Effects of L-carnitine supplementation on lipid profiles in patients with coronary artery disease

Bor-Jen Lee, Jun-Shuo Lin, Yi-Chin Lin, Ping-Ting Lin, Bor-Jen Lee, Jun-Shuo Lin, Yi-Chin Lin, Ping-Ting Lin

Abstract

Background: L-carnitine (LC) plays an important physiologic role in lipid metabolism. To date, no clinical study has been performed to examine the effect of LC supplementation on the lipid status of coronary artery disease (CAD) patients. The aim of this study was to investigate the lipid lowering effects of LC supplementation (1000 mg/d) in CAD patients.

Methods: CAD patients were identified by cardiac catheterization as having at least 50 % stenosis of one major coronary artery. Forty-seven subjects were recruited and randomly assigned to the placebo (n = 24) and to the LC (n = 23) groups. The intervention was administered for 12 weeks. The levels of LC, lipid profiles, and antioxidant enzyme activity (superoxide dismutase, SOD) were measured.

Results: The subjects in the LC group had significantly higher SOD activity (20.7 ± 4.2 versus 13.1 ± 2.9 U/mg of protein, P < 0.01), high density lipoprotein-cholesterol (1.34 ± 0.42 vs. 1.16 ± 0.24 mmol/L, HDL-C, P = 0.03), and apolipoprotein-A1 (Apo-A1, 1.24 ± 0.18 vs. 1.12 ± 0.13 g/L, P = 0.02) than those in the placebo group at week 12. Triglyceride (TG) level was slightly significantly reduced (1.40 ± 0.74 vs. 1.35 ± 0.62 mmol/L, P = 0.06) and the level of LC was negatively correlated with TG and apolipoprotein-B (Apo-B), and positively correlated with HDL-C and Apo-A1 after LC supplementation. Additionally, SOD activity was significantly negatively correlated with lipid profiles (total cholesterol, TG, and Apo-B) after supplementation.

Conclusion: LC supplementation at a dose of 1000 mg/d showed significantly increased in HDL-C and Apo-A1 levels and a slight decrease in TG levels but no other changes in other lipids in CAD patients, and this lipid-lowering effect may be related to its antioxidant ability. Further studies should be conducted to define an optimal dose of LC for lipid-lowering in patients with CAD.

Trial registration: Clinical Trials.gov Identifier: NCT01819701.

Keywords: Antioxidant; Coronary artery disease; L-carnitine supplement; Lipid profiles.

Figures

Fig. 1
Fig. 1
Consort flow diagram
Fig. 2
Fig. 2
Levels of lipids profiles after supplementation
Fig. 3
Fig. 3
Correlations between the levels of lipids profiles and L-carnitine after supplementation

