Effects of combined treatment with simvastatin and L-carnitine on triglyceride levels in diabetic patients with hyperlipidaemia.

OBJECTIVE

To investigate the effects of L-carnitine, coadministered with simvastatin, on hypercholesterolaemia and hypertriglyceridaemia in patients with diabetes.

DESIGN

Randomised, open, parallel-group study.

SETTING

One investigational centre (hospital).

PATIENTS

Thirty-two patients with type 2 diabetes mellitus and hyperlipidaemia (total cholesterol levels > 200 mg/dl and triglyceride levels >150 mg/dl).

INTERVENTIONS

PATIENTS were randomised to receive simvastatin alone (n = 16) or simvastatin plus L-carnitine (n = 16) for 60 days. Both treatments were given orally. Simvastatin was administered, in both groups, at a dosage of 20 mg/day, while L-carnitine was administered at a dosage of 2000 mg/day twice daily.

MAIN OUTCOME MEASURES AND RESULTS

Plasma levels of triglycerides, total cholesterol and high-density lipoprotein (HDL) cholesterol were measured at baseline and at 30 and 60 days after starting treatment. In both groups, there was a progressive improvement in all measured parameters during the study period. However, triglyceride levels decreased to a significantly greater extent in patients co-treated with L-carnitine (from 266.8 mg/dl at baseline to 153.8 mg/dl at 60 days) compared with those receiving simvastatin alone (from 300.2 to 227.8 mg/dl, respectively; p = 0.012 vs combined treatment). HDL-cholesterol levels increased from 49.8 mg/dl at baseline to 51.8 mg/dl at 60 days in the combined treatment group, and decreased from 51.2 to 47.8 mg/dl, respectively in simvastatin recipients, with a trend in favour of the combined treatment (p = 0.076), while no significant differences between groups were observed for total cholesterol levels.

CONCLUSIONS

Combined treatment with L-carnitine and simvastatin resulted in greater antihyperlipidaemic effects (i.e. a less atherogenic plasma lipid profile) than with simvastatin alone. The results of this preliminary study strongly suggest that L-carnitine may have a role among antihyperlipidaemic strategies.