左旋肉碱补充剂对超重和肥胖成年人体重管理的有益作用：一项更新的系统评价和随机对照试验的剂量反应荟萃分析。
Beneficial effects of l-carnitine supplementation for weight management in overweight and obese adults: An updated systematic review and dose-response meta-analysis of randomized controlled trials.
机构信息
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Halal Research Center of IRI, FDA, Tehran, Iran; Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
Pharmacol Res. 2020 Jan;151:104554. doi: 10.1016/j.phrs.2019.104554. Epub 2019 Nov 17.
Despite preclinical studies demonstrating the efficacy of l-carnitine supplementation for weight management, findings in clinical setting are contradictory. Electronic bibliographical databases were systematically searched up to February 2019 with no limitation in language, including Scopus, PubMed, ISI Web of Science and Cochrane Library. Clinical trials registry platform were also searched. All randomized controlled trials (RCTs) which reported an effect of l-carnitine supplementation on obesity-related indices were included. Weighted mean difference (WMD) was estimated using a random-effect model (DerSimonian-Laird method). Eventually 43 eligible RCTs were included for quantitative analysis. Meta-analysis results revealed that l-carnitine supplementation significantly decreased weight (WMD: -1.129 kg, 95 % CI: -1.590, -0.669; I: 63.4), body mass index (BMI) (WMD: -0.359 kg/m, 95 % CI: -0.552, -0.167; I: 85.2) and fat mass (WMD: -1.158 kg, 95 % CI: -1.763, -0.554, I: 15.5). However, l-carnitine supplementation did not change body fat percentage (WMD: -0.874 %, 95 % CI: -1.890, 0.142, I: 98.2) or waist circumference (WMD: -0.883 mg/dl, 95 % CI: -1.770, 0.004, I: 74.8). l-Carnitine supplementation changed weight (r = -0.98) and BMI (r = -0.67) in a non-linear fashion based on carnitine dosage and BMI according to trial duration (r = -0.04). Interestingly subgroup analysis revealed that l-carnitine showed anti-obesity effects only in overweight and obese subjects; l-carnitine decreased weight, and BMI alone when combined with other lifestyle modifications. Anthropometric indexes were not changed following l-carnitine supplementation among patients' undergoing hemodialysis. Our study revealed that l-carnitine supplementation might have a positive effects in achieving an improved body weight and BMI especially in overweight and obese subjects.
尽管临床前研究表明左旋肉碱补充剂在体重管理方面具有疗效，但临床研究结果却存在矛盾。我们系统地检索了截至 2019 年 2 月的电子文献数据库，包括 Scopus、PubMed、ISI Web of Science 和 Cochrane Library，同时也检索了临床试验注册平台。我们纳入了所有报告左旋肉碱补充剂对肥胖相关指标影响的随机对照试验（RCT）。使用随机效应模型（DerSimonian-Laird 方法）估计加权均数差（WMD）。最终纳入 43 项符合条件的 RCT 进行定量分析。Meta 分析结果表明，左旋肉碱补充剂可显著降低体重（WMD：-1.129kg，95%CI：-1.590，-0.669；I²：63.4%）、体重指数（BMI）（WMD：-0.359kg/m，95%CI：-0.552，-0.167；I²：85.2%）和脂肪量（WMD：-1.158kg，95%CI：-1.763，-0.554，I²：15.5%）。然而，左旋肉碱补充剂对体脂百分比（WMD：-0.874%，95%CI：-1.890，0.142，I²：98.2%）或腰围（WMD：-0.883mg/dl，95%CI：-1.770，0.004，I²：74.8%）无影响。根据试验持续时间（r=-0.04），根据肉碱剂量和 BMI，左旋肉碱补充剂对体重（r=-0.98）和 BMI（r=-0.67）的影响呈非线性变化。有趣的是，亚组分析显示，左旋肉碱仅在超重和肥胖患者中显示出抗肥胖作用；当与其他生活方式改变结合使用时，左旋肉碱可单独降低体重和 BMI。接受血液透析的患者中，左旋肉碱补充后体重和 BMI 无变化。我们的研究表明，左旋肉碱补充剂可能对超重和肥胖患者的体重和 BMI 改善有积极影响。
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