Effects of L-carnitine on Polycystic Ovary Syndrome

Saghar Salehpour, Leila Nazari, Sedighe Hoseini, Parya Bameni Moghaddam, Latif Gachkar, Saghar Salehpour, Leila Nazari, Sedighe Hoseini, Parya Bameni Moghaddam, Latif Gachkar

Abstract

Objective: Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age. This study investigated the effects of L-carnitine on the clinical and laboratory findings of women with PCOS.

Methods: Eighty women diagnosed with PCOS between 2017 and 2018 by the Rotterdam Criteria were enrolled in the study; six were lost during the study. The participants were given L-carnitine 3 g daily (Pursinapharma, Iran) for three months. Blood samples were taken after overnight fasting at baseline and three months into the study to assess the levels of fasting glucose, insulin, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), free testosterone, dehydroepiandrosterone (DHEA), and the insulin resistance index (HOMA-IR). The patients were weighed before and after treatment and had their body mass index (BMI) calculated. Menstrual cycles and manifestations of hirsutism were also assessed.

Results: The data showed a significant improvement in insulin sensitivity and decreases in serum LDL levels and the BMI after three months of treatment. There was a significant increase in serum HDL levels. More regular menstrual cycles and decreased hirsutism were also observed.

Conclusion: It appears that treatment with L-carnitine might decrease the risk of cardiovascular events by normalizing metabolic profiles and the BMI.

Keywords: HOMA index; L-carnitine; hyperinsulinemia; polycystic ovary syndrome.

