Ciacci C, Peluso G, Iannoni E, Siniscalchi M, Iovino P, Rispo A, Tortora R, Bucci C, Zingone F, Margarucci S, Calvani M
Gastrointestinal Unit, Department of Clinical and Experimental Medicine, University Federico II, Naples, Italy.
Dig Liver Dis. 2007 Oct;39(10):922-8. doi: 10.1016/j.dld.2007.06.013. Epub 2007 Aug 10.
Fatigue is common in celiac disease. L-Carnitine blood levels are low in untreated celiac disease. L-Carnitine therapy was shown to improve muscular fatigue in several diseases.
To evaluate the effect of L-carnitine treatment in fatigue in adult celiac patients.
Randomised double-blind versus placebo parallel study. Thirty celiac disease patients received 2 g daily, 180 days (L-carnitine group) and 30 were assigned to the placebo group (P group). The patients underwent clinical investigation and questionnaires (Scott-Huskisson Visual Analogue Scale for Asthenia, Verbal Scale for Asthenia, Zung Depression Scale, SF-36 Health Status Survey, EuroQoL). OCTN2 levels, the specific carnitine transporter, were detected in intestinal tissue.
Fatigue measured by Scott-Huskisson Visual Analogue Scale for Asthenia was significantly reduced in the L-carnitine group compared with the placebo group (p=0.0021). OCTN2 was decreased in celiac patients when compared to normal subjects (-134.67% in jejunum), and increased after diet in both celiac disease treatments. The other scales used did not show any significant difference between the two celiac disease treatment groups.
L-Carnitine therapy is safe and effective in ameliorating fatigue in celiac disease. Since L-carnitine is involved in muscle energy production its decreased absorption due to OCTN2 reduction might explain muscular symptoms in celiac disease patients. The diet-induced OCTN2 increase, improving carnitine absorption, might explain the L-carnitine treatment efficacy.
疲劳在乳糜泻中很常见。未经治疗的乳糜泻患者血液中左旋肉碱水平较低。左旋肉碱治疗已被证明可改善多种疾病中的肌肉疲劳。
评估左旋肉碱治疗对成年乳糜泻患者疲劳的影响。
随机双盲与安慰剂平行研究。30名乳糜泻患者每天接受2克，共180天（左旋肉碱组），30名被分配到安慰剂组（P组）。患者接受了临床检查和问卷调查（用于疲劳的斯科特-赫斯基森视觉模拟量表、疲劳言语量表、zung抑郁量表、SF-36健康状况调查、欧洲生活质量量表）。在肠道组织中检测了OCTN2水平，即特定的肉碱转运体。
与安慰剂组相比，左旋肉碱组通过斯科特-赫斯基森视觉模拟量表测量的疲劳显著降低（p = 0.0021）。与正常受试者相比，乳糜泻患者的OCTN2降低（空肠中降低134.67%），两种乳糜泻治疗方法在饮食后均升高。使用的其他量表在两个乳糜泻治疗组之间未显示任何显著差异。
左旋肉碱治疗在改善乳糜泻患者的疲劳方面是安全有效的。由于左旋肉碱参与肌肉能量产生，OCTN2减少导致其吸收减少可能解释了乳糜泻患者的肌肉症状。饮食诱导的OCTN2增加，改善了肉碱吸收，可能解释了左旋肉碱治疗的疗效。
