Effects of Oral L-Carnitine Supplementation on Leptin and Adiponectin Levels and Body Weight of Hemodialysis Patients: a Randomized Clinical Trial. L-carnitine supplementation and adipokines in patients with end-stage renal disease on regular hemodialysis. Effects of supplementation with curcumin on serum adipokine concentrations: A randomized controlled trial. Potential inhibitory effects of L-carnitine supplementation on tissue advanced glycation end products in patients with hemodialysis. Effects of carnitine and coenzyme Q10 on lipid profile and serum levels of lipoprotein(a) in maintenance hemodialysis patients on statin therapy. Free and total carnitine in human serum after oral ingestion of L-carnitine. Carnitine depletion in peripheral blood mononuclear cells from patients with AIDS: effect of oral L‐carnitine A randomised, double-blind, placebo-controlled trial of L-carnitine in suspected acute myocardial infarction. Effects of L-carnitine supplementation on respiratory distress syndrome development and prognosis in premature infants: A single blind randomized controlled trial. Effect of L-carnitine supplementation in comparison with moderate aerobic training on serum inflammatory parameters in healthy obese women. Nutritional effects of carnitine supplementation in hemodialysis patients. L-carnitine supplementation in patients with advanced cancer and carnitine deficiency: a double-blind, placebo-controlled study. Results of a single blind, randomized, placebo-controlled clinical trial to study the effect of intravenous L-carnitine supplementation on health-related quality of life in Indian patients on maintenance hemodialysis. L-Carnitine supplementation improved clinical status without changing oxidative stress and lipid profile in women with knee osteoarthritis. Effects of L-carnitine supplement on serum inflammatory cytokines, C-reactive protein, lipoprotein (a), and oxidative stress in hemodialysis patients with Lp (a) hyperlipoproteinemia. Effects of combination of sibutramine and L-carnitine compared with sibutramine monotherapy on inflammatory parameters in diabetic patients. Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients. Effect of zinc supplementation on serum leptin levels and insulin resistance of obese women Effects of Oral L-Carnitine Administration in Narcolepsy Patients: A Randomized, Double-Blind, Cross-Over and Placebo-Controlled Trial Correlation between increased serum and tissue L-carnitine levels and improved muscle symptoms in hemodialyzed patients. Serum carnitine levels during the doxorubicin therapy. Its role in cardiotoxicity. Effects of zinc supplementation on serum zinc and leptin levels, BMI, and body composition in hemodialysis patients. Effects of l-carnitine supplement on serum amyloid A and vascular inflammation markers in hemodialysis patients: a randomized controlled trial.
INTRODUCTION Carnitine supplementation may improve the general health and quality of life of hemodialysis patients by improving adipokines levels . The aim of the study was to investigate the effects of L-carnitine supplementation on leptin levels , adiponectin levels , and body weight of hemodialysis patients . MATERIAL S AND METHODS Fifty hemodialysis patients were r and omly divided into the carnitine group , who received oral L-carnitine , 1 g/L for 3 months , and the control group . Anthropometric measurements and serum levels of adipokines were measured at baseline and at the end of the intervention . RESULTS Forty-two participants completed the study . Serum leptin concentrations decreased after 12 weeks of the intervention in both groups , but these changes were not significant . The mean change of leptin concentration were , -1.7 ± 19.0 µg/mL and -7.1 ± 20.0 µg/mL in the carnitine group and the control group , respectively ( P = .39 ) . The mean adiponectin levels at baseline and after the intervention were 8.6 ± 11.19 µg/mL and 9.8 ± 4.1 µg/mL in the carnitine group ( P = .67 ) and 5.0 ± 2.5 µg/mL and 11.2 ± 5.4 µg/mL in the control group , respectively ( P < .001 ) . Serum adiponectin levels increased significantly in the control group only . The decrease in body mass index was not significant . CONCLUSIONS This study showed that a daily supplementation of 1000 mg oral syrup of L-carnitine for 12 weeks did not affect leptin and adiponectin levels or the body weight or body mass index of hemodialysis patients Chronic hemodialysis ( HD ) patients frequently encounter carnitine depletion , elevated adipose tissue-derived hormones/cytokines , that may contribute to accelerated arteriosclerosis . 