Elmslie Jane L, Porter Richard J, Joyce Peter R, Hunt Penelope J, Mann Jim I
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand.
Bipolar Disord. 2006 Oct;8(5 Pt 1):503-7. doi: 10.1111/j.1399-5618.2006.00345.x.
Carnitine deficiency impairs fatty acid beta-oxidation and may partly explain weight gain in valproate-treated patients. The aim of this study was to determine whether l-carnitine supplementation improves weight loss outcomes in bipolar patients taking sodium valproate.
Sixty bipolar patients with clinically significant weight gain thought to be related to sodium valproate, who had been taking sodium valproate for >or=6 months, were randomized to l-carnitine (15 mg/kg/day) or placebo for 26 weeks, in conjunction with a moderately energy-restricted, low-fat diet. The primary outcome measure was weight change.
l-carnitine had no effect on mean weight loss compared with placebo (-1.9 kg versus - 0.9 kg) (F = 0.778, df = 1,58, p = 0.381). The number of people in each group able to lose any weight was identical ( = 0, p = 1.0); more patients in the carnitine group (nine versus five) achieved a clinically significant weight loss (>or=5%) but this was not statistically significant (p = 1.0, Fisher's exact test).
At the dose prescribed in this study carnitine supplementation did not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted, low-fat diet.
肉碱缺乏会损害脂肪酸β氧化，这可能部分解释了丙戊酸盐治疗患者体重增加的原因。本研究的目的是确定补充左旋肉碱是否能改善服用丙戊酸钠的双相情感障碍患者的体重减轻情况。
60例因服用丙戊酸钠而出现临床显著体重增加、且服用丙戊酸钠≥6个月的双相情感障碍患者，被随机分为左旋肉碱组（15mg/kg/天）或安慰剂组，为期26周，同时采用适度能量限制的低脂饮食。主要结局指标是体重变化。
与安慰剂相比，左旋肉碱对平均体重减轻无影响（-1.9kg对-0.9kg）（F=0.778，自由度=1,58，p=0.381）。每组能够减轻体重的人数相同（χ²=0，p=1.0）；左旋肉碱组有更多患者（9例对5例）实现了具有临床意义的体重减轻（≥5%），但这无统计学意义（p=1.0，Fisher精确检验）。
在本研究规定的剂量下，补充肉碱并不能改善食用能量限制低脂饮食的丙戊酸盐治疗双相情感障碍患者的体重减轻情况。
