title: Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Antiinflammatory effects of L-carnitine supplementation (1000 mg/d) in coronary artery disease patients. Effect of oral acetyl L-carnitine arginate on resting and postprandial blood biomarkers in pre-diabetics Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial Effects of combination of sibutramine and L-carnitine compared with sibutramine monotherapy on inflammatory parameters in diabetic patients. l-Carnitine Supplementation to Diet: A New Tool in Treatment of Nonalcoholic Steatohepatitis—A Randomized and Controlled Clinical Trial Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. Effect of L-carnitine supplementation in comparison with moderate aerobic training on serum inflammatory parameters in healthy obese women. Sibutramine and L-carnitine compared to sibutramine alone on insulin resistance in diabetic patients. Effect of Probiotic Soy Milk on Serum Levels of Adiponectin, Inflammatory Mediators, Lipid Profile, and Fasting Blood Glucose Among Patients with Type II Diabetes Mellitus Orlistat and L-carnitine compared to orlistat alone on insulin resistance in obese diabetic patients. Effect of cinnamon, cardamom, saffron and ginger consumption on blood pressure and a marker of endothelial function in patients with type 2 diabetes mellitus: A randomized controlled clinical trial Effects of L-Carnitine supplement on plasma coagulation and anticoagulation factors in hemodialysis patients Randomized Trial of Carnitine for the Prevention of Perioperative Atrial Fibrillation. Effects of acetyl-L-carnitine oral administration on lymphocyte antibacterial activity and TNF-alpha levels in patients with active pulmonary tuberculosis. A randomized double blind versus placebo study. Effects of L-carnitine supplement on serum inflammatory cytokines, C-reactive protein, lipoprotein (a), and oxidative stress in hemodialysis patients with Lp (a) hyperlipoproteinemia.
abstract: BACKGROUND Interleukin-6 ( IL-6 ) plays a central role in inflammation and tissue injury . However , epidemiological data evaluating the role of IL-6 in atherogenesis are sparse . METHODS AND RESULTS In a prospect i ve study involving 14 916 apparently healthy men , we measured baseline plasma concentration of IL-6 in 202 participants who subsequently developed myocardial infa rct ion ( MI ) and in 202 study participants matched for age and smoking status who did not report vascular disease during a 6-year follow-up .  Median concentrations of IL-6 at baseline were higher among men who subsequently had an MI than among those who did not ( 1.81 versus 1 . 46 pg/mL ; P=0.002 ) . The risk of future MI increased with increasing quartiles of baseline IL-6 concentration ( P for trend < 0.001 ) such that men in the highest quartile at entry had a relative risk 2.3 times higher than those in the lowest quartile ( 95 % CI 1.3 to 4.3 , P=0.005 ) ; for each quartile increase in IL-6 , there was a 38 % increase in risk (P=0.001).This relationship remained significant after adjustment for other cardiovascular risk factors , was stable over long periods of follow-up , and was present in all low-risk subgroups , including nonsmokers . Although the strongest correlate of IL-6 in these data was C-reactive protein ( r=0.43 , P<0.001 ) , the relationship of IL-6 with subsequent risk remained after control for this factor ( P<0.001 ) . CONCLUSIONS In apparently healthy men , elevated levels of IL-6 are associated with increased risk of future MI . These data thus support a role for cytokine-mediated inflammation in the early stages of atherogenesis OBJECTIVE Inflammation mediators have been recognized as risk factors for the pathogenesis of coronary artery disease ( CAD ) . The purpose of this study was to investigate the effect of L-carnitine supplementation ( LC , 1000 mg/d ) on inflammation markers in patients with CAD . METHODS We enrolled 47 patients with CAD in the study . The patients with CAD were identified by cardiac catheterization as having < 50 % stenosis of one major coronary artery . The patients were r and omly assigned to the placebo ( n = 24 ) and LC ( n = 23 ) groups and the intervention was administered for 12 wk . The levels of LC , antioxidant status ( malondialdehyde and antioxidant enzymes activities ) , and inflammation markers ( C-reactive protein [ CRP ] , interleukin [IL]-6 , and tumor necrosis factor [TNF]-α ) were measured . RESULTS Thirty-nine participants completed the study ( 19 placebo ; 20 LC ) . After LC supplementation , the levels of inflammation markers were significantly reduced compared with the baseline ( CRP , P < 0.01 ; IL-6 , P = 0.03 ; TNF-α , P = 0.07 ) and those in the placebo group ( CRP , P < 0.05 ; IL-6 , P = 0.04 ; TNF-α , P = 0.03 ) . The levels of inflammation markers were significantly negatively correlated with the levels of LC and antioxidant enzymes activities ( P < 0.05 ) . CONCLUSIONS We suggest that LC supplementation , due to its antioxidant effects , may have potential utility to reduce inflammation in CAD Background Resting and postpr and ial oxidative stress is elevated in those with metabolic disorders such as diabetes .  