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Li M, Zhu J, Liu X, Dong Z, Tang J, Zhang C, Jiao J, Chen J, Yin F, Qiu S, Zhang F, Gao S, Wang Z, Tao X, Yue X, Sun L, Chen W. Chaihu-Guizhi-Ganjiang Decoction is more efficacious in treating irritable bowel syndrome than Dicetel according to metabolomics analysis. Chin Med 2022; 17:139. [PMID: 36517857 PMCID: PMC9749322 DOI: 10.1186/s13020-022-00695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Chaihu-Guizhi-Ganjiang Decoction (CGGD) is a traditional Chinese medicine (TCM) prescription used to treat viral influenza. There is evidence that CGGD can be used to treat irritable bowel syndrome (IBS) but the potential mechanism of action and metabolites produced upon CGGD treatment remains elusive. METHODS Patients with IBS were treated with pinaverium bromide (Dicetel™) and then CGGD after a washout period of 1 week. Both treatments lasted for 30 days. The efficacy and changes of metabolites in plasma after the two treatments were compared. Plasma samples were acquired before and after each treatment, and untargeted metabolics analysis was performed. RESULTS Efficacy was measured according to the Rome IV criteria and TCM theory. Our results indicated that CGGD showed significantly better efficacy than Dicetel in the treatment of IBS utilizing each criterion. CGGD exerted greater effects on plasma metabolism than Dicetel. Dicetel treatment led to increased tryptophan metabolism (increased levels of 5-Hydroxyindoleacetaldehyde) and increased protein metabolism (increased levels of L-arginine). CGGD treatment significantly (p < 0.05) increased carnitine metabolism, with elevated levels of L-carnitine and acylcarnitine in plasma. Such changes in these metabolites could exert effects against IBS by improving gastrointestinal motility and suppressing pain, depression, and inflammation. CONCLUSIONS CGGD appeared to be more efficacious than Dicetel for treating patients with IBS. The findings provide a sound support for the underlying biomolecular mechanism of CGGD in the prevention and treatment of IBS.
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Affiliation(s)
- Mingming Li
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
- Department of Pharmacy, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
| | - Jiawei Zhu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Xuan Liu
- Department of Traditional Chinese Medicine, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
| | - Zhiying Dong
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Jigui Tang
- Department of Traditional Chinese Medicine, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
| | - Cian Zhang
- Department of Traditional Chinese Medicine, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
| | - Jianpeng Jiao
- Department of Traditional Chinese Medicine, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
| | - Jiani Chen
- Department of Pharmacy, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
| | - Fenghao Yin
- Department of Pharmacy, 905 Hospital of People's Liberation Army Navy, Shanghai, 200050, China
| | - Shi Qiu
- Traditional Chinese Medicine Resource and Technology Center, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Feng Zhang
- Department of Pharmacy, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai, 200433, China
| | - Shouhong Gao
- Department of Pharmacy, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai, 200433, China
| | - Zhipeng Wang
- Department of Pharmacy, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
| | - Xia Tao
- Department of Pharmacy, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China
| | - Xiaoqiang Yue
- Department of Traditional Chinese Medicine, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China.
| | - Lianna Sun
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China.
| | - Wansheng Chen
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China.
- Department of Pharmacy, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China.
- Traditional Chinese Medicine Resource and Technology Center, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai, 200433, China.
