左旋肉碱补充剂对改善血液透析患者瘦体重和身体功能的疗效：一项随机对照试验。

Efficacy of L-carnitine supplementation for improving lean body mass and physical function in patients on hemodialysis: a randomized controlled trial.

机构信息

Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.

Department of Nephrology, Keiai Hospital, Tokyo, Japan.

出版信息

Eur J Clin Nutr. 2019 Feb;73(2):293-301. doi: 10.1038/s41430-018-0348-y. Epub 2018 Oct 23.

DOI:10.1038/s41430-018-0348-y

PMID:30353121

Abstract

BACKGROUND

Carnitine deficiency is common in patients on hemodialysis. However, the efficacy of L-carnitine supplementation for improving lean body mass (LBM) and physical function has not yet been evaluated.

METHODS

In this multicenter, prospective, parallel, randomized, controlled trial, 91 patients on hemodialysis who developed carnitine deficiency were randomly assigned to receive injections of 1,000 mg L-carnitine 3 times per week after each hemodialysis session (L-carnitine group) or no injections (control group) with monitoring for 12 months.

RESULTS

The data for 84 of the 91 patients were available for analysis (L-carnitine group, n = 42; control group, n = 42). Dry weight and body mass index did not significantly change in the L-carnitine group, but significantly decreased in the control group. Arm muscle area (AMA) did not change significantly in the L-carnitine group but decreased significantly in the control group; the difference in mean AMA between the groups was 6.22% (95% confidence interval [CI] 1.90-10.5; P = 0.037). Hand grip strength did not change significantly in the L-carnitine group, but decreased significantly in the control group. The difference in change in hand grip strength between the groups was 4.27% (95% CI 0.42-8.12; P = 0.030). Furthermore, LBM did not change significantly in the L-carnitine group but decreased significantly in the control group; the difference in mean LBM between the groups was 2.92 % (95% CI 1.28-4.61; P = 0.0007).

CONCLUSIONS

L-carnitine supplementation is useful in patients who develop carnitine deficiency on hemodialysis because it maintains physical function and LBM.

摘要

背景

肉碱缺乏在血液透析患者中很常见。然而，补充左旋肉碱以改善瘦体重（LBM）和身体功能的疗效尚未得到评估。

方法

在这项多中心、前瞻性、平行、随机、对照试验中，91 名出现肉碱缺乏的血液透析患者被随机分为接受每周 3 次每次血液透析后给予 1000mg 左旋肉碱注射（左旋肉碱组）或不给予注射（对照组），并进行 12 个月的监测。

结果

91 名患者中有 84 名患者的数据可用于分析（左旋肉碱组，n=42；对照组，n=42）。左旋肉碱组的干体重和体重指数没有显著变化，但对照组显著下降。左旋肉碱组的手臂肌肉面积（AMA）没有显著变化，但对照组显著下降；两组间 AMA 的平均差异为 6.22%（95%置信区间[CI]为 1.90-10.5；P=0.037）。左旋肉碱组的手握力没有显著变化，但对照组显著下降。两组间手握力变化的差异为 4.27%（95%CI 为 0.42-8.12；P=0.030）。此外，左旋肉碱组的 LBM 没有显著变化，但对照组显著下降；两组间 LBM 的平均差异为 2.92%（95%CI 为 1.28-4.61；P=0.0007）。