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补充左旋肉碱对血液透析儿童炎症标志物和血糖的影响:一项随机、安慰剂对照临床试验

Effect of L-Carnitine Supplementation on Inflammatory Markers and Serum Glucose in Hemodialysis Children: A Randomized, Placebo-Controlled Clinical Trial.

作者信息

Hamedi-Kalajahi Fatemeh, Imani Hossein, Mojtahedi SayedYousef, Shabbidar Sakineh

机构信息

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Ren Nutr. 2022 Mar;32(2):144-151. doi: 10.1053/j.jrn.2021.03.009. Epub 2021 Nov 3.

Abstract

OBJECTIVES

Chronic inflammation is present in a high proportion of the chronic kidney disease (CKD) population, which can increase the risk of cardiovascular disease. Moreover, it is known as the leading cause of death in these patients. In addition, change in glucose metabolism is another common problem among CKD population. In this regard, it was found that insulin resistance and inflammation can perpetuate each other and simultaneously cause atherosclerosis. Because some studies have previously shown the positive effects of L-carnitine on reducing inflammation and controlling blood sugar, in the present study, we examined the effects of L-carnitine supplementation on serum inflammatory markers, fasting blood sugar (FBS), free carnitine (FC), albumin levels, and quality of life score among children on hemodialysis.

METHOD

Twenty-four children on hemodialysis (aged between 6 and 18 years) were enrolled in this randomized clinical trial study. Thereafter, 12 patients received 50 mg/kg of L-carnitine and 12 patients received placebo for a 10-week period. Afterward, we determined serum FC, interleukin-6 (IL-6), high-sensitivity C-reactive protein, FBS, and albumin and Pediatrics Quality of Life scores once at the baseline and once after performing intervention for 10 weeks. Moreover, the one-way repeated measures analysis was used to evaluate the effects of L-carnitine supplementation.

RESULTS

Although oral L-carnitine supplementation led to the decreased high-sensitivity C-reactive protein, this change was not significant compared with the placebo. Also, L-carnitine supplementation has significantly reduced serum levels of IL-6 and FBS, which has also raised serum FC and Pediatrics Quality of Life scores compared with the placebo. Notably, no significant change was observed in serum albumin levels.

CONCLUSION

Given the significant reductions in IL-6 and FBS levels, L-carnitine supplementation appeared to have some positive effects on the inflammation, blood glucose control, and prevention of cardiovascular events in these patients, as well as the improvement of quality of life. In this regard, L-carnitine therapy with a longer duration is recommended to obtain more effective results.

摘要

目的

慢性炎症在很大比例的慢性肾脏病(CKD)人群中存在,这会增加心血管疾病风险。此外,它是这些患者死亡的主要原因。另外,糖代谢改变是CKD人群中的另一个常见问题。在这方面,研究发现胰岛素抵抗和炎症会相互作用并同时导致动脉粥样硬化。由于此前一些研究显示左旋肉碱在减轻炎症和控制血糖方面有积极作用,在本研究中,我们检测了补充左旋肉碱对血液透析儿童的血清炎症标志物、空腹血糖(FBS)、游离肉碱(FC)、白蛋白水平及生活质量评分的影响。

方法

24名接受血液透析的儿童(年龄在6至18岁之间)被纳入这项随机临床试验研究。之后,12名患者接受50mg/kg的左旋肉碱,12名患者接受安慰剂,为期10周。随后,我们在基线时以及干预10周后分别测定血清FC、白细胞介素-6(IL-6)、高敏C反应蛋白、FBS、白蛋白以及儿科生活质量评分。此外,采用单向重复测量分析来评估补充左旋肉碱的效果。

结果

尽管口服补充左旋肉碱使高敏C反应蛋白降低,但与安慰剂相比,这种变化并不显著。此外,补充左旋肉碱显著降低了血清IL-6和FBS水平,与安慰剂相比,还提高了血清FC水平和儿科生活质量评分。值得注意的是,血清白蛋白水平未观察到显著变化。

结论

鉴于IL-6和FBS水平显著降低,补充左旋肉碱似乎对这些患者的炎症、血糖控制、心血管事件预防以及生活质量改善有一些积极作用。在这方面,建议延长左旋肉碱治疗时间以获得更有效的结果。

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