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Fah M, Van Althuis LE, Ohnuma T, Winthrop HM, Haines KL, Williams DG, Krishnamoorthy V, Raghunathan K, Wischmeyer PE. Micronutrient deficiencies in critically ill patients receiving continuous renal replacement therapy. Clin Nutr ESPEN 2022; 50:247-254. [DOI: 10.1016/j.clnesp.2022.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022]
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Yano J, Ito S, Kodama G, Nakayama Y, Kaida Y, Yokota Y, Kinoshita Y, Tashiro K, Fukami K. Kinetics of Serum Carnitine Fractions in Patients with Chronic Kidney Disease Not on Dialysis. Kurume Med J 2021; 66:153-160. [PMID: 32848104 DOI: 10.2739/kurumemedj.ms663001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Carnitine plays a pivotal role in energy synthesis through β-oxidation in mitochondria. Serum and tissue levels of free carnitine are significantly decreased in dialysis patients, whereas acylcarnitine levels are increased. However, the precise kinetics and fate of carnitine fractions in chronic kidney disease (CKD) patients who are not on dialysis have not been clarified. This study aims to determine the kinetics of serum carnitine fractions in patients who were not on dialysis. METHODS Seventy-five CKD patients not on dialysis were recruited in this study. Serum and urinary carnitine fraction levels were measured to evaluate the kinetics and regulation of serum carnitine fractions. Carnitine fractions were measured by the enzymatic cycling method. RESULTS Total and free serum carnitine levels did not change with progression of CKD, whereas acylcarnitine levels and the acyl/free carnitine ratio significantly increased. Serum acylcarnitine levels were inversely associated with estimated glomerular filtration rate (r2 = 0.239, p < 0.001), but free carnitine levels were not. Serum free carnitine levels were positively associated with urinary free carnitine excretion (r2 = 0.214, p < 0.001), but serum acylcarnitine levels were not. Multiple stepwise regression analysis revealed that urinary free carnitine excretion and blood urea nitrogen were independent determinants of serum free carnitine and acylcarnitine levels, respectively. CONCLUSIONS The present study demonstrated that serum acylcarnitine levels increased with renal dysfunction independent of urinary excretion levels. Serum free carnitine was not affected by renal function in CKD patients who were not on dialysis.
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Affiliation(s)
- Junko Yano
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine
| | - Sakuya Ito
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine
| | - Goh Kodama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine
| | - Yosuke Nakayama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine
| | - Yusuke Kaida
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine
| | - Yunosuke Yokota
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine
| | - Yukie Kinoshita
- Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine
| | - Kyoko Tashiro
- Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine
| | - Kei Fukami
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine
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Sugiyama M, Hazama T, Nakano K, Urae K, Moriyama T, Ariyoshi T, Kurokawa Y, Kodama G, Wada Y, Yano J, Otsubo Y, Iwatani R, Kinoshita Y, Kaida Y, Nasu M, Shibata R, Tashiro K, Fukami K. Effects of Reducing L-Carnitine Supplementation on Carnitine Kinetics and Cardiac Function in Hemodialysis Patients: A Multicenter, Single-Blind, Placebo-Controlled, Randomized Clinical Trial. Nutrients 2021; 13:nu13061900. [PMID: 34073024 PMCID: PMC8230272 DOI: 10.3390/nu13061900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 01/20/2023] Open
Abstract
L-carnitine (LC) supplementation improves cardiac function in hemodialysis (HD) patients. However, whether reducing LC supplementation affects carnitine kinetics and cardiac function in HD patients treated with LC remains unclear. Fifty-nine HD patients previously treated with intravenous LC 1000 mg per HD session (three times weekly) were allocated to three groups: LC injection three times weekly, once weekly, and placebo, and prospectively followed up for six months. Carnitine fractions were assessed by enzyme cycling methods. Plasma and red blood cell (RBC) acylcarnitines were profiled using tandem mass spectrometry. Cardiac function was evaluated using echocardiography and plasma B-type natriuretic peptide (BNP) levels. Reducing LC administration to once weekly significantly decreased plasma carnitine fractions and RBC-free carnitine levels during the study period, which were further decreased in the placebo group (p < 0.001). Plasma BNP levels were significantly elevated in the placebo group (p = 0.03). Furthermore, changes in RBC (C16 + C18:1)/C2 acylcarnitine ratio were positively correlated with changes in plasma BNP levels (β = 0.389, p = 0.005). Reducing LC administration for six months significantly decreased both plasma and RBC carnitine levels, while the full termination of LC increased plasma BNP levels; however, it did not influence cardiac function in HD patients.
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Affiliation(s)
- Miki Sugiyama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
- Sugi Hospital, Omuta, Fukuoka 837-0916, Japan
| | - Takuma Hazama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Kaoru Nakano
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Kengo Urae
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Tomofumi Moriyama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Takuya Ariyoshi
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Yuka Kurokawa
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Goh Kodama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | | | - Junko Yano
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
- Kurume Ekimae Clinic, Kurume, Fukuoka 830-0023, Japan
| | | | | | - Yukie Kinoshita
- Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (Y.K.); (K.T.)
| | - Yusuke Kaida
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Makoto Nasu
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Ryo Shibata
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
| | - Kyoko Tashiro
- Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (Y.K.); (K.T.)
| | - Kei Fukami
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan; (M.S.); (T.H.); (K.N.); (K.U.); (T.M.); (T.A.); (Y.K.); (G.K.); (J.Y.); (Y.K.); (M.N.); (R.S.)
