L-Carnitine Increases High Density Lipoprotein-Cholesterol in Healthy Individuals: A Randomized Trial
Sabrina J. Rodrigues
*
Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos, Vieira 590, Santa Efigênia, 30150-240, Belo Horizonte, MG, Brazil and Clínica Cor & Ação, Rua Rui Barbosa 383/703, Centro, 28300-000, Itaperuna, RJ, Brazil and Hospital São José do Avaí, Rua Coronel Luis Ferraz 397, Centro, 28300-000, Itaperuna, RJ, Brazil
Vinícius Evangelista Dias
Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos, Vieira 590, Santa Efigênia, 30150-240, Belo Horizonte, MG, Brazil and Clínica Cor & Ação, Rua Rui Barbosa 383/703, Centro, 28300-000, Itaperuna, RJ, Brazil and Hospital São José do Avaí, Rua Coronel Luis Ferraz 397, Centro, 28300-000, Itaperuna, RJ, Brazil and Universidade Iguaçu (UNIG), Campus V, BR-356/02, Cidade Nova, 28300-000, Itaperuna, RJ, Brazil.
Caroline M. O. Volpe
Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos, Vieira 590, Santa Efigênia, 30150-240, Belo Horizonte, MG, Brazil.
Carlos Barbuto
Clínica Cor & Ação, Rua Rui Barbosa 383/703, Centro, 28300-000, Itaperuna, RJ, Brazil.
Homero Terra Padilha Filho
Universidade Iguaçu (UNIG), Campus V, BR-356/02, Cidade Nova, 28300-000, Itaperuna, RJ, Brazil.
José A. Nogueira-Machado
Núcleo de Pós-Graduação e Pesquisa, Hospital Santa Casa de Belo Horizonte, Rua Domingos, Vieira 590, Santa Efigênia, 30150-240, Belo Horizonte, MG, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background/ Objective: The popular use of L-carnitine (LC) as a food supplement for patients with diverse disorders is based on the antioxidant, anti-inflammatory and hypolipidemic properties of the amino acid. Since no clinical studies have focused on the effects of LC supplementation in healthy subjects, our objective was to determine whether daily administration of LC to adults presenting no morbidities would induce changes in their glycemic, lipid or inflammatory status.
Methods: Thirty healthy volunteers aged between 19 and 52 years were divided randomly into two equal groups, one of which received 1000 mg of LC per day over a 12-week period while the other received a corresponding dose of identical matching placebo. Serum levels of glucose, total cholesterol, high- and low-density lipoprotein cholesterol (HDL-C and LDL-C, respectively), triglycerides, apolipoprotein A1 (ApoA1) and C-reactive protein were assessed before and after intervention.
Results: Total cholesterol and HDL-C increased significantly (p < 0.05) after supplementation with LC but not with placebo. A strong, statistically significant inverse correlation between triglycerides and HDL-C was detected after supplementation with LC but not with placebo. Strong and significant direct correlations between HDL-C and ApoA1 were observed in both groups before and after intervention. No significant correlations between LDL-C and HDL-C or triglycerides and glucose were observed in either group.
Conclusions: The significant increase in HDL-C observed in healthy adults after LC supplementation indicates that the nutraceutical could be useful in impeding the development of heart diseases in subjects with low HDL-C.
Keywords: Cardiovascular risk, L-Carnitine supplementation, lipid profile, high-density lipoprotein cholesterol, Apolipoprotein A1
How to Cite
Downloads
References
Flanagan JL, Simmons PA, Vehige J, Wilcox MDP, Garret Q. Role of carnitine in disease. Nutr Metab. 2010;7:Article number 30. DOI: https://doi.org/10.1186/1743-7075-7-30
Ribas GS, Vargas CR, Wajner M. L-carnitine supplementation as a potential antioxidant therapy for inherited neurometabolic disorders. Gene. 2014; 533:469-76.
DOI:https://doi.org/10.1016/j.gene.2013.10.017
Lima-Silva AE, Adami F, Nakamura FY, de Oliveira FR, Gevaerd MS. Metabolismo de gordura durante o exercício físico: mecanismos de regulação. Rev Bras Cineantrop Desempenho Hum. 2006;8(4): 106-14. DOI: https://doi.org/10.1590/%25x
Stocker R, Keaney JF Jr. Role of oxidative modifications in atherosclerosis. Physiol Rev. 2004;84(4):1381-1478. DOI:10.1152/physrev.00047.2003
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
Lee BJ, Lin JS, Lin YC, Lin PT. Effects of L-carnitine supplementation on lipid profiles in patients with coronary artery disease. Lipids Health Dis. 2016;15:107. DOI:10.1186/s12944-016-0277-5
Pereira DAG, Faria BMA, Gonçalves RAM, Carvalho VBF, Prata KO, Saraiva PS, et al. Relationship between muscle strength and functional capacity in patients with peripheral arterial disease: a pilot study. J Vasc Bras. 2011;10:26-30.
DOI:https://doi.org/10.1590/S1677-54492011000100005
Mukaka MM. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69-71
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):1-18. DOI:10.1007/s00394-011-0284-2
Vidal-Casariego A, Burgos-Peláez R, Martínez-Faedo C, et al. Metabolic effects of L-carnitine on type 2 diabetes mellitus: Systematic review and meta-analysis. Exp Clin Endocrinol Diabetes. 2013;121(4): 234-238. DOI:10.1055/s-0033-1333688
Duffy D, Rader DJ. Emerging therapies targeting high-density lipoprotein metabolism and reverse cholesterol transport. Circulation. 2006;113(8): 1140-1150.
