Zachariah Justin P, Pena Sandra, Lupo Philip J, Putluri Nagireddy, Penny Daniel J, Richard Melissa A
Section of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Section of Hematology-Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Contemp Clin Trials Commun. 2023 Jun 30;34:101174. doi: 10.1016/j.conctc.2023.101174. eCollection 2023 Aug.
Atherosclerotic cardiovascular disease (ASCVD) risk factors including vascular remodeling leading to hypertension and dyslipidemia are prevalent among children and adolescents. Conflicting observational and Mendelian randomization data suggest endogenous carnitine may affect arterial stiffness and lipid traits. Because of this, we developed a study to evaluate the causal role for carnitine in arterial stiffness at a point when the lifecourse trajectory to hypertension can be modified.
This study is a mechanistic, double-blinded, randomized control trial (RCT) in 166 adolescents with dyslipidemia for the effect of 6 months of maximum dose 3 g daily oral l-carnitine supplementation (CS+) versus placebo (CS-) on aortic stiffness measured as carotid-femoral pulse wave velocity (CFPWV) and pulse pressure (PP); lipid concentrations (total cholesterol, HDL-C, triglycerides, and LDL-C) and serum fatty acid oxidation biomarkers by metabolomic analysis.
The simultaneous evaluation of endogenous carnitine genetic effects and exogenous l-carnitine supplementation may facilitate future therapies for youth with cardiometabolic derangement to arrest atherosclerotic changes.
动脉粥样硬化性心血管疾病（ASCVD）的危险因素，包括导致高血压和血脂异常的血管重塑，在儿童和青少年中很普遍。相互矛盾的观察性和孟德尔随机化数据表明，内源性肉碱可能会影响动脉僵硬度和脂质特征。因此，我们开展了一项研究，旨在评估在高血压的生命历程轨迹可以改变的阶段，肉碱在动脉僵硬度中的因果作用。
本研究是一项机制性、双盲、随机对照试验（RCT），对166名血脂异常的青少年进行了为期6个月的最大剂量每日3克口服左旋肉碱补充剂（CS+）与安慰剂（CS-）的对照试验，以评估其对以颈动脉-股动脉脉搏波速度（CFPWV）和脉压（PP）衡量的主动脉僵硬度的影响；通过代谢组学分析评估脂质浓度（总胆固醇、高密度脂蛋白胆固醇、甘油三酯和低密度脂蛋白胆固醇）和血清脂肪酸氧化生物标志物。
对内源性肉碱遗传效应和外源性左旋肉碱补充剂的同时评估，可能有助于未来针对患有心脏代谢紊乱的青少年的治疗，以阻止动脉粥样硬化的变化。
