Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan.
Program in Pharmacology and Toxicology, Tzu Chi University, Hualien 97004, Taiwan.
Nutrients. 2019 Aug 24;11(9):2000. doi: 10.3390/nu11092000.
l-carnitine is an important co-factor in fatty-acid metabolism, and its deficiency is associated with insulin resistance, which is independently associated with arterial stiffness. This study evaluated the relationship between serum l-carnitine level and peripheral arterial stiffness (PAS) in kidney transplantation (KT). Fasting blood samples were collected from 65 patients who underwent KT. We measured the brachial-ankle pulse wave velocity, and 36 patients (55.4%) had PAS. Patients with PAS had a significantly higher percentage of diabetes ( = 0.001), hypertension ( = 0.033), and metabolic syndrome ( = 0.044); higher waist circumference ( = 0.010), systolic blood pressure ( = 0.002), serum triglyceride level ( = 0.040), insulin level ( = 0.002), and homeostasis model assessment of insulin resistance ( = 0.002); lower high-density lipoprotein cholesterol ( = 0.036) and serum l-carnitine levels ( < 0.001); older age ( = 0.041); and a longer KT duration ( = 0.025) than those without PAS. Statistical analysis revealed an independent association between PAS in KT and KT duration (95% confidence interval (CI): 1.003-1.054, = 0.029) and serum l-carnitine levels (95% CI: 0.842-0.998, = 0.044). The area under the receiver operating characteristic curve indicated that the diagnostic power of l-carnitine to predict PAS was 0.789 (95% CI: 0.670-0.881, < 0.001). Serum-free l-carnitine level is negatively associated with PAS in patients who undergo KT.
左旋肉碱是脂肪酸代谢的重要辅酶，其缺乏与胰岛素抵抗有关，而胰岛素抵抗与动脉僵硬度独立相关。本研究评估了血清左旋肉碱水平与肾移植（KT）患者外周动脉僵硬度（PAS）之间的关系。从 65 例行 KT 的患者中采集空腹血样。我们测量了肱踝脉搏波速度，其中 36 例（55.4%）患者存在 PAS。患有 PAS 的患者糖尿病（ = 0.001）、高血压（ = 0.033）和代谢综合征（ = 0.044）的比例显著更高；腰围（ = 0.010）、收缩压（ = 0.002）、血清甘油三酯水平（ = 0.040）、胰岛素水平（ = 0.002）和胰岛素抵抗评估的稳态模型（ = 0.002）更高；高密度脂蛋白胆固醇（ = 0.036）和血清左旋肉碱水平（ < 0.001）更低；年龄更大（ = 0.041）；KT 持续时间更长（ = 0.025）。统计分析显示，KT 中的 PAS 与 KT 持续时间（95%置信区间（CI）：1.003-1.054， = 0.029）和血清左旋肉碱水平（95%CI：0.842-0.998， = 0.044）独立相关。接受者操作特征曲线下的面积表明，左旋肉碱预测 PAS 的诊断能力为 0.789（95%CI：0.670-0.881， < 0.001）。接受 KT 的患者的血清游离左旋肉碱水平与 PAS 呈负相关。
