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Effects of Acetyl L-Carnitine Supplementation on Clinical, Metabolic and Inflammatory Symptoms in Obese, Diabetic, Postmenopausal Women With Osteoarthritis
Effects of Acetyl L-Carnitine Supplementation on Clinical, Metabolic and Inflammatory Symptoms in Obese, Diabetic, Postmenopausal Women With Osteoarthritis: Randomized Controlled Trial
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Osteoarthritis (OA) is a chronic degenerative joint disease that commonly affects older adults and is associated with pain, stiffness, reduced mobility, and disability. The coexistence of obesity and type 2 diabetes mellitus may aggravate the progression and severity of OA through metabolic dysfunction, chronic low-grade inflammation, oxidative stress, and altered adipokine profiles. Postmenopausal women are particularly vulnerable because hormonal changes contribute to increased inflammation, obesity, insulin resistance, and joint degeneration.
Acetyl L-Carnitine is a naturally occurring compound involved in mitochondrial energy metabolism. Previous studies have demonstrated anti-inflammatory, antioxidant, and metabolic benefits of Acetyl L-Carnitine, including improvements in insulin resistance, lipid metabolism, oxidative stress, and inflammatory cytokine production. Experimental studies have also suggested chondroprotective effects through enhancement of cartilage matrix synthesis and mitochondrial function.
This double-blind, placebo-controlled randomized clinical trial will enroll 100 obese, diabetic, postmenopausal women with radiologically confirmed osteoarthritis. Participants will be randomly assigned to receive either Acetyl L-Carnitine (1.5 g twice daily) or placebo for 12 weeks in addition to conventional osteoarthritis treatment.
Clinical outcomes will include assessment of osteoarthritis symptoms using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), radiological severity using the Kellgren-Lawrence grading system, perceived stress, and depression, anxiety and stress scores. Laboratory outcomes will include glycemic profile, lipid profile, insulin resistance markers, inflammatory biomarkers (CRP and IL-6), oxidative stress markers, adipokines, stress hormones, and complete blood count parameters.
The study seeks to determine whether Acetyl L-Carnitine supplementation can improve clinical, metabolic, inflammatory, and radiological outcomes in obese, diabetic, postmenopausal women with osteoarthritis.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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KPK
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Bannu, KPK, Pakistan, 28100
- Khalifa Gulnawaz Teaching Hospital, DHQ Teaching Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Age 55-65 years
- Duration of menopause 2-15 years.
- Duration of diabetes 5-15 years
- BMI Obese ≥30 kg/m2
- Grade≥2 K&L on radiologic examination
Exclusion Criteria:
Female patients with osteoarthritis meeting the following criteria will be excluded from the study;
- Age˂55 ˃65yrs
- Post-menopausal duration of ˂2yrs
- Duration of diabetes ˂ 5years
- Patients with alcohol abuse, asthma, cardiac disease, chronic gastric problems (malabsorption, crohn's disease chronic diarrhea), non-diabetes related renal disease,ovariectomy, rheumatoid arthritis or other rheumatic inflammatory diseases, smoking
- Patients taking steroids (oral/ injections)
- Patients with a history of parathyroid and thyroid surgery/dysfunction
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Acetyl L-Carnitine Group
Participants will receive conventional treatment for osteoarthritis, including NSAIDs, COX-2 inhibitors, or acetaminophen as prescribed, together with Acetyl L-Carnitine capsules 1.5 g orally twice daily (total daily dose 3 g) after meals for 12 weeks.
Participants will continue their usual oral antihyperglycemic medications but will not receive insulin.
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Acetyl L-Carnitine capsules, 1.5 g administered orally twice daily (total daily dose 3 g) after meals for 12 weeks in addition to conventional osteoarthritis treatment.
Andere namen:
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Placebo-vergelijker: Placebo Control Group
Participants will receive matching placebo capsules administered orally at a dose of two capsules daily after meals for 12 weeks, in addition to conventional osteoarthritis treatment, including NSAIDs, COX-2 inhibitors, or acetaminophen as prescribed.
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Matching placebo capsules administered orally twice daily for 12 weeks in addition to conventional osteoarthritis treatment.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Serum C-Reactive Protein Concentration
Tijdsspanne: Baseline and Week 12
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Change in Serum C-Reactive Protein (CRP) Concentration (mg/L) from baseline following 12 weeks of Acetyl L-Carnitine supplementation.