10 non-diabetic HD patients were studied over 28 weeks . In the 12 weeks treatment period 1 g L-carnitine was given iv after each HD session . Measurements of plasma free- and acylcarnitines , insulin , leptin , adiponectin , resistin and ghrelin were performed at baseline , at weeks 2 , 4 , 8 , 12 ( treatment period ) and at weeks 24 - 28 ( post-treatment period ) . L-carnitine supplementation result ed in progressive increase of free- and acylcarnitine levels . Plasma levels of insulin , resistin , leptin and ghrelin remained at the already elevated baseline values . L-carnitine therapy induced a significant increase in plasma adiponectin from 20.2 ± 12.7 μg/ml ( baseline ) to 32.7 ± 20.2 μg/ml in week 2 ( p<0.05 ) and 35.4 ± 19.6 μg/ml in week 12 ( p < 0.03 ) , which remained unchanged in the post-carnitine period . Plasma insulin levels correlated positively with leptin ( r = 0.525 , p<0.0001 ) and resistin ( r = 0.284 , p<0.005 ) ; adiponectin levels correlated inversely with leptin ( r = -0.255 , p<0.02 ) and resistin ( r = -0.213 , p<0.04 ) irrespective of carnitine status . Plasma levels of adipokines and related hormones are greatly elevated in patients on regular HD  . L-carnitine administration further augmented the plasma levels of protective adiponectin , therefore it may have a role in preventing cardiovascular complications of uremia OBJECTIVE Previous experimental studies have suggested curcumin as a safe phytochemical that can improve insulin resistance through effects on adiponectin and leptin . This study aim ed to investigate the effect of curcumin on circulating adiponectin and leptin concentrations in patients with metabolic syndrome . METHODS In this pilot , r and omized , double-blind , placebo-controlled trial , subjects who met the criteria of metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria were r and omly assigned to curcumin ( n = 59 ; 1000 mg/d ) or a placebo ( n = 58 ) for 8 wk . Serum adiponectin and leptin concentrations were determined before and after intervention . The pooled effect size for the impact of curcumin supplementation on serum adiponectin and leptin levels was also estimated using r and om-effects meta analysis . RESULTS Eight-week supplementation with curcumin was associated with a significant increase in serum adiponectin levels ( P < 0.001 ) and a reduction in serum leptin concentrations ( P < 0.001 ) . Serum leptin : adiponectin ratio was also improved by curcumin ( P < 0.001 ) . These beneficial effects of curcumin remained significant after adjustment for changes in serum lipids and glucose concentrations and baseline differences in body mass index and serum levels of glucose and glycated hemoglobin as potential confounders of treatment response . Meta analysis suggested that curcumin supplementation can increase adiponectin levels by 76.78 % ( 95 % CI : 6.14 - 147.42 ; P = 0.0330 ) , and reduce leptin by 26.49 % ( 95 % CI : -70.44 to 17.46 ) , however this latter effect size did not reach statistical significance ( P = 0.238 ) . CONCLUSIONS Curcumin can improve serum levels of adiponectin and leptin in patients with metabolic syndrome . This trial was registered at the UMIN Clinical Trials Registry ( http://www.umin.ac.jp/ctr/ ) under Trial No. UMIN000018339 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 r and omized 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 INTRODUCTION Dyslipidemia and high serum lipoprotein(a ) are among the risk factors for cardiovascular diseases in hemodialysis patients .  Statins as a first line of therapy in hyperlipidemia does not always reduce the serum lipoprotein(a ) level . Several studies have reported the lipid-lowering effects of carnitine and coenzyme Q10 in hemodialysis patients . This study was design ed to investigate the effects of carnitine and coenzyme Q10 on serum lipid profile and lipoprotein(a ) level in maintenance hemodialysis patients . MATERIAL S AND METHODS This was a r and omized placebo-controlled trial . We studied on hemodialysis patients who were on treatment with atorvastatin or lovastatin to assess the efficacy of supplement therapy . They were divided into 4 groups to receive carnitine , coenzyme Q10 , both carnitine and coenzyme Q10 , and placebo . After a 3-month experiment , blood sample s were collected to measure serum levels of lipoprotein(a ) , triglyceride , total cholesterol , high-density lipoprotein cholesterol and low-density lipoprotein cholesterol . RESULTS Fifty-two hemodialysis patients , 27 men and 25 women , completed the course of the study . Three months after supplement therapy , serum levels of lipoprotein(a ) reduced significantly in the carnitine , coenzyme Q10 , and combination groups compared to the baseline values and the 3-month value of lipoprotein(a ) in the placebo group ( P = .01 ) . Serum levels of triglyceride and other lipoproteins did not significantly alter . CONCLUSIONS Our study showed that supplementation with carnitine and coenzyme Q10 could reduce serum levels of lipoprotein(a ) in maintenance hemodialysis patients treated with statins Twelve students with in apparent good health and fasting since the previous evening ingested 2 g of L-carnitine on one day and a placebo on another day in a single-blind trial . Six blood sample s were taken during the 24 h following the ingestion . Their blood carnitine levels increased ( the free form by 81 % , and the total by 57 % ) to a maximum at about 3.5 h and then slowly decreased . Twenty-four hours after ingestion , blood carnitine concentrations had still not