKA. Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial. Clin Interv Aging 2016; 11:1675-1686. [PMID: 27895474 PMCID: PMC5117993 DOI: 10.2147/cia.s113287] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Frailty is a biological syndrome of decreased reserve and resistance to stressors due to decline in multiple physiological systems. Amino acid deficiency, including L-carnitine, has been proposed to be associated with its pathophysiology. Nevertheless, the efficacy of L-carnitine supplementation on frailty status has not been documented. Thus, this study aimed to determine the effect of 10-week L-carnitine supplement (1.5 g/day) on frailty status and its biomarkers and also physical function, cognition, and nutritional status among prefrail older adults in Klang Valley, Malaysia. Methodology This study is a randomized, double-blind, placebo-controlled clinical trial conducted among 50 prefrail subjects randomized into two groups (26 in L-carnitine group and 24 in placebo group). Outcome measures include frailty status using Fried criteria and Frailty Index accumulation of deficit, selected frailty biomarkers (interleukin-6, tumor necrosis factor-alpha, and insulin-like growth factor-1), physical function, cognitive function, nutritional status and biochemical profile. Results The results indicated that the mean scores of Frailty Index score and hand grip test were significantly improved in subjects supplemented with L-carnitine (P<0.05 for both parameters) as compared to no change in the placebo group. Based on Fried criteria, four subjects (three from the L-carnitine group and one from the control group) transited from prefrail status to robust after the intervention. Conclusion L-carnitine supplementation has a favorable effect on the functional status and fatigue in prefrail older adults.
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Affiliation(s)
- M Badrasawi
- Dietetic Programme, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Nutrition Program, Faulty of Applied Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Suzana Shahar
- Dietetic Programme, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A M Zahara
- Dietetic Programme, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - R Nor Fadilah
- Biomedical Programme, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Abu Ahmad N, Armaly Z, Berman S, Jabour A, Aga-Mizrachi S, Mosenego-Ornan E, Avital A. l-Carnitine improves cognitive and renal functions in a rat model of chronic kidney disease. Physiol Behav 2016; 164:182-8. [DOI: 10.1016/j.physbeh.2016.05.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 05/05/2016] [Accepted: 05/19/2016] [Indexed: 11/16/2022]
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Schättin A, Baur K, Stutz J, Wolf P, de Bruin ED. Effects of Physical Exercise Combined with Nutritional Supplements on Aging Brain Related Structures and Functions: A Systematic Review. Front Aging Neurosci 2016; 8:161. [PMID: 27458371 PMCID: PMC4933713 DOI: 10.3389/fnagi.2016.00161] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 06/20/2016] [Indexed: 01/12/2023] Open
Abstract
Age-related decline in gray and white brain matter goes together with cognitive depletion. To influence cognitive functioning in elderly, several types of physical exercise and nutritional intervention have been performed. This paper systematically reviews the potential additive and complementary effects of nutrition/nutritional supplements and physical exercise on cognition. The search strategy was developed for EMBASE, Medline, PubMed, Cochrane, CINAHL, and PsycInfo databases and focused on the research question: “Is the combination of physical exercise with nutrition/nutritional supplementation more effective than nutrition/nutritional supplementation or physical exercise alone in effecting on brain structure, metabolism, and/or function?” Both mammalian and human studies were included. In humans, randomized controlled trials that evaluated the effects of nutrition/nutritional supplements and physical exercise on cognitive functioning and associated parameters in healthy elderly (>65 years) were included. The systematic search included English and German language literature without any limitation of publication date. The search strategy yielded a total of 3129 references of which 67 studies met the inclusion criteria; 43 human and 24 mammalian, mainly rodent, studies. Three out of 43 human studies investigated a nutrition/physical exercise combination and reported no additive effects. In rodent studies, additive effects were found for docosahexaenoic acid supplementation when combined with physical exercise. Although feasible combinations of physical exercise/nutritional supplements are available for influencing the brain, only a few studies evaluated which possible combinations of nutrition/nutritional supplementation and physical exercise might have an effect on brain structure, metabolism and/or function. The reason for no clear effects of combinatory approaches in humans might be explained by the misfit between the combinations of nutritional methods with the physical interventions in the sense that they were not selected on sharing of similar neuronal mechanisms. Based on the results from this systematic review, future human studies should focus on the combined effect of docosahexaenoic acid supplementation and physical exercise that contains elements of (motor) learning.