References

    1. Aquino CI, Nori SL. Complementary therapy in polycystic ovary syndrome. Transl Med UniSa. 2014;9:56–65.
    1. Artini PG, Di Berardino OM, Papini F, Genazzani AD, Simi G, Ruggiero M, Cela V. Endocrine and clinical effects of myo-inositol administration in policystyc ovary syndrome. A randomized study. Gynecol Endocrinol. 2013;29:375–379. doi: 10.3109/09513590.2012.743020.
    1. Bacurau RF, Navarro F, Bassit RA, Meneguello MO, Santos RV, Almeida AL, Costa Rosa LF. Does exercise training interfere with the effects of L-carnitine supplementation? Nutrition. 2003;19:337–341.
    1. Baillargeon JP, Nestler JE. Commentary: polycystic ovary syndrome: a syndrome of ovarian hypersensitivity to insulin? J Clin Endocrinol Metab. 2006;91:22–24. doi: 10.1210/jc.2005-1804.
    1. Banaszewska B, Pawelczyk L, Spaczynski RZ, Duleba AJ. Comparison of simvastatin and metformin in treatment of polycystic ovary syndrome: prospective randomized trial. J Clin Endocrinol Metab. 2009;94:4938–4945. doi: 10.1210/jc.2009-1674.
    1. Banaszewska B, Pawelczyk L, Spaczynski RZ, Duleba AJ. Effects of simvastatin and metformin on polycystic ovary syndrome after six months of treatment. J Clin Endocrinol Metab. 2011;96:3493–3501. doi: 10.1210/jc.2011-0501.
    1. Celik F, Kose M, Yilmazer M, Köken GN, Arioz DT, Kanat Pektas M. Plasma L-carnitine levels of obese and non-obese polycystic ovary syndrome patients. J Obstet Gynaecol. 2017;37:476–479. doi: 10.1080/01443615.2016.1264375.
    1. De Leo V, la Marca A, Petraglia F. Insulin-lowering agents in the management of polycystic ovary syndrome. Endocr Rev. 2003;24:633–667. doi: 10.1210/er.2002-0015.
    1. Fenkci SM, Fenkci V, Oztekin O, Rota S, Karagenc N. Serum total L-carnitine levels in non-obese women with polycystic ovary syndrome. Hum Reprod. 2008;23:1602–1606. doi: 10.1093/humrep/den109.
    1. Genazzani AD, Battaglia C, Malavasi B, Strucchi C, Tortolani F, Gamba O. Metformin administration modulates and restores luteinizing hormone spontaneous episodic secretion and ovarian function in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2004;81:114–119. doi: 10.1016/j.fertnstert.2003.05.020.
    1. Genazzani AD, Lanzoni C, Ricchieri F, Baraldi E, Casarosa E, Jasonni VM. Metformin administration is more effective when non-obese patients with polycystic ovary syndrome show both hyperandrogenism and hyperinsulinemia. Gynecol Endocrinol. 2007;23:146–152. doi: 10.1080/09513590701214398.
    1. Ismail AM, Hamed AH, Saso S, Thabet HH. Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2014;180:148–152. doi: 10.1016/j.ejogrb.2014.06.008.
    1. Jamilian H, Jamilian M, Samimi M, Afshar Ebrahimi F, Rahimi M, Bahmani F, Aghababayan S, Kouhi M, Shahabbaspour S, Asemi Z. Oral carnitine supplementation influences mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Gynecol Endocrinol. 2017;33:442–447. doi: 10.1080/09513590.2017.1290071.
    1. Karlic H, Lohninger A. Supplementation of L-carnitine in athletes: does it make sense? Nutrition. 2004;20:709–715. doi: 10.1016/j.nut.2004.04.003.
    1. Kumar AN, Naidu JN, Satyanarayana U, Ramalingam K, Anitha M. Metabolic and Endocrine Characteristics of Indian Women with Polycystic Ovary Syndrome. Int J Fertil Steril. 2016;10:22–28.
    1. Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertil Steril. 2012;97:18–22. doi: 10.1016/j.fertnstert.2011.11.036.
    1. Motta AB. The role of obesity in the development of polycystic ovary syndrome. Curr Pharm Des. 2012;18:2482–2491. doi: 10.2174/13816128112092482.
    1. Naderpoor N, Shorakae S, Joham A, Boyle J, De Courten B, Teede HJ. Obesity and polycystic ovary syndrome. Minerva Endocrinol. 2015;40:37–51.
    1. Ou HT, Chen PC, Wu MH. Effect of metformin by employing 2-hour postload insulin for measuring insulin resistance in Taiwanese women with polycystic ovary syndrome. J Formos Med Assoc. 2017;116:80–89.
    1. Pillich RT, Scarsella G, Risuleo G. Reduction of apoptosis through the mitochondrial pathway by the administration of acetyl-L-carnitine to mouse fibroblasts in culture. Exp Cell Res. 2005;306:1–8. doi: 10.1016/j.yexcr.2005.01.019.
    1. Raja-Khan N, Stener-Victorin E, Wu X, Legro RS. The physiological basis of complementary and alternative medicines for polycystic ovary syndrome. Am J Physiol Endocrinol Metab. 2011;301:E1–E10. doi: 10.1152/ajpendo.00667.2010.
    1. Ratnakumari ME, Manavalan N, Sathyanath D, Ayda YR, Reka K. Study to Evaluate the Changes in Polycystic Ovarian Morphology after Naturopathic and Yogic Interventions. Int J Yoga. 2018;11:139–147. doi: 10.4103/ijoy.IJOY_62_16.
    1. Ringseis R, Keller J, Eder K. Role of carnitine in the regulation of glucose homeostasis and insulin sensitivity: evidence from in vivo and in vitro studies with carnitine supplementation and carnitine deficiency. Eur J Nutr. 2012;51:1–18. doi: 10.1007/s00394-011-0284-2.
    1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004a;81:19–25.
    1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS) Hum Reprod. 2004b;19:41–47.
    1. Salehpour S, Sene AA, Saharkhiz N, Sohrabi MR, Moghimian F. N-Acetylcysteine as an adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic ovary syndrome. J Obstet Gynaecol Res. 2012;38:1182–1186. doi: 10.1111/j.1447-0756.2012.01844.x.
    1. Salehpour S, Nazari L, Hoseini S, Saharkhiz N, Ghazi F, Sohrabi MR. A Potential Therapeutic Role of Myoinositol in the Metabolic and Cardiovascular Profile of PCOS Iranian Women Aged between 30 and 40 Years. Int J Endocrinol. 2016;2016:7493147–7493147. doi: 10.1155/2016/7493147.
    1. Samimi M, Jamilian M, Ebrahimi FA, Rahimi M, Tajbakhsh B, Asemi Z. Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf) 2016;84:851–857. doi: 10.1111/cen.13003.
    1. Steiber A, Kerner J, Hoppel CL. Carnitine: a nutritional, biosynthetic, and functional perspective. Mol Aspects Med. 2004;25:455–473. doi: 10.1016/j.mam.2004.06.006.
    1. Stener-Victorin E, Holm G, Janson PO, Gustafson D, Waerm M. Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome: secondary analysis from a randomized controlled trial. BMC Complement Altern Med. 2013;13:131–131. doi: 10.1186/1472-6882-13-131.
    1. Suvarna Y, Maity N, Kalra P, Shivamurthy MC. Comparison of efficacy of metformin and oral contraceptive combination of ethinyl estradiol and drospirenone in polycystic ovary syndrome. J Turk Ger Gynecol Assoc. 2016;17:6–9. doi: 10.5152/jtgga.2016.16129.
    1. Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol. 2012;28:509–515. doi: 10.3109/09513590.2011.650660.
    1. Vanella A, Russo A, Acquaviva R, Campisi A, Di Giacomo C, Sorrenti V, Barcellona ML. L-propionyl-carnitine as superoxide scavenger, antioxidant, and DNA cleavage protector. Cell Biol Toxicol. 2000;16:99–104. doi: 10.1023/A:1007638025856.
    1. Wächter S, Vogt M, Kreis R, Boesch C, Bigler P, Hoppeler H, Krähenbühl S. Long-term administration of L-carnitine to humans: effect on skeletal muscle carnitine content and physical performance. Clin Chim Acta. 2002;318:51–61. doi: 10.1016/S0009-8981(01)00804-X.
    1. Yang B, Sun ZJ, Chen B, Zhang J, Zhao H, Li CW, Cao YK, Cao F. Statin ameliorates endothelial dysfunction and insulin resistance in Tibet women with polycystic ovary syndrome. Eur Rev Med Pharmacol Sci. 2016;20:1185–1191.

Source: PubMed

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