- Correspondence: ; Tel.: +81-942317002
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Taguchi K, Fukami K, Elias BC, Brooks CR. Dysbiosis-Related Advanced Glycation Endproducts and Trimethylamine N-Oxide in Chronic Kidney Disease. Toxins (Basel) 2021; 13:361. [PMID: 34069405 PMCID: PMC8158751 DOI: 10.3390/toxins13050361] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/17/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Chronic kidney disease (CKD) is a public health concern that affects approximately 10% of the global population. CKD is associated with poor outcomes due to high frequencies of comorbidities such as heart failure and cardiovascular disease. Uremic toxins are compounds that are usually filtered and excreted by the kidneys. With the decline of renal function, uremic toxins are accumulated in the systemic circulation and tissues, which hastens the progression of CKD and concomitant comorbidities. Gut microbial dysbiosis, defined as an imbalance of the gut microbial community, is one of the comorbidities of CKD. Meanwhile, gut dysbiosis plays a pathological role in accelerating CKD progression through the production of further uremic toxins in the gastrointestinal tracts. Therefore, the gut-kidney axis has been attracting attention in recent years as a potential therapeutic target for stopping CKD. Trimethylamine N-oxide (TMAO) generated by gut microbiota is linked to the progression of cardiovascular disease and CKD. Also, advanced glycation endproducts (AGEs) not only promote CKD but also cause gut dysbiosis with disruption of the intestinal barrier. This review summarizes the underlying mechanism for how gut microbial dysbiosis promotes kidney injury and highlights the wide-ranging interventions to counter dysbiosis for CKD patients from the view of uremic toxins such as TMAO and AGEs.
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Affiliation(s)
- Kensei Taguchi
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (B.C.E.); (C.R.B.)
| | - Kei Fukami
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan;
| | - Bertha C. Elias
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (B.C.E.); (C.R.B.)
| | - Craig R. Brooks
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (B.C.E.); (C.R.B.)
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Nie LJ, Liang J, Shan F, Wang BS, Mu YY, Zhou XH, Xia QR. L-Carnitine and Acetyl-L-Carnitine: Potential Novel Biomarkers for Major Depressive Disorder. Front Psychiatry 2021; 12:671151. [PMID: 34658942 PMCID: PMC8514700 DOI: 10.3389/fpsyt.2021.671151] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/02/2021] [Indexed: 12/25/2022] Open
Abstract
The lack of biomarkers greatly limits the diagnosis and treatment of major depressive disorder (MDD). Endogenous L-carnitine (LC) and its derivative acetyl-L-carnitine (ALC) play antidepressant roles by improving brain energy metabolism, regulating neurotransmitters and neural plasticity. The levels of ALC in people and rodents with depression are significantly reduced. It is necessary to determine whether serum LC and ALC might be used as novel biomarkers for the diagnosis of MDD. Here, ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to determine the concentration of LC and ALC in the serum of healthy controls and patients with MDD; among the latter, in patients who were responsive (effective group) and non-responsive (ineffective group) after 2 weeks of treatment. The diagnostic value of serum LC and ALC for MDD was assessed. Compared with healthy controls, the serum LC and ALC concentrations in patients with MDD were significantly decreased (P < 0.001). Pearson correlation analysis shows that the HDRS-24 score was negatively associated with serum ALC (r = -0.325, P = 0.007). Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.801 with 83.1% sensitivity and 66.3% specificity for LC, and an AUC of 0.898 with 88.8% sensitivity and 76.4% specificity for ALC, differentiating patients with MDD from healthy controls. Furthermore, the concentration of LC and ALC in patients with depression was significantly increased in the effective treatment group, and no significant change was observed in the ineffective treatment group. These results suggest that serum LC and ALC may be novel biomarkers for the diagnosis of MDD.