References

    1. Kendler BS. Carnitine: an overview of its role in preventive medicine. Prev Med. 1986;15:373–90. doi: 10.1016/0091-7435(86)90005-8.
    1. Flanagan JL, Simmons PA, Vehige J, Willcox MD, Garrett Q. Role of carnitine in disease. Nutr Metab. 2010;7:30. doi: 10.1186/1743-7075-7-30.
    1. Gülçin I. Antioxidant and antiradical activities of L-carnitine. Life sci. 2006;78:803–11. doi: 10.1016/j.lfs.2005.05.103.
    1. Ribas GS, Vargas CR, Wajner M. L-carnitine supplementation as a potential antioxidant therapy for inherited neurometabolic disorders. Gene. 2014;533:469–76. doi: 10.1016/j.gene.2013.10.017.
    1. Kolodziejczyk J, Saluk-Juszczak J, Wachowicz B. L-Carnitine protects plasma components against oxidative alterations. Nutrition. 2011;27:693–9. doi: 10.1016/j.nut.2010.06.009.
    1. Savica V, Santoro D, Mazzaglia G, Ciolino F, Monardo P, Calvani M, et al. L-carnitine infusions may suppress serum C-reactive protein and improve nutritional status in maintenance hemodialysis patients. J Ren Nutr. 2005;15:225–30. doi: 10.1053/j.jrn.2004.10.002.
    1. Duranay M, Akay H, Yilmaz FM, Senes M, Tekeli N, Yücel D. Effects of L-carnitine infusions on inflammatory and nutritional markers in haemodialysis patients. Nephrol Dial Transplant. 2006;21:3211–4. doi: 10.1093/ndt/gfl356.
    1. Shakeri A, Tabibi H, Hedayati M. Effects of L-carnitine supplement on serum inflammatory cytokines, C-reactive protein, lipoprotein (a), and oxidative stress in hemodialysis patients with Lp (a) hyperlipoproteinemia. Hemodial Int. 2010;14:498–504. doi: 10.1111/j.1542-4758.2010.00476.x.
    1. Cetinkaya A, Bulbuloglu E, Kantarceken B, Ciralik H, Kurutas EB, Buyukbese MA, et al. Effects of L-carnitine on oxidant/antioxidant status in acetic acid-induced colitis. Dig Dis Sci. 2006;51:488–94. doi: 10.1007/s10620-006-3160-9.
    1. Koc A, Ozkan T, Karabay AZ, Sunguroglu A, Aktan F. Effect of L-carnitine on the synthesis of nitric oxide in RAW 264A7 murine macrophage cell line. Cell Biochem Funct. 2011;29:679–85. doi: 10.1002/cbf.1807.
    1. Moeinian M, Ghasemi-Niri SF, Mozaffari S, Abdollahi M. Synergistic effect of probiotics, butyrate and L-Carnitine in treatment of IBD. JMHI. 2013;7:50–3.
    1. Stocker R, Keaney JF. Role of oxidative modifications in atherosclerosis. Physiol Rev. 2004;84:1381–478. doi: 10.1152/physrev.00047.2003.
    1. Shojaei M, Djalali M, Khatami M, Siassi F, Eshraghian M. Effects of carnitine and coenzyme Q10 on lipid profile and serum levels of lipoprotein(a) in maintenance hemodialysis patients on statin therapy. Iran J Kidney Dis. 2011;5:114–8.
    1. Suchitra MM, Ashalatha VL, Sailaja E, Rao AM, Reddy VS, Bitla AR, et al. The effect of L-carnitine supplementation on lipid parameters, inflammatory and nutritional markers in maintenance hemodialysis patients. Saudi J Kidney Dis Transpl. 2011;22:1155–9.
    1. Tabibi H, Hakeshzadeh F, Hedayati M, Malakoutian T. Effects of l-carnitine supplement on serum amyloid A and vascular inflammation markers in hemodialysis patients: a randomized controlled trial. J Ren Nutr. 2011;21:485–91. doi: 10.1053/j.jrn.2011.01.001.
    1. Naini AE, Moradi M, Mortazavi M, Amini Harandi A, Hadizadeh M, Shirani F, et al. Effects of oral L-carnitine supplementation on lipid Profile, anemia, and quality of life in chronic renal disease patients under hemodialysis: a randomized, double-blinded, placebo-controlled trial. J Nutr Metab. 2012;2012:510483.
    1. Naini AE, Sadeghi M, Mortazavi M, Moghadasi M, Harandi AA. Oral carnitine supplementation for dyslipidemia in chronic hemodialysis patients. Saudi J Kidney Dis Transpl. 2012;23:484–8.
