L-Carnitine Supplementation to Diet: A New Tool in... : Official journal of the American College of Gastroenterology | ACG (original) (raw)

ORIGINAL CONTRIBUTIONS: LIVER

L-Carnitine Supplementation to Diet: A New Tool in Treatment of Nonalcoholic Steatohepatitis—A Randomized and Controlled Clinical Trial

Malaguarnera, Mariano AP1; Gargante, Maria Pia MD1; Russo, Cristina MD1; Antic, Tijana MD1; Vacante, Marco MD1; Malaguarnera, Michele MD2; Avitabile, Teresio3; Li Volti, Giovanni AP2; Galvano, Fabio AP2

1Department of Senescence, Urological and Neurological Sciences, University of Catania, Catania, Italy

2Department of Biological Chemistry, Medical Chemistry and Molecular Biology University of Catania, Catania, Italy

3Department of Ophtalmology, University of Catania, Catania, Italy

Correspondence: Mariano Malaguarnera, Department of Senescence, Urological and Neurological Sciences, University of Catania, Ospedale Cannizzaro, Viale Messina, Catania 829-95125, Italy. E-mail: [email protected]

published online 12 January 2010

Received 10 September 2009; accepted 2 December 2009

Abstract

OBJECTIVES:

Nonalcoholic steatohepatitis (NASH) is a known metabolic disorder of the liver. No treatment has been conclusively shown to improve NASH or prevent disease progression. The function of L-carnitine to modulate lipid profile, glucose metabolism, oxidative stress, and inflammatory responses has been shown. The aim of this study was to evaluate the effects of L-carnitine's supplementation on regression of NASH.

METHODS:

In patients with NASH and control subjects, we randomly dispensed one 1-g L-carnitine tablet after breakfast plus diet and one 1 g tablet after dinner plus diet for 24 weeks or diet alone at the same dosage and regimen. We evaluated liver enzymes, lipid profile, fasting plasma glucose, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, homeostasis model assessment (HOMA)-IR, body mass index, and histological scores.

RESULTS:

At the end of the study, L-carnitine-treated patients showed significant improvements in the following parameters: aspartate aminotransferase ( P =0.000), alanine aminotransferase (ALT) ( P =0.000), γ-glutamyl-transpeptidase (γ-GT) ( P =0.000), total cholesterol ( P =0.000), low-density lipoprotein (LDL) ( P =0.000), high-density lipoprotein (HDL) ( P =0.000), triglycerides ( P =0.000), glucose ( P =0.000), HOMA-IR ( P =0.000), CRP ( P =0.000), TNF-α ( P =0.000), and histological scores ( P =0.000).

CONCLUSIONS:

L-carnitine supplementation to diet is useful for reducing TNF-α and CRP, and for improving liver function, glucose plasma level, lipid profile, HOMA-IR, and histological manifestations of NASH.