Sato Shinya, Namisaki Tadashi, Furukawa Masanori, Saikawa Soichiro, Kawaratani Hideto, Kaji Kosuke, Takaya Hiroaki, Shimozato Naotaka, Sawada Yasuhiko, Kitagawa Koh, Moriya Kei, Akahane Takemi, Mitoro Akira, Hoki Noriyuki, Ann Tatsuichi, Yoshiji Hitoshi
Department of Gastroenterology and Metabolism, Nara Medical University, Kashihara, Nara 634-8522, Japan.
Department of Gastroenterology in Bellland General Hospital, Sakai, Osaka 599-8247, Japan.
Biomed Rep. 2020 Dec;13(6):65. doi: 10.3892/br.2020.1372. Epub 2020 Oct 20.
L-carnitine (4--trimethylammonium-3-hydroxybutyric acid) is the physiologically active form of carnitine and is a natural compound that has been shown to exhibit antioxidant activity. L-carnitine is used as a supplementary treatment in patients with cirrhosis with hepatic encephalopathy, hyperammonemia or muscle cramps. In the present study, the effect of L-carnitine supplementation on health-related quality of life in 30 patients with cirrhosis was prospectively examined. L-carnitine (1,800 mg/day) was administered orally for 6 months. To assess the effects of L-carnitine on chronic fatigue, patients filled out a self-report questionnaire regarding their physical and mental health. The levels of total and free carnitine, and acylcarnitine were found to be significantly higher 1, 3 and 6 months after therapy initiation compared with before treatment. Serum albumin levels were significantly increased 3 and 6 months after initiation of therapy. L-carnitine supplementation significantly increased the BAP/d-ROM ratio, a marker of antioxidant status in patients with cirrhosis. Changes in serum carnitine concentrations were positively correlated with changes in serum albumin levels (R=0.369; P=0.012), but not with changes in serum ammonia levels (R= 0.005; P=0.78). Total and mental health scores improved significantly, and physical scores improved marginally 3 and 6 months after initiation of L-carnitine. These findings may be attributed to the enhanced serum albumin levels and oxidative stress rather than the reduced serum ammonia levels. Based on these results, it is suggested that L-carnitine can potentially alleviate chronic fatigue, along with the increased BAP/d-ROM ratio, which were involved in increased oxidative stress in patients with cirrhosis. The specific mechanisms by which L-carnitine ameliorates chronic fatigue is not fully understood and requires further investigation.
左旋肉碱（4-三甲基铵-3-羟基丁酸）是肉碱的生理活性形式，是一种天然化合物，已被证明具有抗氧化活性。左旋肉碱用作肝硬化伴肝性脑病、高氨血症或肌肉痉挛患者的辅助治疗。在本研究中，前瞻性地研究了补充左旋肉碱对30例肝硬化患者健康相关生活质量的影响。口服左旋肉碱（1800毫克/天），持续6个月。为评估左旋肉碱对慢性疲劳的影响，患者填写了一份关于其身心健康的自我报告问卷。发现治疗开始后1、3和6个月的总肉碱、游离肉碱和酰基肉碱水平显著高于治疗前。治疗开始后3和6个月，血清白蛋白水平显著升高。补充左旋肉碱显著提高了BAP/d-ROM比值，这是肝硬化患者抗氧化状态的一个指标。血清肉碱浓度的变化与血清白蛋白水平的变化呈正相关（R=0.369；P=0.012），但与血清氨水平的变化无关（R=0.005；P=0.78）。左旋肉碱治疗开始后3和6个月，总体健康和心理健康评分显著改善，身体评分略有改善。这些发现可能归因于血清白蛋白水平的提高和氧化应激增强，而不是血清氨水平的降低。基于这些结果，提示左旋肉碱可能潜在地缓解慢性疲劳，同时提高BAP/d-ROM比值，这与肝硬化患者氧化应激增加有关。左旋肉碱改善慢性疲劳的具体机制尚不完全清楚，需要进一步研究。