returned to their initial levels . In the time interval where the decay curve approximated a single exponential , the half-life of the carnitine appeared to be of the order of 15 h. During the 24 h after the administration of the 2 g of L-carnitine , 7 % + /- 1 % of it was eliminated in the urine . This work suggest that the daily administration during a long period , of 2 g of L-carnitine guarantee in a healthy subject blood carnitine concentrations superior to the normal levels . Its remains to determine if the dose is sufficient in the case where L-carnitine is given to ameliorate a primary or secondary lack of carnitine , or to lower a high level of lipids in blood Objective Reduced levels of serum carnitines ( 3-hydroxy-4-N-trimethyl-ammonio-butanoate ) are found in most patients treated with zidovudine .  However , since serum carnitines do not strictly reflect cellular concentrations we examined whether a carnitine depletion could be found in peripheral blood mononuclear cells ( P BMC ) from AIDS patients with normal serum carnitine levels . In addition , we explored whether it was posssible to relate the host 's immunoreactivity to the content of carnitine in P BMC and whether carnitine levels can be corrected by oral supplementation of L-carnitine . Design Immunopharmacologic study . Methods Twenty male patients with advanced AIDS ( Centers for Disease Control and Prevention stage IVCI ) and normal serum levels of carnitines were enrolled . Patients were r and omly assigned to receive either L-carnitine ( 6g/day ) or placebo for 2 weeks . At baseline and at the end of the trial , we measured carnitines in both sera and P BMC , serum triglycerides , CD4 cell counts , and the frequency of cells entering the S and G2-M phases of cell cycle following mitogen stimulation . Results Concentrations of total carnitine in P BMC from AIDS patients was lower than in healthy controls . A significant trend towards the restoration of appropriate intracellular carnitine levels was found in patients treated with high-dose L-carnitine and was associated with an increased frequency of S and G2-M cells following mitogen stimulation . Furthermore , at the end of the trial we found a strong reduction in serum triglycerides in the L-carnitine group compared with baseline levels . Conclusions Our data indicate that carnitine deficiency occurs in P BMC from patients with advanced AIDS , despite normal serum concentrations . The increase in cellular carnitine content strongly improved lymphocyte proliferative responsiveness to mitogens . Because carnitine status is an important contributing factor to immune function in patients with advanced AIDS , we therefore believe that L-carnitine supplementation could have a role as a complementary therapy for HIV-infected individuals In a r and omised , double-blind placebo-controlled trial , the effects of the administration of oral L-carnitine ( 2 g/day ) for 28 days were compared in the management of 51 ( carnitine group ) and 50 ( placebo group ) patients with suspected acute myocardial infa rct ion . At study entry , the extent of cardiac disease , cardiac enzymes and lipid peroxides were comparable between the groups , although both groups showed an increase in cardiac enzymes and lipid peroxides . At the end of the 28-day treatment period , the mean infa rct size assessed by cardiac enzymes showed a significant reduction in the carnitine group compared to placebo . Electrocardiographic assessment of infa rct size revealed that the QRS-score was significantly less in the carnitine group compared to placebo ( 7.4 + /- 1.2 vs 10.7 + /- 2.0 ) , while serum aspartate transaminase and lipid peroxides showed significant reduction in the carnitine group . Lactate dehydrogenase measured on the sixth or seventh day following infa rct ion showed a smaller rise in the carnitine group compared to placebo . Angina pectoris ( 17.6 vs 36.0 % ) , New York Heart Association class III and IV heart failure plus left ventricular enlargement ( 23.4 vs 36.0 % ) and total arrhythmias ( 13.7 vs 28.0 % ) were significantly less in the carnitine group compared to placebo . Total cardiac events including cardiac deaths and nonfatal infa rct ion were 15.6 % in the carnitine group vs 26.0 % in the placebo group . It is possible that L-carnitine supplementation in patients with suspected acute myocardial infa rct ion may be protective against cardiac necrosis and complications during the first 28 days The aim of the present study was to investigate the efficacy of L-carnitine therapy on the occurrence and prognosis of respiratory distress syndrome ( RDS ) . A single blind , r and omized controlled trial study was conducted on 130 infants with gestational ages of 28 - 36 weeks . Infants were assigned to experimental groups ( groups 1 and 2 ) and control groups ( groups 3 and 4 ) . Groups 1 and 3 consisted of infants with RDS , and groups 2 and 4 groups were composed of infants without RDS . The experimental groups were treated with carnitine . No statistically significant differences in serum carnitine levels