Zhou Xin, Liu Fang, Zhai Suodi
Department of Pharmacy, Peking University Third Hospital, Beijing, China 100083.
Asia Pac J Clin Nutr. 2007;16 Suppl 1:383-90.
The aim of this systematic review was to quantify the efficacy of L-carnitine (LC) and/or L-acetyl-carnitine (LAC) in nutrition treatment for male infertility according to present clinical evidence. Biomedical databases were searched to collect related clinical trials and nine relevant randomized controlled trials (RCTs) were included. The quality of the RCTs was assessed based on their performance in randomization, blinding, and allocation concealment. The meta-analysis compared LC and /or LAC therapy to placebo treatment found significant improvement in pregnancy rate (OR = 4.10, 95% CI (2.08, 8.08), p< 0.0001), total sperm motility (WMD = 7.43, 95% CI (1.72, 13.14), p = 0.04, forward sperm motility (WMD = 11.83, 95% CI (0.49, 23.16), p = 0.04) and atypical sperm cell (WMD = -5.72, 95% CI (-7.89, -3.56), p< 0.00001). However, no significant difference was found in the sperm concentration (WMD = 5.69, 95% CI (-4.47, 15.84), p = 0.27) and semen volume (WMD = 0.28, 95% CI (-0.02, 0.58), p = 0.07). In conclusion, the administration of LC and/or LAC may be effective in improving pregnancy rate and sperm kinetic features in patients affected by male infertility. However, the exact efficacy of carnitines on male infertility needs to be confirmed by further investigations.
本系统评价的目的是根据目前的临床证据，量化左旋肉碱（LC）和/或左旋乙酰肉碱（LAC）在男性不育营养治疗中的疗效。检索生物医学数据库以收集相关临床试验，并纳入了9项相关的随机对照试验（RCT）。根据随机化、盲法和分配隐藏方面的表现对RCT的质量进行评估。对LC和/或LAC治疗与安慰剂治疗进行的荟萃分析发现，妊娠率有显著改善（OR = 4.10，95% CI（2.08，8.08），p < 0.0001），总精子活力（WMD = 7.43，95% CI（1.72，13.14），p = 0.04），前向精子活力（WMD = 11.83，95% CI（0.49，23.16），p = 0.04）和非典型精子细胞（WMD = -5.72，95% CI（-7.89，-3.56），p < 0.00001）。然而，精子浓度（WMD = 5.69，95% CI（-4.47，15.84），p = 0.27）和精液量（WMD = 0.28，95% CI（-0.02，0.58），p = 0.07）没有显著差异。总之，LC和/或LAC的给药可能对改善男性不育患者的妊娠率和精子动力学特征有效。然而，肉碱对男性不育的确切疗效需要进一步研究来证实。