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Baseline and Week 12
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Fasting Blood Glucose Concentration
Tijdsspanne: Baseline and Week 12
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Change in fasting blood glucose levels (mg/dL) from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Glycated Hemoglobin (HbA1c) Percentage
Tijdsspanne: Baseline and Week 12
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Change in HbA1c levels (%) from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)
Tijdsspanne: Baseline and Week 12
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Change in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) Score from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Fasting Serum Insulin Concentration
Tijdsspanne: Baseline and Week 12
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Change in fasting serum insulin concentration (µIU/mL) from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Serum Leptin Concentration
Tijdsspanne: Baseline and Week 12
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Change in serum leptin concentration (ng/mL) from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Serum Adiponectin Concentration
Tijdsspanne: Baseline and Week 12
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Change in serum adiponectin concentration (µg/mL) from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Serum Adrenocorticotropic Hormone (ACTH) Concentration
Tijdsspanne: Baseline and Week 12
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Change in serum ACTH concentration from baseline following 12 weeks of intervention
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Baseline and Week 12
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Serum Malondialdehyde (MDA) Concentration
Tijdsspanne: Baseline and Week 12
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Change in serum malondialdehyde levels as a marker of oxidative stress from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Serum Advanced Glycation End Products (AGEs) Concentration
Tijdsspanne: Baseline and Week 12
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Change in serum AGEs levels from baseline following 12 weeks of intervention.
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Baseline and Week 12
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WOMAC Osteoarthritis Index total Score
Tijdsspanne: Baseline and Week 12
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Change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Kellgren-Lawrence Radiographic Grade
Tijdsspanne: Baseline and Week 12
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Change in osteoarthritis radiographic severity assessed by the Kellgren-Lawrence grading system from baseline following 12 weeks of intervention.
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Baseline and Week 12
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Interleukin-6 (IL-6)
Tijdsspanne: Baseline and Week 12
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Change in serum IL-6 concentration from baseline following 12 weeks of Acetyl L-Carnitine supplementation.
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Baseline and Week 12
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Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Dr Safia Bibi, PhD*, Khyber Medical University Peshawar, Pakistan
- Hoofdonderzoeker: Dr Mohsin Shah, PhD, Khyber Medical University Peshawar, Pakistan
- Hoofdonderzoeker: Dr Zia Ullah, PhD, Khalifa Gul Nawaz Teaching Hospital
Publicaties en nuttige links
Algemene publicaties
- Prieto-Alhambra D, Judge A, Javaid MK, Cooper C, Diez-Perez A, Arden NK. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014 Sep;73(9):1659-64. doi: 10.1136/annrheumdis-2013-203355. Epub 2013 Jun 6.
- GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023 Aug 21;5(9):e508-e522. doi: 10.1016/S2665-9913(23)00163-7. eCollection 2023 Sep.
- Thijssen E, van Caam A, van der Kraan PM. Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis. Rheumatology (Oxford). 2015 Apr;54(4):588-600. doi: 10.1093/rheumatology/keu464. Epub 2014 Dec 11.
- Francisco V, Tovar S, Conde J, Pino J, Mera A, Lago F, Gonzalez-Gay MA, Dieguez C, Gualillo O. Levels of the Novel Endogenous Antagonist of Ghrelin Receptor, Liver-Enriched Antimicrobial Peptide-2, in Patients with Rheumatoid Arthritis. Nutrients. 2020 Apr 6;12(4):1006. doi: 10.3390/nu12041006.
- Lu Q, Zhang Y, Elisseeff JH. Carnitine and acetylcarnitine modulate mesenchymal differentiation of adult stem cells. J Tissue Eng Regen Med. 2015 Dec;9(12):1352-62. doi: 10.1002/term.1747. Epub 2013 Apr 29.
- Walker C, Faustino A, Lanas A. Monitoring complete blood counts and haemoglobin levels in osteoarthritis patients: results from a European survey investigating primary care physician behaviours and understanding. Open Rheumatol J. 2014 Dec 19;8:110-5. doi: 10.2174/1874312901408010110. eCollection 2014.
Studie record data
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Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
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Laatste update ingediend die voldeed aan QC-criteria
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Endocriene systeemziekten
- Musculoskeletale aandoeningen
- Voedingsstoornissen
- Artritis
- Gewrichtsziekten
- Reumatische aandoeningen
- Metabole ziekten
- Overvoeding
- Lichaamsgewicht
- Glucosemetabolismestoornissen
- Suikerziekte
- Overgewicht
- Pathologische aandoeningen, tekenen en symptomen
- Voedings- en stofwisselingsziekten
- Tekenen en symptomen
- Obesitas
- Diabetes mellitus, type 2
- Artrose
- Organische chemicaliën
- Amines
- Quaternaire ammoniumverbindingen
- Trimethyl ammoniumverbindingen
- Acetylcarnitine
- Carnitine
Andere studie-ID-nummers
- KMU/DIR/CTU/2026/05
Plan Individuele Deelnemersgegevens (IPD)
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Beschrijving IPD-plan
IPD-tijdsbestek voor delen
IPD-toegangscriteria voor delen
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
- ICF
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