were detected between the study and the control groups on day 1 of treatment ( P=0.06 ) . However , on day 7 of treatment , serum carnitine levels in the experimental groups were significantly increased ( P=0.02 ) , as compared with the control groups . The surfactant requirement value , which is how many rounds of surfactant therapy were required , was 1.56±0.97 in group 1 , and 2.12±0.99 in group 3 ( P<0.001 ) . The mean duration of mechanical ventilation required was 3.04±3.60 days in group 1 , and 4.73±5.63 days in group 3 ( P<0.001 ) . The present results indicate that carnitine supplementation in premature infants with RDS may help to increase carnitine levels , thus decreasing the duration of mechanical ventilation and surfactant requirement AIM Obesity is an important worldwide public health problem and considered a disease of chronic low- grade inflammation . The aim of this study was to evaluate the effect of L-carnitine supplementation in comparison with moderate aerobic exercise training on serum inflammatory parameters in healthy obese women . METHODS In this double-blind r and omized controlled clinical trial , 44 obese women were r and omly assigned to 4 groups ( N.=11 ) as follows : 1 : L-carnitine supplementation ( 2 g/day ) ( CAR ) , 2 : aerobic training + placebo ( EXR+PLA ) , 3 : L-carnitine supplementation + aerobic training ( CAR+EXR ) and 4 : placebo ( PLA ) . All intervention periods were eight weeks and subjects of aerobic training groups underwent 8-week aerobic training protocol ( 3 sessions a week [ 24 sessions ] ) . Body Mass Index , daily dietary intake and serum free L-carnitine , IL-6 , high-sensitivity C-reactive protein ( Hs-CRP ) and IL-10 levels of subjects were measured before and after interventions . RESULTS Interventions had no significant effects on body weight , BMI , daily dietary intake and serum IL-10 levels of subjects in all groups . Serum free L-carnitine concentration increased significantly after interventions in CAR and CAR+EXR groups . Significant decreases of IL-6 were observed in EXR+PLA and CAR+EXR groups compared with placebo group . L-carnitine supplementation plus aerobic training led to significant decrease of serum Hs-CRP levels in CAR+EXR group compared with baseline values . CONCLUSION L-carnitine supplementation did not affect serum IL-6 , Hs-CRP and IL-10 levels in obese women .  Aerobic training alone or in combination with L-carnitine had favorable effect on serum Il-6 and Hs-CRP levels as markers of inflammation in studied subjects AIMS Carnitine is involved in fatty acid metabolism and it is cleared by dialysis . As it plays a role in energy utilization and because malnutrition is a frequent complication of HD treatment , we studied the effects of carnitine supplementation on several nutritional parameters in HD patients . MATERIAL AND METHODS The main selection criterion was a body mass index ( BMI ; body weight/(height)2 ) < 22 kg/m2 . Fifty-three patients were enrolled to participate in this open and r and omized study . For 6 months , 28 patients received 15 mg/kg of intravenous L-carnitine at the end of each  hemodialysis ( HD ) treatment  ( Group A ) , the remaining 25 patients were controls ( Group B ) . The measured parameters were the post-dialysis body weight , serum albumin concentration ( nephelemetry ) , food intake assessed by a 3-day food question naire , nPNA ( normalized protein equivalent of nitrogen appearance ) , creatinine generation , and anthropometry . RESULTS Forty-five patients completed the study ( Group A : 14 F/9 M , 66.7 years old ; Group B : 11 F/11 M , 65.2 years old ) . At the beginning of the study , there were no differences between the groups for age , gender , HD duration , BMI , diabetes prevalence , plasma carnitine levels and measured nutritional parameters . 65.2 % and 77.3 % in each group were carnitine-deficient ( plasma total carnitine level < 35 micromol/l ) . After 6 months of L-carnitine supplementation , none of the nutritional parameters had changed in either group , except that serum albumin concentration decreased in both groups . Dividing each group according to their respective median serum albumin concentrations , daily energy and protein intakes , creatinine generation or triceps skinfold thickness did not show any difference in the various nutritional parameters with or without carnitine supplementation . CONCLUSION Carnitine supplementation , despite normalization of plasma carnitine levels , has no effect on the nutritional status of HD patients Carnitine deficiency is prevalent in population s with chronic illness , including cancer . In a recent open-label study , L-carnitine supplementation was well tolerated and appeared to improve fatigue and other outcomes in cancer patients . To further evaluate this finding , adult patients with advanced cancer , carnitine deficiency ( free carnitine more than 35 micromol/L for males or less than 25 micromol/L for females , or acyl/free carnitine ratio of more than 0.4 ) , moderate to severe fatigue , and a Karnofsky Performance Status ( KPS ) score of 50 or more , were r and omly assigned to receive either L-carnitine ( 0.5 g/day for two days , followed by 1g/day for two days , and then 2g/day for 10 days ) or placebo . This double-blind phase was followed by an open-label phase , during which all patients received L-carnitine supplementation for two weeks . Outcomes included the fatigue subscale of the Functional Assessment of Cancer Therapy-Anemia ( FACT-An ) , the Linear Analog Scale Assessment s ( LASA ) , the Mini-Mental State Exam ( MMSE ) , and the KPS .  