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Affiliation(s)
- Li-Juan Nie
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China.,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China.,Anhui Clinical Research Center for Mental Diseases, Hefei, China
| | - Jun Liang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China.,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China.,Anhui Clinical Research Center for Mental Diseases, Hefei, China
| | - Feng Shan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China.,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China.,Anhui Clinical Research Center for Mental Diseases, Hefei, China
| | - Bao-Shi Wang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China.,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China.,Anhui Clinical Research Center for Mental Diseases, Hefei, China
| | - Yuan-Yuan Mu
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China.,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China.,Anhui Clinical Research Center for Mental Diseases, Hefei, China
| | - Xie-Hai Zhou
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China.,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China.,Anhui Clinical Research Center for Mental Diseases, Hefei, China
| | - Qing-Rong Xia
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China.,Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China.,Anhui Clinical Research Center for Mental Diseases, Hefei, China
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7
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Yano J, Kaida Y, Maeda T, Hashida R, Tonan T, Nagata S, Hazama T, Nakayama Y, Ito S, Kurokawa Y, Otome T, Shibata R, Tashiro K, Kakuma T, Matsuse H, Fukami K. l-carnitine supplementation vs cycle ergometer exercise for physical activity and muscle status in hemodialysis patients: A randomized clinical trial. Ther Apher Dial 2020; 25:304-313. [PMID: 32777142 PMCID: PMC8247310 DOI: 10.1111/1744-9987.13576] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/12/2022]
Abstract
Serum carnitine is decreased in hemodialysis patients, which induces muscle atrophy. Thus, we examined the different effects of l-carnitine and exercise on exercise activity and muscle status in hemodialysis patients. Twenty patients were divided into l-carnitine and cycle ergometer groups and were followed for 3 months. Muscle and fat mass, physical activities, and muscle status were evaluated by an impedance, physical function test, and magnetic resonance imaging, respectively. The l-carnitine significantly increased muscle mass (P = .023) and thigh circumference (P = .027), decreased fat mass (P = .007), and shortened chair stand-up time (P = .002) and 10-m walk test (P = .037). The fat fraction was improved by the l-carnitine (P = .047). Compared with the exercise group, l-carnitine improved the changes in 10-m walk test (P = .026), chair stand-up time (P = .014), and thigh circumference (P = .022). Baseline fibroblast growth factor-21 and myostatin levels predicted the l-carnitine-associated changes in exercise activities. l-carnitine, rather than exercise, improved physical activity and muscle status in hemodialysis patients.
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Affiliation(s)
- Junko Yano
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Yusuke Kaida
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Takashi Maeda
- Division of Rehabilitation, Kurume University Hospital, Kurume City, Fukuoka, Japan
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, Kurume City, Fukuoka, Japan
| | - Tatsuyuki Tonan
- Department of Radiology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Shuji Nagata
- Department of Radiology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Takuma Hazama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Yosuke Nakayama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Sakuya Ito
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Yuka Kurokawa
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Takaomi Otome
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Ryo Shibata
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Kyoko Tashiro
- Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Tatsuyuki Kakuma
- Biostatistics Center, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, Kurume City, Fukuoka, Japan
| | - Kei Fukami
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
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Yamagishi SI, Sotokawauchi A, Matsui T. Pathological Role of Advanced Glycation End Products (AGEs) and their Receptor Axis in Atrial Fibrillation. Mini Rev Med Chem 2019; 19:1040-1048. [PMID: 30854960 DOI: 10.2174/1389557519666190311140737] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/28/2019] [Accepted: 03/02/2019] [Indexed: 12/12/2022]
Abstract
Accumulating evidence has shown that the incidence of atrial fibrillation (AF) is higher in patients with diabetes, especially those with poor glycemic control or long disease duration. Nonenzymatic glycation of amino acids of proteins, lipids, and nucleic acids has progressed under normal aging process and/or diabetic condition, which could lead to the formation and accumulation of advanced glycation end products (AGEs). AGEs not only alter the tertiary structure and physiological function of macromolecules, but also evoke inflammatory and fibrotic reactions through the interaction of cell surface receptor for AGEs (RAGE), thereby being involved in aging-related disorders. In this paper, we briefly review the association of chronic hyperglycemia and type 1 diabetes with the risk of AF and then discuss the pathological role of AGE-RAGE axis in AF and its thromboembolic complications.
