Shakeri Azam, Tabibi Hadi, Hedayati Mehdi
Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
Hemodial Int. 2010 Oct;14(4):498-504. doi: 10.1111/j.1542-4758.2010.00476.x. Epub 2010 Aug 31.
Inflammation, oxidative stress, and high concentration of serum lipoprotein (a) [Lp (a)] are common complications in hemodialysis patients. The present study was designed 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, randomized clinical trial. Thirty-six hyper Lp (a) hemodialysis patients (23 men and 13 women) were randomly 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.
炎症、氧化应激和高浓度血清脂蛋白(a)[Lp(a)]是血液透析患者常见的并发症。本研究旨在探讨补充左旋肉碱对伴有Lp(a)高脂蛋白血症[高Lp(a)]的血液透析患者血清炎症细胞因子、C反应蛋白(CRP)、Lp(a)及氧化应激的影响。这是一项非盲、随机临床试验。36例高Lp(a)血液透析患者(23例男性和13例女性)被随机分为左旋肉碱组或对照组。左旋肉碱组患者接受1000mg/d口服左旋肉碱,共12周,而对照组患者未接受任何左旋肉碱补充剂。在基线期和第12周结束时,禁食12至14小时后采集5ml血液,检测血清游离肉碱、CRP、白细胞介素-1β、白细胞介素-6(IL-6)、肿瘤坏死因子-α、Lp(a)和氧化型低密度脂蛋白。与基线相比,左旋肉碱组在第12周结束时血清游离肉碱浓度显著增加86%(P<0.001),而血清CRP和IL-6分别显著降低29%(P<0.05)和61%(P<0.001)。对照组血清游离肉碱、CRP和IL-6无显著变化。两组血清白细胞介素-1β、肿瘤坏死因子-α、Lp(a)和氧化型低密度脂蛋白浓度的平均变化无显著差异。补充左旋肉碱可减轻血液透析患者的炎症,但对高Lp(a)和氧化应激无影响。