Twenty-nine patients ( 12 placebo , 17 L-carnitine )  were included in the intent-to-treat ( ITT ) analysis . From baseline to the end of the double-blind phase , serum total and free L-carnitine increased from 32.9+/-3.8 to 56.6+/-20.5 ( P=0.004 ) , and from 22.9+/-19.4 to 45.3+/-17.2 ( P=0.004 ) , respectively , in the L-carnitine-treated group , and from 28.2+/-10.2 to 36.2+/-8.7 ( P = ns ) , and from 22.6+/-7.9 to 28.7+/-8.6 ( P = ns ) in the placebo group , respectively . The planned ITT analysis revealed no significant improvement in any of the study 's endpoints , and these negative findings were not different when data from two patients who did not adhere to the protocol were eliminated . However , an exploratory covariate analysis that excluded these two protocol violators and included outcome data from both the double-blind and open-label phases demonstrated significantly improved fatigue on the FACT-An fatigue subscale ( P<0.03 ) , and significantly improved FACT-An functional well-being subscale ( P<0.03 ) , and KPS ( P<0.003 ) , in the group that started with L-carnitine during the double-blind phase . These data do not support the conclusion that L-carnitine in the doses tested reverses cancer-related fatigue in carnitine-deficient patients . However , L-carnitine supplementation does increase L-carnitine serum levels , and the positive findings in an exploratory analysis justify a larger study to determine if this strategy could be of benefit for a sub population of cancer patients BACKGROUND Carnitine insufficiency is responsible for various co-morbid conditions in maintenance hemodialysis ( MHD ) patients .  L-carnitine supplementation is expected to improve the quality of life ( QoL ) of patients on MHD . AIMS To study the effect of L-carnitine supplementation on QoL of Indian patients on MHD . SETTING AND DESIGN This was a single ( patient ) blind , r and omized , placebo-controlled clinical trial conducted on patients on MHD attending hemodialysis unit of the study center . MATERIAL S AND METHODS Twenty patients on MHD suffering from hemodialysis-related symptoms were r and omly assigned to receive intravenous L-carnitine 20 mg/kg or placebo after every dialysis session for 8 weeks . SF36 ( Short Form with 36 questions ) score for QoL , laboratory investigations and dialysis related symptoms were recorded at baseline and after 8 weeks . Improvement in QoL , laboratory parameters and dialysis related symptoms in the two groups after 8 weeks was compared . STATISTICAL ANALYSIS USED Depending on normality of data , unpaired T test or Mann Whitney U test was used for comparison of change ( 8 weeks-baseline ) in SF36 scores and laboratory parameters observed in the two groups . RESULTS L-carnitine supplementation increased total SF36 score by 18.29 + /- 12.71 ( 95 % CI : 10.41 to 26 ) while placebo result ed in reduction in total SF36 score by 6.4 + /- 16.39 ( 95 % CI : -16.59 to 3.73 ) . L-carnitine also result ed in significant increase in hemoglobin and serum albumin and decrease in serum creatinine as compared to placebo . More patients were relieved of dialysis related symptoms in L-carnitine group . CONCLUSION Intravenous L-carnitine supplementation improves QoL in patients on MHD Considering the pathologic importance of oxidative stress and altered lipid metabolism in osteoarthritis ( OA ) , this study aim ed to investigate the effect of l-carnitine supplementation on oxidative stress , lipid profile , and clinical status in women with knee OA . We hypothesized that l-carnitine would improve clinical status by modulating serum oxidative stress and lipid profile . In this r and omized double-blind , placebo-controlled trial , 72 overweight or obese women with mild to moderate knee OA were r and omly allocated into 2 groups to receive 750 mg/d l-carnitine or placebo for 8 weeks . Dietary intake was evaluated using 24-hour recall for 3 days . Serum malondialdehyde ( MDA ) , total antioxidant capacity ( TAC ) and lipid profile , visual analog scale for pain intensity , and patient global assessment of severity of disease were assessed before and after supplementation . Only 69 patients ( 33 in the l-carnitine group and 36 in the placebo group ) completed the study . l-Carnitine supplementation result ed in significant reductions in serum MDA ( 2.46 ± 1.13 vs 2.16 ± 0.94 nmol/mL ) , total cholesterol ( 216.09 ± 34.54 vs 206.12 ± 39.74 mg/dL ) , and low-density lipoprotein cholesterol ( 129.45 ± 28.69 vs 122.05 ± 32.76 mg/dL ) levels compared with baseline ( P < .05 ) , whereas these parameters increased in the placebo group . Serum triglyceride , high-density lipoprotein cholesterol , and TAC levels did not change significantly in both groups ( P > .05 ) . No significant differences were observed in dietary intake , serum lipid profile , MDA , and TAC levels between groups after adjusting for baseline values and covariates ( P > .05 ) . There were significant intragroup and intergroup differences in pain intensity and patient global assessment of disease status after supplementation ( P < .05 ) . Collectively , l-carnitine improved clinical status without changing oxidative stress and lipid profile significantly in women with knee OA Inflammation , oxidative stress , and high concentration of serum lipoprotein ( a ) [ Lp ( a ) ] are common complications in hemodialysis patients . The present study was design ed to investigate the effects of L-carnitine supplement on serum inflammatory cytokines , C-reactive protein ( CRP ) , Lp ( a ) , and oxidative stress in hemodialysis patients with Lp ( a ) hyperlipoproteinemia [ hyper Lp ( a ) ] . This was an unblinded , r and omized clinical trial . Thirty-six hyper Lp ( a ) hemodialysis patients ( 23 men and 13 women ) were r and omly assigned to either a carnitine or control group . Patients in the carnitine group received 1000 mg/d oral L-carnitine for 12 weeks , whereas patients in the control group did not receive any L-carnitine supplement . At baseline and the end of week 12 , 5 mL of blood were collected after a 12- to 14-hours fast and serum free carnitine , CRP , interleukin-1β , interleukin-6 ( IL-6 ) , tumor necrosis factor-α , Lp ( a ) , and oxidized low-density lipoprotein were measured . Serum free carnitine concentration increased significantly by 86 % in the carnitine group at the end of week 12 compared with baseline ( P<0.001 ) , while serum CRP and IL-6 showed a significant decrease of 29 % ( P<0.05 ) and 61 % ( P<0.001 ) , respectively . No significant changes were observed in serum free carnitine , CRP , and IL-6 in the control group . There were no significant differences between the two groups in mean changes of serum interleukin-1β , tumor necrosis factor-α , Lp ( a ) , and oxidized low-density lipoprotein concentrations . L-carnitine supplement  reduces inflammation in hemodialysis patients , but has no effect on hyper Lp ( a ) and oxidative stress The aim of the study was to evaluate the effects of 12-month treatment with sibutramine plus L-carnitine compared with sibutramine alone on body weight , glycemic control , insulin resistance , and inflammatory state in type 2 diabetes mellitus patients . Two hundred fifty-four patients with uncontrolled type 2 diabetes mellitus ( glycated hemoglobin [ HbA(1c ) ] > 8.0 % ) in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy . We evaluated at baseline and after 3 , 6 , 9 , and 12 months these parameters : body weight , body mass index , HbA(1c ) , fasting plasma glucose , postpr and ial plasma glucose , fasting plasma insulin , homeostasis model assessment of insulin resistance index , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , leptin , tumor necrosis factor-α , adiponectin , vaspin , and high-sensitivity C-reactive protein .  Sibutramine plus L-carnitine gave a faster improvement of fasting plasma glucose , postpr and ial plasma glucose , lipid profile , leptin , tumor necrosis factor-α , and high-sensitivity C-reactive protein compared with sibutramine alone . Furthermore , there was a better improvement of body weight , HbA(1c ) , fasting plasma insulin , homeostasis model assessment of insulin resistance index , vaspin , and adiponectin  with sibutramine plus L-carnitine compared with sibutramine alone . Sibutramine plus L-carnitine gave a better and faster improvement of all the analyzed parameters compared with sibutramine alone without giving any severe adverse effect To evaluate the effects of 1-year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight , glycemic and lipid control , and inflammatory parameters in obese type 2 diabetic patients . Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus ( T2DM ) [ glycated hemoglobin ( HbA(1c ) ) > 8.0 % ] in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day . We evaluated the following parameters at baseline and after 3 , 6 , 9 , and 12 months : body weight , body mass index ( BMI ) , glycated hemoglobin ( HbA(1c ) ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triglycerides ( Tg ) , adiponectin ( ADN ) , leptin , tumor necrosis factor-α ( TNF-α ) , vaspin , and high-sensitivity C-reactive protein ( Hs-CRP ) . We observed a better decrease in body weight , glycemic profile , HOMA-IR , LDL-C , and ADN and a faster improvement in FPI , TC , Tg , leptin , TNF-α , Hs-CRP  with orlistat plus L-carnitine compared to orlistat alone . We also recorded an improvement in vaspin  with orlistat plus l-carnitine not reached with orlistat alone . Orlistat plus L-carnitine gave a better improvement in body weight , glycemic and lipid profile compared to orlistat alone ; furthermore , a