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The effect of L-carnitine on lipid metabolism in patients with obesity
... Conversely, there was a notable decrease in the oxidation of fatty acid and protein. [144] Antidiabetic activity Administration of carnitine reduced insulin resistance in mice subjected to a high-fat diet (HFD). and the injection of carnitine decreased insulin resistance without influencing the intake or weight of the mice. ...
L-carnitine (LC), also known as β-hydroxy γ-trimethyl-amino-butyric acid, is a quaternary amine synthesized within the liver and kidneys from the amino acid lysine and methionine. It is the pharmacologically active form of carnitine that plays a crucial role in energy production and the metabolism of long-chain fatty acids (LCFAs) through β-oxidation. Deficiency in the organic cation transporter-2 (OCTN2) can arise due to genetic mutations or in conjunction with other illnesses like hepatic or renal disease. Deficits in carnitine regulation can result in various diseases including endocrine disorders, cardiomyopathy, diabetes, malnutrition, aging, sepsis, and cirrhosis. LC has been reported to have antioxidant and anti-inflammatory effects. Supplementation of LC has shown benefits in improving inflammatory conditions by reducing levels of inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6). Supplementation of LC is particularly useful for individuals with primary carnitine deficiencies, which can be life-threatening, as well as certain secondary deficiencies such as organic acidurias, muscle wasting, and weakness. Moreover, emerging evidence suggests that LC may hold therapeutic potential for various diseases including renal diseases, liver diseases, neurodegenerative disorders, cardiovascular diseases (CVDs), cancer, diabetes, cachexia, obesity, depression, epilepsy, and more.
... There are significant differences in the data, and it is unclear whether LC raises and when LC lowers free fatty acids (Sakai et al., 2016). In obese individuals, for instance, LC decreases all free fatty acids by delivering them to the mitochondria (Isaeva and Gapparova, 2018). An experiment looked at 13 patients with chronic liver disease before and after four weeks of LC treatment (1800 mg/day) and discovered that after LC treatment, free fatty acid levels and whole-body carbohydrate oxidation increased, but whole-body fatty acid and protein oxidation dropped dramatically (Sakai et al., 2016). ...
Carnitine is a medically needful nutrient that contributes in the production of energy and the metabolism of fatty acids. Bioavailability is higher in vegetarians than in people who eat meat. Deficits in carnitine transporters occur as a result of genetic mutations or in combination with other illnesses such like hepatic or renal disease. Carnitine deficit can arise in diseases such endocrine maladies, cardiomyopathy, diabetes, malnutrition, aging, sepsis, and cirrhosis due to abnormalities in carnitine regulation. The exogenously provided molecule is obviously useful in people with primary carnitine deficits, which can be life-threatening, and also some secondary deficiencies, including such organic acidurias: by eradicating hypotonia, muscle weakness, motor skills, and wasting are all improved L-carnitine (LC) have reported to improve myocardial functionality and metabolism in ischemic heart disease patients, as well as athletic performance in individuals with angina pectoris. Furthermore, although some intriguing data indicates that LC could be useful in a variety of conditions, including carnitine deficiency caused by long-term total parenteral supplementation or chronic hemodialysis, hyperlipidemias, and the prevention of anthracyclines and valproate-induced toxicity, such findings must be viewed with caution.
... There are some discrepancies in findings, and it is not entirely understood when L-carnitine elevates free fatty acids [81] and when L-carnitine reduces free fatty acid [82]. For example in patients with obesity, L-carnitine directly reduces all free fatty acids in the plasma by transporting them to the mitochondria [83]. One study investigated 13 patients with liver cirrhosis before and after four weeks of L-carnitine treatment (1800 mg/day), and found that, after L-carnitine treatment, free fatty acid levels increased, whole-body carbohydrate oxidation increased, whilst whole-body fatty acid and protein oxidation significantly decreased [81]. ...
L-carnitine transports fatty acids into the mitochondria for oxidation and also buffers excess acetyl-CoA away from the mitochondria. Thus, L-carnitine may play a key role in maintaining liver function, by its effect on lipid metabolism. The importance of L-carnitine in liver health is supported by the observation that patients with primary carnitine deficiency (PCD) can present with fatty liver disease, which could be due to low levels of intrahepatic and serum levels of L-carnitine. Furthermore, studies suggest that supplementation with L-carnitine may reduce liver fat and the liver enzymes alanine aminotransferase (ALT) and aspartate transaminase (AST) in patients with Non-Alcoholic Fatty Liver Disease (NAFLD). L-carnitine has also been shown to improve insulin sensitivity and elevate pyruvate dehydrogenase (PDH) flux. Studies that show reduced intrahepatic fat and reduced liver enzymes after L-carnitine supplementation suggest that L-carnitine might be a promising supplement to improve or delay the progression of NAFLD.
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