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Affiliation(s)
- Sho-Ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Ami Sotokawauchi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Takanori Matsui
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume 830-0011, Japan
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Yano J, Kaida Y, Nakayama Y, Ito S, Kurokawa Y, Nakamura N, Hazama T, Maeda T, Hashida R, Tashiro K, Inokuchi T, Matsuse H, Fukami K. Carnitine deficiency is associated with decreased exercise activity in hemodialysis patients. RENAL REPLACEMENT THERAPY 2019. [DOI: 10.1186/s41100-019-0197-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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10
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Kamada Y, Masuda T, Kotani K, Tanaka S, Nakamura T, Hamazaki N, Itoh Y, Moriguchi I, Kobayashi N, Okubo M, Takeuchi K, Naito S, Takeuchi Y. Decreased level of serum carnitine might lead to arteriosclerosis progression via the accumulation of advanced glycation end products in maintenance hemodialysis patients. RENAL REPLACEMENT THERAPY 2017. [DOI: 10.1186/s41100-017-0135-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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11
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Tashiro K, Kaida Y, Yamagishi SI, Tanaka H, Yokoro M, Yano J, Sakai K, Kurokawa Y, Taguchi K, Nakayama Y, Inokuchi T, Fukami K. L-Carnitine Supplementation Improves Self-Rating Depression Scale Scores in Uremic Male Patients Undergoing Hemodialysis. LETT DRUG DES DISCOV 2017; 14:737-742. [PMID: 28670223 PMCID: PMC5470074 DOI: 10.2174/1570180814666170216102632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/05/2017] [Accepted: 02/17/2017] [Indexed: 11/25/2022]
Abstract
Background: Depression is highly prevalent in uremic patients undergoing hemodialysis (HD). We previously found that low free-carnitine levels are associated with depression severity in male patients undergoing HD. However, whether L-carnitine supplementation improves the depression state in male patients undergoing HD remains unclear. Methods: Sixteen male patients undergoing HD were orally administered 900 mg L-carnitine daily or intravenously administered 1000 mg L-carnitine immediately after undergoing HD for 3 months. The depression state and various types of carnitine levels were evaluated using the self-rating depression scale (SDS) and tandem mass spectrometry, respectively, at baseline and 3 months after treatment. Results: L-carnitine supplementation significantly increased serum levels of free and other acylcarnitine types, associated with improved SDS scores in male patients undergoing HD. Univariate analysis revealed that low baseline butyryl- and isovaleryl-/2-methylbutyryl-carnitine levels were significantly correlated with SDS scores after treatment. Multiple regression analysis revealed that butyryl-carnitine levels were a sole independent predictor of SDS scores after treatment (r2 = 0.533). Conclusion: L-carnitine supplementation for 3 months improved the depression state in uremic male patients undergoing HD. Thus, low butyryl-carnitine levels may predict the clinical response to L-carnitine supplementation in male patients undergoing HD and who have mild depression.
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Affiliation(s)
| | | | - Sho-Ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
| | | | | | - Junko Yano
- Department of Medicine, Division of Nephrology
| | | | | | | | | | | | - Kei Fukami
- Department of Medicine, Division of Nephrology
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12
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Yamagishi SI, Fukami K, Matsui T. Evaluation of tissue accumulation levels of advanced glycation end products by skin autofluorescence: A novel marker of vascular complications in high-risk patients for cardiovascular disease. Int J Cardiol 2015; 185:263-8. [DOI: 10.1016/j.ijcard.2015.03.167] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 03/13/2015] [Accepted: 03/16/2015] [Indexed: 11/25/2022]
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Oral L-Carnitine Supplementation Increases Trimethylamine-N-oxide but Reduces Markers of Vascular Injury in Hemodialysis Patients. J Cardiovasc Pharmacol 2015; 65:289-95. [DOI: 10.1097/fjc.0000000000000197] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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14
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Guarnieri G. Carnitine in Maintenance Hemodialysis Patients. J Ren Nutr 2015; 25:169-75. [DOI: 10.1053/j.jrn.2014.10.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 10/29/2014] [Indexed: 11/11/2022] Open
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15
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Fukami K, Yamagishi SI, Sakai K, Kaida Y, Minami A, Nakayama Y, Ando R, Obara N, Ueda S, Wada Y, Okuda S. Carnitine deficiency is associated with late-onset hypogonadism and depression in uremic men with hemodialysis. Aging Male 2014; 17:238-42. [PMID: 24611884 DOI: 10.3109/13685538.2014.888053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Late-onset hypogonadism (LOH) and depression contribute to cardiovascular disease (CVD) in male hemodialysis (HD) patients. Carnitine deficiency is frequently observed in HD patients, playing a role in CVD. We examined whether carnitine deficiency was independently associated with LOH and depression in these patients. Twenty-six male HD patients underwent determinations of serum levels of free carnitine and testosterone. Status of LOH and depression were evaluated by questionnaires using aging male symptoms' (AMS) scale and self-rating depression scale (SDS), respectively. Free carnitine and testosterone levels in male HD patients were significantly lower than those in age-matched healthy male subjects. Linear regression analysis showed that AMS scale was positively associated with SDS. Univariate regression analysis revealed that total carnitine (inversely), free carnitine (inversely) and HD duration were correlated with AMS scale. Multiple stepwise regression analysis revealed that free carnitine was an independent determinant of AMS scale. Furthermore, free carnitine was also independently correlated with SDS in male HD patients. This study demonstrated that decreased free carnitine levels were independently associated with AMS scale and SDS in male HD patients. The observations suggest that decreased free carnitine levels could be a marker and therapeutic target of LOH and depression in uremic men with HD.