faster and better improvement in inflammatory parameters was observed with orlistat plus L-carnitine compared to orlistat alone Leptin is thought to be a lipostatic signal that contributes to body weight regulation . Zinc might play an important role in appetite regulation and its administration stimulates leptin production . However , there are few reports in the literature on its role on leptin levels in the obese population . The present work asseses the effect of zinc supplementation on serum leptin levels in insulin resistance ( IR ) . A prospect i ve double-blind , r and omized , clinical , placebo-controlled study was conducted . Fifty-six normal glucose-tolerant obese women ( age : 25–45 yr , body mass index [ BMI ] = 36.2 ±2.3 kg/m2 ) were r and omized for treatment with 30 mg zinc daily for 4 wk . Baseline values of both groups were similar for age , BMI , caloric intake , insulin concentration , insulin resistance , and zinc concentration in diet , plasma , urine , and erythrocytes . Insulin and leptin were measured by radioimmunoassay and IR was estimated by the homeostasis model assessment ( HOMA ) . The determinations of zinc in plasma , erythrocytes , and 24-h urine were performed by using atomic absorption spectrophotometry . After 4 wk , BMI , fasting glucose , and zinc concentration in plasma and erythrocyte did not change in either group , although zinc concentration in the urine increased from 385.9±259.3 to 470.2±241.2±μg/24 h in the group with zinc supplementation ( p<0.05 ) . Insulin did not change in the placebo group , whereas there was a significant decrease of this hormone in the supplemented group . HOMA also decreased from 5.8±2.6 to 4.3±1.7 ( p<0.05 ) in the zinc-supplemented group but did not change in the placebo group . Leptin did not change in the placebo group . In the zinc group , leptin was 23.6±12.3 μg/L and did not change . More human data from a unique population of obese individuals with documented insulin resistance would be useful in guiding future studies on zinc supplementation ( with higher doses or longer intervals ) or different measures Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness , cataplexy , and rapid eye movement ( REM ) sleep abnormalities . A genome-wide association study ( GWAS ) identified a novel narcolepsy-related single nucleotide polymorphism ( SNP ) , which is located adjacent to the carnitine palmitoyltransferase 1B ( CPT1B ) gene encoding an enzyme involved in β-oxidation of long-chain fatty acids . The mRNA expression levels of CPT1B were associated with this SNP . In addition , we recently reported that acylcarnitine levels were abnormally low in narcolepsy patients . To assess the efficacy of oral l-carnitine for the treatment of narcolepsy , we performed a clinical trial administering l-carnitine ( 510 mg/day ) to patients with the disease . The study design was a r and omized , double-blind , cross-over and placebo-controlled trial . Thirty narcolepsy patients were enrolled in our study . Two patients were withdrawn and 28 patients were included in the statistical analysis ( 15 males and 13 females , all with HLA-DQB1 * 06:02 ) . l-carnitine treatment significantly improved the total time for dozing off during the daytime , calculated from the sleep logs , compared with that of placebo-treated periods . l-carnitine efficiently increased serum acylcarnitine levels , and reduced serum triglycerides concentration . Differences in the Japanese version of the Epworth Sleepiness Scale ( ESS ) and the Medical Outcomes Study 36-Item Short-Form Health Survey ( SF-36 ) vitality and mental health subscales did not reach statistical significance between l-carnitine and placebo . This study suggests that oral l-carnitine can be effective in reducing excessive daytime sleepiness in narcolepsy patients . Trial Registration University hospital Medical Information Network ( UMIN ) A group of 14 uremic patients on intermittent hemodialysis was admitted to a cross-over double-blind trial in order to evaluate serum and muscle carnitine levels before and after 60 days of L-carnitine oral ( 2 g/day ) treatment . The morphology of muscle fragments was studied by light and electron microscopy . Symptoms ( asthenia , cramps ) occurring during hemodialysis were also recorded . After L-carnitine treatment the blood and muscle levels of the metabolite increased simultaneously to reduced asthenia and cramps . Morphological examination of the muscle of 13 of 14 patients did not reveal any pre- or posttreatment pathological alterations . The presence of nemaline rods was morphologically diagnosed in only one case and was no longer observed at the second biopsy at 2 months of L-carnitine treatment Doxorubicin is an anthracycline antibiotic with a broad spectrum of antineoplastic activity . Cardiotoxicity is a serious long-term complication of the drug . Simultaneous administration of carnitine has been proposed to prevent cardiotoxicity . We aim ed to monitor the serum carnitine levels during the treatment of doxorubicin and to determine a relationship between serum carnitine levels and cardiac dysfunction . Fifteen patients were evaluated prospect ively . Measurement of carnitine levels and evaluation of cardiac function were performed prior to treatment , and after cumulative doses of 180 and 300 mg/m2 of doxorubicin .  