Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia; Research Centre of Excellence for NCD (Nutrition and Non-Communicable Diseases), Universiti Putra Malaysia, 43400, UPM Serdang, Selangor, Malaysia.
Complement Ther Med. 2020 Jan;48:102273. doi: 10.1016/j.ctim.2019.102273. Epub 2019 Nov 29.
The beneficial effects of carnitine supplementation on nonalcoholic fatty liver disease are unclear. We conducted a systematic review and meta-analysis to evaluate the effects of carnitine supplementation on liver function, lipid profile, body mass index, body weight, and homeostasis model assessment of insulin resistance in patients with nonalcoholic fatty liver disease.
A comprehensive search of PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases were performed. Only randomized placebo-controlled human studies that examined the effects of carnitine supplementation on liver function, lipid profile, body mass index, body weight, and homeostasis model assessment of insulin resistance up to September 2019 were included. Fixed effects or random-effects models were applied to compute the pooled effect size. Heterogeneity assessments were performed using Cochran's Q test and I-squared statistics. The quality of the studies was assessed using the Jaded scale.
A total of 5 articles were selected, including 334 individuals (167 in control and 167 in intervention groups). The results demonstrated that carnitine supplementation significantly reduced homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: -0.91; 95 % CI: -1.11, -0.72; p < 0.001, I = 0.0 %) and the levels of aspartate aminotransferase (AST) (WMD: -16.62; 95 % CI: -28.11, -5.14; IU/l; p = 0.005, I = 93.5 %), alanine aminotransferase (ALT) (WMD: -33.39; 95 % CI: -45.13, -21.66; IU/l; p < 0.001, I = 93.4 %), and triglycerides (TG) (WMD: -22.13; 95 % CI: -38.91, -5.34; mg/dl; p = 0.01; I = 0.0 %). However, the results of the pooled effect size did not show any significant effect of carnitine supplementation on body mass index (BMI) (WMD: 0.07; 95 % CI: -0.15, 0.29; p = 0.55; I = 0.0 %), body weight (WMD: -0.28; 95 % CI: -2.23, 1.68; p = 0.78; I = 45.7 %), the levels of gamma-glutamyl transferase (γGT) (WMD: -11.31; 95 % CI: -24.35, 1.73; IU/l; p = 0.09, I = 61.1 %), cholesterol (WMD: -13.58; 95 % CI: -46.77, 19.60; mg/dl; p = 0.42; I = 94.9 %), high-density lipoprotein-cholesterol (HDL-C) (WMD: 1.36; 95 % CI: -0.96, 3.68; mg/dl; p = 0.25; I = 64.7 %), and low density lipoprotein-cholesterol (LDL-C) (WMD: -14.85; 95 % CI: -45.43, 15.73; mg/dl; p = 0.34; I = 96.4 %).
This analysis shows that carnitine supplementation for patients with nonalcoholic fatty liver disease demonstrates a reduction in AST, ALT, TG levels and HOMA-IR. However, no significant effect of carnitine supplementation was observed on BMI, body weight, the levels of γGT, TC, HDL-cholesterol and LDL-cholesterol.
左旋肉碱对非酒精性脂肪性肝病的有益作用尚不清楚。我们进行了一项系统评价和荟萃分析，以评估左旋肉碱补充剂对非酒精性脂肪性肝病患者肝功能、血脂谱、体重指数、体重和胰岛素抵抗稳态模型评估的影响。
全面检索了 PubMed、Web of Science、Scopus、Cochrane Library 和 Google Scholar 数据库。仅纳入了截至 2019 年 9 月，研究左旋肉碱补充剂对肝功能、血脂谱、体重指数、体重和胰岛素抵抗稳态模型评估影响的随机安慰剂对照人体研究。采用固定效应或随机效应模型计算汇总效应量。采用 Cochran's Q 检验和 I-squared 统计量评估异质性。使用 Jaded 量表评估研究质量。
共纳入 5 篇文章，包括 334 人（对照组 167 人，干预组 167 人）。结果表明，左旋肉碱补充剂可显著降低胰岛素抵抗稳态模型评估（HOMA-IR）（WMD：-0.91；95%CI：-1.11，-0.72；p<0.001，I=0.0%）和天门冬氨酸氨基转移酶（AST）（WMD：-16.62；95%CI：-28.11，-5.14；IU/L；p=0.005，I=93.5%）、丙氨酸氨基转移酶（ALT）（WMD：-33.39；95%CI：-45.13，-21.66；IU/L；p<0.001，I=93.4%）和三酰甘油（TG）（WMD：-22.13；95%CI：-38.91，-5.34；mg/dl；p=0.01；I=0.0%）水平。然而，汇总效应量的结果并未显示左旋肉碱补充剂对体重指数（BMI）（WMD：0.07；95%CI：-0.15，0.29；p=0.55；I=0.0%）、体重（WMD：-0.28；95%CI：-2.23，1.68；p=0.78；I=45.7%）、γ-谷氨酰转移酶（γGT）（WMD：-11.31；95%CI：-24.35，1.73；IU/L；p=0.09，I=61.1%）、胆固醇（WMD：-13.58；95%CI：-46.77，19.60；mg/dl；p=0.42；I=94.9%）、高密度脂蛋白胆固醇（HDL-C）（WMD：1.36；95%CI：-0.96，3.68；mg/dl；p=0.25；I=64.7%）和低密度脂蛋白胆固醇（LDL-C）（WMD：-14.85；95%CI：-45.43，15.73；mg/dl；p=0.34；I=96.4%）水平有显著影响。
本分析表明，左旋肉碱补充剂可降低非酒精性脂肪性肝病患者的 AST、ALT、TG 水平和 HOMA-IR。然而，左旋肉碱补充剂对 BMI、体重、γGT、TC、HDL-cholesterol 和 LDL-cholesterol 水平无显著影响。
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