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Affiliation(s)
- Kei Fukami
- Division of Nephrology, Department of Medicine
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16
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Fukami K, Yamagishi SI, Sakai K, Nasu M, Okuda S. Effects of switching from oral administration to intravenous injection of l-carnitine on lipid metabolism in hemodialysis patients. Clin Kidney J 2014; 7:470-4. [PMID: 25878778 PMCID: PMC4379340 DOI: 10.1093/ckj/sfu082] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 07/06/2014] [Indexed: 12/26/2022] Open
Abstract
Background Carnitine deficiency may contribute to cardiovascular disease (CVD) in patients with hemodialysis (HD). Dyslipidemia plays a role in CVD and its prevalence is also high in HD patients. We examined here the effects of switching from oral administration (PO) to intravenous (IV) injection of l-carnitine on lipid metabolism in patients with HD. Methods Nine HD patients who had received l-carnitine orally (900 mg/day) for 1 year were enrolled in this study. We examined whether lipid parameters were improved by switching to IV injection therapy of 1000 mg l-carnitine. Results IV injection of l-carnitine for 1 week significantly increased total, free and acyl carnitine levels both before and after HD. Switching to IV injection therapy for 1 and 4 weeks decreased serum free fatty acid (FFA) (322 ± 104 versus 261 ± 124 µmol/L) and increased high-density lipoprotein-cholesterol levels (1.46 ± 0.49 versus 1.63 ± 0.62 mmol/L), respectively. Change in FFA values from the baseline (ΔFFA) was positively correlated with the Δacyl/free carnitine ratio (r2 = 0.553, P = 0.022). Conclusion This study demonstrated that switching to IV l-carnitine therapy from oral supplementation improved lipid profiles, thus supporting the clinical utility of IV administration of l-carnitine for the treatment of patients on HD.
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Affiliation(s)
- Kei Fukami
- Division of Nephrology, Department of Medicine , Kurume University School of Medicine , Kurume , Japan
| | - Sho-Ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications , Kurume University School of Medicine , Kurume , Japan
| | - Kazuko Sakai
- Division of Nephrology, Department of Medicine , Kurume University School of Medicine , Kurume , Japan
| | - Makoto Nasu
- Division of Nephrology, Department of Medicine , Kurume University School of Medicine , Kurume , Japan
| | - Seiya Okuda
- Division of Nephrology, Department of Medicine , Kurume University School of Medicine , Kurume , Japan
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Fukami K, Yamagishi SI, Sakai K, Kaida Y, Adachi T, Ando R, Okuda S. Potential inhibitory effects of L-carnitine supplementation on tissue advanced glycation end products in patients with hemodialysis. Rejuvenation Res 2014; 16:460-6. [PMID: 23909402 DOI: 10.1089/rej.2013.1459] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND AIMS Advanced glycation end products (AGEs) contribute to cardiovascular disease in patients with hemodialysis (HD). We have recently found that carnitine levels are inversely associated with skin AGE levels in HD patients. We examined whether L-carnitine supplementation reduced skin AGE levels in HD patients with carnitine deficiency. METHODS This was a single-center study. One hundred and two HD patients (total carnitine levels <50 μmol/L) were enrolled and randomized to either oral administration of L-carnitine (900 mg/day) (n=51) or control (n=51). After 6 months, metabolic and inflammatory variables, including serum levels of carnitine, were measured. Skin AGE levels were determined by evaluating skin auto-fluorescence with an AGE-reader. RESULTS There were no significant differences of clinical variables at baseline between the control and L-carnitine therapy group. Thirty-two patients did not complete the assessment or treatment of the study. Oral L-carnitine supplementation for 6 months significantly increased low-density lipoprotein cholesterol (LDL-C), triglycerides, total, free, and acyl carnitine levels, while it decreased alanine transaminase, acyl/free carnitine ratio, β₂-microglobulin, and skin AGE values. Change in total carnitine values from baseline (Δtotal carnitine) and Δfree carnitine were inversely associated with Δskin AGE levels in L-carnitine-treated patients (p=0.036 and p=0.016, respectively). In multiple regression analysis, Δfree carnitine was a sole independent determinant of Δskin AGEs (R²=0.178). CONCLUSIONS The present study demonstrated that oral L-carnitine supplementation significantly decreased skin AGE levels in HD patients with carnitine deficiency. These observations suggest that supplementation of L-carnitine might be a novel therapeutic strategy for preventing the accumulation of tissue AGEs in carnitine-deficient patients with HD.