A group of 20 healthy children served as control group to obtain reference values . We found sub clinical abnormalities in cardiac function , while the cumulative doses of the doxorubicin was increasing . The mean end diastolic and end systolic left ventricular dimensions of the patient group after completion of the treatment were significantly increased compared with initial values . The ejection and shortening fraction of the patient group after cumulative doses of 300 mg/m2 of doxorubicin were significantly lower than those of the control group . A statistically significant augmentation was observed in mitral A , with a decrease in mitral E/A ratio . There was a trend towards lower serum carnitine levels with higher cumulative doses of doxorubicin , although it was not statistically significant . Our results invite new detailed investigations depending on the measurement of serum and urinary free and acyl carnitine and myocardial carnitine levels to evaluate possible roles of carnitine in the prevention of doxorubicin-induced  cardiotoxicity PROJECT The aim of this study was to determine the effects of zinc supplementation on serum zinc and leptin levels as well as on anthropometric status and some biochemical parameters in hemodialysis ( HD ) patients . PROCEDURE In this r and omized , double-blind , and placebo-controlled trial , sixty HD patients were r and omly divided into groups to receive a daily supplement of 100 mg elemental Zn ( supplemented group ) or placebo ( control group ) for 60 days . Anthropometric measurements were taken using st and ard calibrated instruments . Serum zinc and leptin levels were determined by atomic absorption and ELISA method respectively before and after intervention . RESULTS Zinc supplementation result ed in significant increase in the mean serum zinc level in the experimental group while changes observed in the placebo group were not significant . The mean serum leptin in women part of the experimental group was decreased significantly after supplementation . After adjusting for age , BMI , body fat ( % ) , serum zinc and dietary Zn intake , a negative and significant association was observed between serum zinc and leptin levels in all subjects ( β=-0.33 , P=0.03 ) as a result of Zn supplementation . CONCLUSIONS More studies are needed to clarify the mechanisms by which serum leptin level is influenced as a result of zinc supplementation in HD patients OBJECTIVE We studied the effects of l-carnitine supplement on serum amyloid A ( SAA ) , a systemic inflammation marker , and vascular inflammation markers in hemodialysis patients . DESIGN This was a r and omized , double-blind , placebo-controlled trial . SETTING The study was performed in Soodeh Hemodialysis Center in Islamshahr , Iran . PATIENTS We included 36 hemodialysis patients ( 15 men and 21 women ) . INTERVENTION The patients on hemodialysis were r and omly assigned to either a carnitine or a placebo group . Patients in the carnitine group received 1,000 mg/day oral l-carnitine for 12 weeks , whereas patients in the placebo group received a corresponding placebo during the study . MAIN OUTCOME MEASURES Serum free carnitine , SAA , soluble intercellular adhesion molecule type 1 , soluble intercellular adhesion molecule type 2 , soluble vascular cell adhesion molecule type 1 , sE-selectin , sP-selectin , and oxidized low-density lipoprotein were measured at baseline and at the end of week 12 of the study . RESULTS Mean serum free carnitine concentration increased significantly to 150 % of baseline in the carnitine group at the end of week 12 ( P < .001 ) , whereas serum SAA showed a significant 32 % decrease ( P < .001 ) . No significant changes were observed in the serum concentrations of free carnitine and SAA in the placebo group during the study . There were no significant differences between the two groups in mean changes in serum soluble intercellular adhesion molecule type 1 , soluble intercellular adhesion molecule type 2 , soluble vascular cell adhesion molecule type 1 , sE-selectin , sP-selectin , and oxidized low-density lipoprotein concentrations . CONCLUSION The study indicates that l-carnitine supplement reduces serum SAA , which is a risk factor for cardiovascular diseases in hemodialysis patients , but has no effect on vascular inflammation markers
Conclusion l-carnitine consumption does not reduce serum leptin significantly .
However , a significant effect on leptin was observed in diabetic patients and patients who received doses more than 3 mg per day in the course of < 12 weeks
Purpose The actual effects of l-carnitine administration on leptin serum level is inconsistent .
In order to assess the efficacy of l-carnitine supplementation on serum leptin we conducted a meta- analysis of r and omized controlled trials ( RCTs ) .