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Affiliation(s)
- Alexandra Schättin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
| | - Kilian Baur
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
| | - Jan Stutz
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
| | - Peter Wolf
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Swiss Federal Institute of Technology (ETH Zurich) Zurich, Switzerland
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Zhu B, Zheng YF, Zhang YY, Cao YS, Zhang L, Li XG, Liu T, Jiao ZZ, Wang Q, Zhao ZG. Protective effect of L-carnitine in cyclophosphamide-induced germ cell apoptosis. J Zhejiang Univ Sci B 2016; 16:780-7. [PMID: 26365120 DOI: 10.1631/jzus.b1500015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Cyclophosphamide (CP) is a widely used anti-cancer agent; however, it can also induce serious male infertility. There are currently no effective drugs to alleviate this side-effect. L-Carnitine has been used to treat male infertility, but whether it can be used to protect against CP-induced male infertility is still unclear. This study aims to explore the effect and mechanism of L-carnitine in male infertility induced by CP. CP was used to establish an animal model. After three weeks of treatment, rats were sacrificed and testis and serum were harvested for further evaluation. Testosterone and estrogen levels were measured by enzyme-linked immunosorbent assay (ELISA). Testicular injury was examined by hematoxylin and eosin (H & E) staining, and germ-cell apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). The expression of LC3 and Beclin-1 was examined by immunohistochemistry, Western blot, and real-time polymerase chain reaction (PCR), respectively. Compared with the CP group, L-carnitine significantly increases sperm motility, viability, and testosterone level (P<0.05). Western blot and real-time PCR results showed that L-carnitine treatment can significantly up-regulate the LC3-II and Beclin-1 expression in the CP+L-carnitine group when compared with the control group (P<0.05). In addition, TUNEL-positive cells were also more numerous in the CP group; however, L-carnitine can effectively retard cell apoptosis in the CP+L-carnitine group. In conclusion, L-carnitine contributes to the inhibition of cell apoptosis and the modulation of autophagy in protecting CP-induced testicular injury. These results suggest the applicability of L-carnitine in the treatment of male infertility.
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Affiliation(s)
- Bin Zhu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Yan-fei Zheng
- School of Basic Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yue-ying Zhang
- Department of Chinese Medicine, Beijing Hepingli Hospital, Beijing 100013, China
| | - Yun-song Cao
- Department of Nephrology, Dongfang Hospital, the Second Clinical Medical College of Beijing University of Chinese Medicine, Beijing 100078, China
| | - Lei Zhang
- Department of Pharmacy, Beijing Shijitan Hospital, Beijing 100038, China
| | - Xin-gang Li
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Teng Liu
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Zhao-zhu Jiao
- School of Basic Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Qi Wang
- School of Basic Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Zhi-gang Zhao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
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Efficacy and safety of an amino acid jelly containing coenzyme Q10 and L-carnitine in controlling fatigue in breast cancer patients receiving chemotherapy: a multi-institutional, randomized, exploratory trial (JORTC-CAM01). Support Care Cancer 2015; 24:637-646. [PMID: 26105516 DOI: 10.1007/s00520-015-2824-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Cancer-related fatigue (CRF) is one of the most common symptoms reported by cancer patients. This randomized trial investigated the efficacy of the amino acid jelly Inner Power(®) (IP), a semi-solid, orally administrable dietary supplement containing coenzyme Q10 and L-carnitine, in controlling CRF in breast cancer patients in Japan. METHODS Breast cancer patients with CRF undergoing chemotherapy were randomly assigned to receive IP once daily or regular care for 21 days. The primary endpoint was the change in the worst level of fatigue during the past 24 h (Brief Fatigue Inventory [BFI] item 3 score) from day 1 (baseline) to day 22. Secondary endpoints were change in global fatigue score (GFS; the average of all BFI items), anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS), quality of life assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EORTC Breast Cancer-Specific QLQ (EORTC QLQ-BR23), and adverse events. RESULTS Fifty-nine patients were enrolled in the study, of whom 57 were included in the efficacy analysis. Median patient age was 50 years. Changes in the worst level of fatigue, GFS, and current feeling of fatigue were significantly different between the intervention and control groups, whereas the change in the average feeling of fatigue was not significantly different between groups. HADS, EORTC QLQ-C30, and EORTC QLQ-BR23 scores were not significantly different between the two groups. No severe adverse events were observed. CONCLUSION IP may control moderate-severe CRF in breast cancer patients. TRIAL REGISTRATION The registration number of this study in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) is UMIN000008646.
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