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Affiliation(s)
- Kei Fukami
- 1 Division of Nephrology, Department of Medicine, Kurume University School of Medicine , Kurume, Japan
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Hazama T, Fukami K, Yamagishi SI, Kusumoto T, Sakai K, Adachi T, Sonoda K, Kasuga S, Ueda S, Okuda S. Dialysate Vascular Endothelial Growth Factor Is an Independent Determinant of Serum Albumin Levels and Predicts Future Withdrawal From Peritoneal Dialysis in Uremic Patients. Ther Apher Dial 2013; 18:391-7. [DOI: 10.1111/1744-9987.12120] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Takuma Hazama
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
| | - Kei Fukami
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
| | - Sho-ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications; Kurume University School of Medicine; Kurume Japan
| | - Takuo Kusumoto
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
| | - Kazuko Sakai
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
| | - Takeki Adachi
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
| | - Kazuhiro Sonoda
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
| | - Syumon Kasuga
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
| | - Seiji Ueda
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
| | - Seiya Okuda
- Division of Nephrology; Department of Medicine; Kurume University School of Medicine; Kurume Japan
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Manabe R, Fukami K, Ando R, Sakai K, Kusumoto T, Hazama T, Adachi T, Kaida Y, Nakayama Y, Ueda S, Kohno K, Wada Y, Yamagishi SI, Okuda S. Effects of switching from calcium carbonate to lanthanum carbonate on bone mineral metabolism in hemodialysis patients. Ther Apher Dial 2013; 17 Suppl 1:35-40. [PMID: 23586511 DOI: 10.1111/1744-9987.12037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Indexed: 01/24/2023]
Abstract
Phosphate binders are useful for the treatment of hyperphosphatemia in hemodialysis (HD) patients. This study was performed to examine the effects of switching from calcium carbonate (CC) to lanthanum carbonate (LC) on bone mineral metabolism and inflammatory markers in HD patients. We conducted 29 stable HD patients receiving CC, which was replaced by LC and followed-up for 12 weeks. Patients underwent determinants of blood chemistries such as serum calcium (Ca), phosphorus, parathyroid hormone (PTH) and vitamin D status, and interleukin-6 (IL-6) mRNA levels in whole blood cells were evaluated by real-time PCR just before and after the treatment with LC. Corrected Ca [corrected] levels were significantly reduced, but serum phosphorus levels (P levels) were unchanged after LC treatment. Switching to LC increased whole-PTH, osteocalcin, 1,25(OH)(2) D(3) levels and 1,25(OH)(2) D(3)/25(OH)D(3) ratio. 1,25(OH)(2) D(3)/25(OH)D(3) ratio was negatively correlated with HD duration. Furthermore, whole blood cell IL-6 mRNA levels were significantly reduced by LC treatment. We provided that the switching from CC to LC improved Ca overload and ameliorated vitamin D and inflammatory status in HD patients. These observations suggest that LC may play a protective role for the progression of atherosclerosis and vascular calcification in these patients.
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Affiliation(s)
- Rie Manabe
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume city, Fukuoka, Japan
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Evidence for a Positive Association Between Serum Carnitine and Free Testosterone Levels in Uremic Men with Hemodialysis. Rejuvenation Res 2013; 16:200-5. [DOI: 10.1089/rej.2012.1399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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