Antioxidant supplementation may attenuate the rise in oxidative stress following feeding . Therefore we sought to determine the effects of acetyl L-carnitine arginate ( ALCA ) on resting and postpr and ial biomarkers of glucose and lipid metabolism , as well as oxidative stress . Methods Twenty-nine pre-diabetic men and women were r and omly assigned to either 3 g·day-1  of ALCA ( n = 14 ; 31 ± 3 yrs )  or placebo ( n = 15 ; 35 ± 3 yrs ) in a double-blind design , to consume for eight weeks . Fasting blood sample s were taken from subjects both pre and post intervention . After each fasting sample was obtained , subjects consumed a high fat , high carbohydrate meal and additional blood sample s were taken at 1 , 2 , 4 , and 6 hours post meal . Sample s were analyzed for a variety of metabolic variables ( e.g. , glucose , HbA1c , lipid panel , C-reactive protein , nitrate/nitrite , and several markers of oxidative stress ) . Area under the curve ( AUC ) was calculated for each variable measured post meal , both pre and post intervention . Results ALCA , but not placebo , result ed in an increase in nitrate/nitrite ( 25.4 ± 1.9 to 30.1 ± 2.8 μmol·L-1 ) from pre to post intervention , with post intervention values greater compared to placebo ( p = 0.01 ) . No other changes of statistical significance were noted ( p > 0.05 ) , although ALCA result ed in slight improvements in glucose ( 109 ± 5 to 103 ± 5 mg·dL-1 ) , HbA1c ( 6.6 ± 1.1 to 6.2 ± 1.2 % ) , and HOMA-IR ( 3.3 ± 1.3 to 2.9 ± 1.2 ) . AUC postpr and ial data were not statistically different between ALCA and placebo for any variable ( p > 0.05 ) . However , nitrate/nitrite demonstrated a moderate effect size ( r = 0.35 ) for increase from pre ( 139.50 ± 18.35 μmol·L-1·6 hr-1 ) to post ( 172.40 ± 21.75 μmol·L-1·6 hr-1 ) intervention with ALCA , and the magnitude of decrease following feeding was not as pronounced as with placebo . ConclusionS upplementation with ALCA results in an increase in resting nitrate/nitrite in pre-diabetics , without any statistically significant change in other metabolic or oxidative stress variables measured at rest or post meal Background Frailty is a biological syndrome of decreased reserve and resistance to stressors due to decline in multiple physiological systems . Amino acid deficiency , including L-carnitine , has been proposed to be associated with its pathophysiology . Nevertheless , the efficacy of L-carnitine supplementation on frailty status has not been documented . Thus , this study aim ed to determine the effect of 10-week L-carnitine supplement ( 1.5 g/day ) on frailty status and its biomarkers and also physical function , cognition , and nutritional status among prefrail older adults in Klang Valley , Malaysia . Methodology This study is a r and omized , double-blind , placebo-controlled clinical trial conducted among 50 prefrail subjects r and omized into two groups ( 26 in L-carnitine group and 24 in placebo group ) . Outcome measures include frailty status using Fried criteria and Frailty Index accumulation of deficit , selected frailty biomarkers ( interleukin-6 , tumor necrosis factor-alpha , and insulin-like growth factor-1 ) , physical function , cognitive function , nutritional status and biochemical profile . Results The results indicated that the mean scores of Frailty Index score and h and grip test were significantly improved in subjects supplemented with L-carnitine ( P<0.05 for both parameters ) as compared to no change in the placebo group . Based on Fried criteria , four subjects ( three from the L-carnitine group and one from the control group ) transited from prefrail status to robust after the intervention . Conclusion L-carnitine supplementation has a favorable effect on the functional status and fatigue in prefrail older adults The aim of the study was to evaluate the effects of 12-month treatment with sibutramine plus L-carnitine compared with sibutramine alone on body weight , glycemic control , insulin resistance , and inflammatory state in type 2 diabetes mellitus patients . Two hundred fifty-four patients with uncontrolled type 2 diabetes mellitus ( glycated hemoglobin [ HbA(1c ) ] > 8.0 % ) in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy . We evaluated at baseline and after 3 , 6 , 9 , and 12 months these parameters : body weight , body mass index , HbA(1c ) , fasting plasma glucose , postpr and ial plasma glucose , fasting plasma insulin , homeostasis model assessment of insulin resistance index , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , leptin , tumor necrosis factor-α , adiponectin , vaspin , and high-sensitivity C-reactive protein .  