L-carnitine supplementation in non-alcoholic fatty liver disease: A systematic review and meta-analysis

An NMR-Based Metabolomics Assessment of the Effect of Combinations of Natural Feed Items on Juvenile Red Drum, Sciaenops ocellatus

This study evaluated the effects of seven diets composed of natural feed components (chopped fish, shrimp, and squid) alone or in combination on the liver metabolite profile of juvenile red drum (Sciaenops ocellatus) cultured in a 24-tank recirculating aquaculture system over the course of 12 weeks using Nuclear Magnetic Resonance (NMR)-based metabolomics. Experimental diets included fish (F), shrimp (SH), squid (SQ), fish and shrimp (FSH), fish and squid (FSQ), shrimp and squid (SHSQ), fish, shrimp, and squid (FSHSQ). A commercial fishmeal-based pelleted diet was used as a control. Fish were fed isocalorically. Red drum liver samples were collected at five different time points: T0, before the start of the trial (n = 12), and subsequently every 3 weeks over the course of 12 weeks (T3, T6, T9, T12), with n = 9 fish/diet/time point. Polar liver extracts were analyzed by NMR-based metabolomics. Multivariate statistical analyses (PCA, PLS-DA) revealed that red drum fed the F diet had a distinct liver metabolite profile from fish fed the other diets, with those fed SH, SQ and the combination diets displaying greater similarities in their metabolome. Results show that 19 metabolites changed significantly among the different dietary treatments, including amino acids and amino acid derivatives, quaternary amines and methylamines, carbohydrates and phospholipids. Specifically, γ-butyrobetaine, N-formimino-L-glutamate (FIGLU), sarcosine and beta-alanine were among the most discriminating metabolites. Significant correlations were found between metabolites and six growth performance parameters (final body weight, total length, condition factor, liver weight, hepatosomatic index, and eviscerated weight). Metabolites identified in this study constitute potential candidates for supplementation in fish feeds for aquaculture and optimization of existing formulations. Additionally, we identified a quaternary amine, γ-butyrobetaine as a potential biomarker of shrimp consumption in red drum. These results warrant further investigation and biomarker validation and have the potential for broader applicability outside of the aquaculture field in future investigations in wild red drum populations and potentially other carnivorous marine fishes.

Effect of l-carnitine supplementation on children and adolescents with nonalcoholic fatty liver disease (NAFLD): a randomized, triple-blind, placebo-controlled clinical trial

OBJECTIVES

Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in the pediatric population at global level. Present study aims to assess the effect of l-carnitine supplementation on the NAFLD in children and adolescents.

METHODS

This randomized, triple-blind, placebo-controlled clinical trial was conducted in 2018-2019. Study was carried out in NAFLD participants (5-15 years). They were randomly assigned to receive either 50 mg/kg/day l-carnitine twice a day or identical placebo per day for three months. Liver enzymes and liver ultrasonography were assessed before and after the intervention. Both groups received similar consultation for lifestyle changes.

RESULTS

Overall, 55 participants completed the study, 30 patients in the l-carnitine group and 25 patients in placebo group. Mean changes of anthropometric measurements did not have significant differences between groups (p>0.05). No significant differences in the mean changes of aspartate aminotransferase (AST) (p=0.82) and alanine aminotransferase (ALT) (p=0.76) levels were documented between two groups. Based on within-group analysis, there were significant changes in AST and ALT levels before and after the intervention in both groups. The sonographic grades of fatty liver were not significantly different between two groups before (p=0.94) and after intervention (p=0.93).

CONCLUSIONS

In the present clinical trial, L-carnitine did not have significant effect on improving biochemical and sonographic markers of NAFLD in children and adolescents. Future studies are necessary to evaluate the applicability and efficacy of long-term l-carnitine supplementation to treatment of NAFLD in pediatric population.

TRIAL REGISTRATION

IRCT20170628034786N2.

The Nutraceutical Value of Carnitine and Its Use in Dietary Supplements

Carnitine can be considered a conditionally essential nutrient for its importance in human physiology. This paper provides an updated picture of the main features of carnitine outlining its interest and possible use. Particular attention has been addressed to its beneficial properties, exploiting carnitine's properties and possible use by considering the main in vitro, in animal, and human studies. Moreover, the main aspects of carnitine-based dietary supplements have been indicated and defined with reference to their possible beneficial health properties.