补充左旋肉碱可改善接受血液透析的男性尿毒症患者的自评抑郁量表评分。
L-Carnitine Supplementation Improves Self-Rating Depression Scale Scores in Uremic Male Patients Undergoing Hemodialysis.
作者信息
Tashiro Kyoko, Kaida Yusuke, Yamagishi Sho-Ichi, Tanaka Hideharu, Yokoro Miyuki, Yano Junko, Sakai Kazuko, Kurokawa Yuka, Taguchi Kensei, Nakayama Yosuke, Inokuchi Takahiro, Fukami Kei
机构信息
Research Institute of Medical Mass Spectrometry.
Department of Medicine, Division of Nephrology.
出版信息
Lett Drug Des Discov. 2017 Jun;14(6):737-742. doi: 10.2174/1570180814666170216102632.
BACKGROUND
Depression is highly prevalent in uremic patients undergoing hemodialysis (HD). We previously found that low free-carnitine levels are associated with depression severity in male patients undergoing HD. However, whether L-carnitine supplementation improves the depression state in male patients undergoing HD remains unclear.
METHODS
Sixteen male patients undergoing HD were orally administered 900 mg L-carnitine daily or intravenously administered 1000 mg L-carnitine immediately after undergoing HD for 3 months. The depression state and various types of carnitine levels were evaluated using the self-rating depression scale (SDS) and tandem mass spectrometry, respectively, at baseline and 3 months after treatment.
RESULTS
L-carnitine supplementation significantly increased serum levels of free and other acylcarnitine types, associated with improved SDS scores in male patients undergoing HD. Univariate analysis revealed that low baseline butyryl- and isovaleryl-/2-methylbutyryl-carnitine levels were significantly correlated with SDS scores after treatment. Multiple regression analysis revealed that butyryl-carnitine levels were a sole independent predictor of SDS scores after treatment (r2 = 0.533).
CONCLUSION
L-carnitine supplementation for 3 months improved the depression state in uremic male patients undergoing HD. Thus, low butyryl-carnitine levels may predict the clinical response to L-carnitine supplementation in male patients undergoing HD and who have mild depression.
背景
抑郁症在接受血液透析（HD）的尿毒症患者中高度流行。我们之前发现，低游离肉碱水平与接受HD的男性患者的抑郁严重程度相关。然而，补充左旋肉碱是否能改善接受HD的男性患者的抑郁状态仍不清楚。
方法
16名接受HD的男性患者每天口服900毫克左旋肉碱，或在HD后立即静脉注射1000毫克左旋肉碱，持续3个月。分别在基线和治疗3个月后，使用自评抑郁量表（SDS）和串联质谱法评估抑郁状态和各种类型的肉碱水平。
结果
补充左旋肉碱显著提高了接受HD的男性患者的血清游离肉碱和其他酰基肉碱水平，这与SDS评分的改善相关。单因素分析显示，低基线丁酰肉碱和异戊酰/2-甲基丁酰肉碱水平与治疗后的SDS评分显著相关。多元回归分析显示，丁酰肉碱水平是治疗后SDS评分的唯一独立预测因子（r2 = 0.533）。
结论
补充左旋肉碱3个月改善了接受HD的尿毒症男性患者的抑郁状态。因此，低丁酰肉碱水平可能预测接受HD且患有轻度抑郁症的男性患者对补充左旋肉碱的临床反应。
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