DOI:10.1161/CIRCULATIONAHA.105.593855
Barter PJ, Nicholls S, Rye KA, Anantharamaiah GM, Navab M, Fogelman AM. Antiinflammatory properties of HDL. Circ Res. 2004;95(8):764-772. DOI:10.1161/01.RES.0000146094.59640.13
Genest J, Choi HY. Novel approaches for HDL-directed therapies. Curr Atheroscler Rep. 2017;19(12):55. Published 2017 Nov 4. DOI:10.1007/s11883-017-0699-1
Seetharam D, Mineo C, Gormley AK, et al. High-density lipoprotein promotes endothelial cell migration and reendothelialization via scavenger receptor-B type I. Circ Res. 2006;98(1):63-72.
DOI:10.1161/01.RES.0000199272.59432.5b
Sumi M, Sata M, Miura S, et al. Reconstituted high-density lipoprotein stimulates differentiation of endothelial progenitor cells and enhances ischemia-induced angiogenesis. Arterioscler Thromb Vasc Biol. 2007;27(4):813-818. DOI:10.1161/01.ATV.0000259299.38843.64
Yvan-Charvet L, Pagler T, Gautier EL, et al. ATP-binding cassette transporters and HDL suppress hematopoietic stem cell proliferation. Science. 2010;328(5986): 1689-1693.
DOI:10.1126/science.1189731
Drew BG, Duffy SJ, Formosa MF, et al. High-density lipoprotein modulates glucose metabolism in patients with type 2 diabetes mellitus. Circulation. 2009;119(15):2103-2111.
DOI:10.1161/CIRCULATIONAHA.108.843219
Drew BG, Rye KA, Duffy SJ, Barter P, Kingwell BA. The emerging role of HDL in glucose metabolism. Nat Rev Endocrinol. 2012;8(4):237-245. DOI:10.1038/nrendo.2011.235
Rye KA, Barter PJ. Formation and metabolism of prebeta-migrating, lipid-poor apolipoprotein A-I. Arterioscler Thromb Vasc Biol. 2004;24(3):421-428.
DOI:10.1161/01.ATV.0000104029.74961.f5
Rye KA, Barter PJ. Cardioprotective functions of HDLs. J Lipid Res. 2014; 55(2):168-179.
DOI:10.1194/jlr.R039297
Rosenson RS, Brewer HB Jr, Ansell BJ, et al. Dysfunctional HDL and atherosclerotic cardiovascular disease. Nat Rev Cardiol. 2016;13(1):48-60. DOI:10.1038/nrcardio.2015.124
He Y, Kothari V, Bornfeldt KE. High-density lipoprotein function in cardiovascular disease and diabetes mellitus. Arterioscler Thromb Vasc Biol. 2018;38(2):e10-e16.
DOI:10.1161/ATVBAHA.117.310222
Gordon DJ, Probstfield JL, Garrison RJ, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation. 1989; 79(1):8-15.
DOI:10.1161/01.cir.79.1.8
Miller M, Seidler A, Kwiterovich PO, Pearson TA. Long-term predictors of subsequent cardiovascular events with coronary artery disease and 'desirable' levels of plasma total cholesterol. Circulation. 1992;86(4):1165-1170. DOI:10.1161/01.cir.86.4.1165
Ishikawa T, Fidge N, Thelle DS, Førde OH, Miller NE. The Tromsø Heart Study: serum apolipoprotein AI concentration in relation to future coronary heart disease. Eur J Clin Invest. 1978;8(3):179-182. DOI:10.1111/j.1365-2362.1978.tb00832.x
Gordon DJ, Knoke J, Probstfield JL, Superko R, Tyroler HA. High-density lipoprotein cholesterol and coronary heart disease in hypercholesterolemic men: The Lipid Research Clinics Coronary Primary Prevention Trial. Circulation. 1986; 74(6):1217-1225. DOI:10.1161/01.cir.74.6.1217
Barter P, Gotto AM, LaRosa JC, et al. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med. 2007;357(13):1301-1310. DOI:10.1056/NEJMoa064278
Simes RJ, Marschner IC, Hunt D, et al. Relationship between lipid levels and clinical outcomes in the Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) Trial: To what extent is the reduction in coronary events with pravastatin explained by on-study lipid levels?. Circulation. 2002;105(10):1162-1169. DOI:10.1161/hc1002.105136
Asadi M, Rahimlou M, Shishehbor F, Mansoori A. The effect of l-carnitine supplementation on lipid profile and glycaemic control in adults with cardiovascular risk factors: A systematic review and meta-analysis of randomized controlled clinical trials. Clin Nutr. 2020;39(1):110-122.
DOI:10.1016/j.clnu.2019.01.020
Koozehchian MS, Daneshfar A, Fallah E, et al. Effects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power, and exercise-induced oxidative stress in resistance-trained males. J Exerc Nutrition Biochem. 2018; 22(4):7-19.
DOI:10.20463/jenb.2018.0026
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(3):154-158. DOI:10.3164/jcbn.2008044
Scicchitano P, Cameli M, Maiello M, Modesti PA, Muiesan ML, Novo S, Palmiero P, Saba PS, Pedrinelli R, Ciccone MM. Nutraceuticals and dyslipidemia: Beyond the common therapeutics. J Funct Foods. 2014;6:11–32. DOI:http://dx.doi.org/10.1016/j.jff.2013.12.006