    1. Derosa G, Cicero AF, Gaddi A, Mugellini A, Ciccarelli L, Fogari R. The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus. Clin Ther. 2003;25:1429–39. doi: 10.1016/S0149-2918(03)80130-3.
    1. Rahbar AR, Shakerhosseini R, Saadat N, Taleban F, Pordal A, Gollestan B. Effect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitus. Eur J Clin Nutr. 2005;59:592–6. doi: 10.1038/sj.ejcn.1602109.
    1. Malaguarnera M, Vacante M, Avitabile T, Malaguarnera M, Cammalleri L, Motta M. L-Carnitine supplementation reduces oxidized LDL cholesterol in patients with diabetes. Am J Clin Nutr. 2009;89:71–6. doi: 10.3945/ajcn.2008.26251.
    1. Hlais S, Reslan DR, Sarieddine HK, Nasreddine L, Taan G, Azar S. Effect of lysine, vitamin B(6), and carnitine supplementation on the lipid profile of male patients with hypertriglyceridemia: a 12-week, open-label, randomized, placebo-controlled trial. Clin Ther. 2012;34:1674–82. doi: 10.1016/j.clinthera.2012.06.019.
    1. Lombardo F, Lunghi R, Pallotti F, Palumbo A, Senofonte G, Cefaloni AC, et al. Effects of a dietary supplement on cholesterol in subjects with moderate hypercholesterolemia. Clin Ter. 2013;164:e147–50.
    1. Chen HJ, Bai CH, Yeh WT, Chiu HC, Pan WH. Influence of metabolic syndrome and general obesity on the risk of ischemic stroke. Stroke. 2006;37:1060–4. doi: 10.1161/01.STR.0000206458.58142.f3.
    1. Marklund S, Marklund G. Involvement of superoxide anion radical in autoxidation of pyrogallol and a convenient assay for superoxide dismutase. Eur J Biochem. 1974;47:469–74. doi: 10.1111/j.1432-1033.1974.tb03714.x.
    1. Bartel LL, Hussey JL, Shrago E. Perturbation of serum carnitine levels in human adults by chronic renal disease and dialysis therapy. Am J Clin Nutr. 1981;34:1314–20.
    1. Lee BJ, Lin JS, Lin YC, Lin PT. Effects of L-carnitine supplementation on oxidative stress and antioxidant enzymes activities in patients with coronary artery disease: a randomized, placebo-controlled trial. Nutr J. 2014;13:79. doi: 10.1186/1475-2891-13-79.
    1. Lee BJ, Lin JS, Lin YC, Lin PT. Anti-inflammation effects of L-carnitine supplementation (1000 mg/d) in coronary artery disease patients. Nutrition. 2015;31:475–9. doi: 10.1016/j.nut.2014.10.001.
    1. Walldius G, Jungner I. Apolipoprotein B and apolipoprotein A-I: risk indicators of coronary heart disease and targets for lipid-modifying therapy. J Intern Med. 2004;255:188–205. doi: 10.1046/j.1365-2796.2003.01276.x.
    1. Brescia F, Balestra E, Iasella MG, Damato AB. Effects of combined treatment with simvastatin and L-carnitine on triglyceride levels in diabetic patients with hyperlipidaemia. Clin Drug Investig. 2002;22:23–8. doi: 10.2165/00044011-200222001-00004.
    1. Chen Y, Abbate M, Tang L, Cai G, Gong Z, Wei R, Zhou J, Chen X. L-Carnitine supplementation for adults with end-stage kidney disease requiring maintenance hemodialysis: a systematic review and meta-analysis. Am J Clin Nutr. 2014;99:408–22. doi: 10.3945/ajcn.113.062802.
    1. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421.
    1. Yang RL, Shi YH, Hao G, Li W, Le GW. Increasing oxidative stress with progressive hyperlipidemia in human: relation between malondialdehyde and atherogenic Index. J Clin Biochem Nutr. 2008;43:154–8. doi: 10.3164/jcbn.2008044.
    1. Adekunle AS, Adedeji AL, Oyewo EO, Adedosu OT, Omotoso AT. Hyperlipidemia induced by atherogenic diet enhanced oxidative stress in the kidney and inflammatory responses: an in-vivo study. Asian J Natural Applied Sci. 2013;2:82–93.
    1. Scicchitano P, Cameli M, Maiello M, Modesti PA, Muiesan ML, Nova S, et al. Nutraceuticals and dyslipidaemia: Beyond the common therapeutics. J Funct Foods. 2014;6:11–32. doi: 10.1016/j.jff.2013.12.006.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren