Liver Unit, Haemek Medical Center, Afula, Israel.
Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7522-7532. doi: 10.26355/eurrev_202210_30023.
Non-alcoholic fatty liver disease (NAFLD) still has no accepted pharmacological therapy. Even though monotherapy of L-carnitine or magnesium supplementation exhibits an essential beneficial role in NAFLD treatment, and despite that new NAFLD treatment strategies focus on combination therapies, the combination of L-carnitine with magnesium has not yet been examined in NAFLD patients. We aimed to assess the efficacy of L-carnitine in combination with magnesium in NAFLD patients.
Double-blinded, randomized controlled trial with 22 NAFLD participants who were randomized to either control group receiving placebo for the first 8 weeks and an additional 8 weeks with CIRRHOS product (2 gr L-carnitine and 150 mg magnesium) or treatment group receiving CIRRHOS product for 16 weeks. Weight, serum aspartate aminotransferase (AST), alanine transaminase (ALT) and C-reactive protein (CRP) levels were measured monthly. Lipid profile and serum insulin levels were monitored at baseline and at week 16 of treatment. Shear-wave elastography was used to evaluate liver stiffness (LS).
While AST and ALT levels decreased progressively over 16 weeks of treatment in the treatment group, AST and ALT levels of the control group were increased modestly or unaffected. AST and ALT levels of the treatment group decreased by 25% (p=0.9) and 20% (p=0.1) respectively, compared to AST and ALT levels at baseline. However, serum CRP levels, insulin levels, lipid profile and LS were not affected by treatment.
Our findings suggest that L-carnitine with magnesium supplementation could be a potential therapy for NAFLD. However, further studies with a larger population and high-sensitivity diagnostic parameters for early stages of NAFLD are needed to elucidate L-carnitine and magnesium efficacy in NAFLD.
非酒精性脂肪性肝病(NAFLD)仍然没有被接受的药物治疗方法。尽管左旋肉碱或镁补充剂的单一疗法在 NAFLD 治疗中表现出重要的有益作用,并且尽管新的 NAFLD 治疗策略侧重于联合疗法,但左旋肉碱与镁的联合治疗尚未在 NAFLD 患者中进行检查。我们旨在评估左旋肉碱联合镁在 NAFLD 患者中的疗效。
这是一项双盲、随机对照试验,纳入了 22 名 NAFLD 患者,他们被随机分为对照组,在前 8 周接受安慰剂治疗,然后再接受 8 周的 CIRRHOS 产品(2 克左旋肉碱和 150 毫克镁)治疗;或治疗组,接受 16 周的 CIRRHOS 产品治疗。每月测量体重、血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和 C 反应蛋白(CRP)水平。在基线和治疗 16 周时监测血脂谱和血清胰岛素水平。使用剪切波弹性成像来评估肝脏硬度(LS)。
在治疗组中,AST 和 ALT 水平在 16 周的治疗过程中逐渐下降,而对照组的 AST 和 ALT 水平则略有升高或不受影响。与基线时相比,治疗组的 AST 和 ALT 水平分别下降了 25%(p=0.9)和 20%(p=0.1)。然而,血清 CRP 水平、胰岛素水平、血脂谱和 LS 不受治疗影响。
我们的研究结果表明,左旋肉碱联合镁补充剂可能是治疗 NAFLD 的一种潜在疗法。然而,需要进一步进行更大规模的研究,并使用高灵敏度的诊断参数来阐明左旋肉碱和镁在 NAFLD 早期阶段的疗效。