Sibutramine plus L-carnitine gave a faster improvement of fasting plasma glucose , postpr and ial plasma glucose , lipid profile , leptin , tumor necrosis factor-α , and high-sensitivity C-reactive protein compared with sibutramine alone . Furthermore , there was a better improvement of body weight , HbA(1c ) , fasting plasma insulin , homeostasis model assessment of insulin resistance index , vaspin , and adiponectin  with sibutramine plus L-carnitine compared with sibutramine alone . Sibutramine plus L-carnitine gave a better and faster improvement of all the analyzed parameters compared with sibutramine alone without giving any severe adverse effect 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 r and omly 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 To evaluate the effects of 1-year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight , glycemic and lipid control , and inflammatory parameters in obese type 2 diabetic patients . Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus ( T2DM ) [ glycated hemoglobin ( HbA(1c ) ) > 8.0 % ] in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day . We evaluated the following parameters at baseline and after 3 , 6 , 9 , and 12 months : body weight , body mass index ( BMI ) , glycated hemoglobin ( HbA(1c ) ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triglycerides ( Tg ) , adiponectin ( ADN ) , leptin , tumor necrosis factor-α ( TNF-α ) , vaspin , and high-sensitivity C-reactive protein ( Hs-CRP ) . We observed a better decrease in body weight , glycemic profile , HOMA-IR , LDL-C , and ADN and a faster improvement in FPI , TC , Tg , leptin , TNF-α , Hs-CRP  with orlistat plus L-carnitine compared to orlistat alone . We also recorded an improvement in vaspin  with orlistat plus l-carnitine not reached with orlistat alone . Orlistat plus L-carnitine gave a better improvement in body weight , glycemic and lipid profile compared to orlistat alone ; furthermore , a faster and better improvement in inflammatory parameters was observed with orlistat plus L-carnitine compared to orlistat alone Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists AIM Obesity is an important worldwide public health problem and considered a disease of chronic low- grade inflammation . The aim of this study was to evaluate the effect of L-carnitine supplementation in comparison with moderate aerobic exercise training on serum inflammatory parameters in healthy obese women . METHODS In this double-blind r and omized controlled clinical trial , 44 obese women were r and omly assigned to 4 groups ( N.=11 ) as follows : 1 : L-carnitine supplementation ( 2 g/day ) ( CAR ) , 2 : aerobic training + placebo ( EXR+PLA ) , 3 : L-carnitine supplementation + aerobic training ( CAR+EXR ) and 4 : placebo ( PLA ) . All intervention periods were eight weeks and subjects of aerobic training groups underwent 8-week aerobic training protocol ( 3 sessions a week [ 24 sessions ] ) . Body Mass Index , daily dietary intake and serum free L-carnitine , IL-6 , high-sensitivity C-reactive protein ( Hs-CRP ) and IL-10 levels of subjects were measured before and after interventions . RESULTS Interventions had no significant effects on body weight , BMI , daily dietary intake and serum IL-10 levels of subjects in all groups . Serum free L-carnitine concentration increased significantly after interventions in CAR and CAR+EXR groups . Significant decreases of IL-6 were observed in EXR+PLA and CAR+EXR groups compared with placebo group . L-carnitine supplementation plus aerobic training led to significant decrease of serum Hs-CRP levels in CAR+EXR group compared with baseline values . CONCLUSION L-carnitine supplementation did not affect serum IL-6 , Hs-CRP and IL-10 levels in obese women .  Aerobic training alone or in combination with L-carnitine had favorable effect on serum Il-6 and Hs-CRP levels as markers of inflammation in studied subjects OBJECTIVE To evaluate the effects of one year of treatment with sibutramine plus L-carnitine compared to sibutramine on body weight , glycemic control , and insulin resistance state in type 2 diabetic patients . METHODS Two hundred and fifty-four patients with uncontrolled type 2 diabetes mellitus ( T2DM ) [ glycated hemoglobin ( HbA(1c ) ) > 8.0 % ] in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and r and omised to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy . We evaluated at baseline , and after 3 , 6 , 9 , and 12 months these parameters : body weight , body mass index ( BMI ) , glycated hemoglobin ( HbA(1c ) ) , fasting plasma glucose ( FPG ) , post-pr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , total cholesterol ( TC ) , low density lipoprotein-cholesterol ( LDL-C ) , high density lipoprotein-cholesterol ( HDL-C ) , triglycerides ( Tg ) , retinol binding protein-4 ( RBP-4 ) , resistin , visfatin , high sensitivity-C reactive protein ( Hs-CRP ) . RESULTS There was a decrease in body weight , BMI , HbA(1c ) , FPI , HOMA-IR , and RBP-4 in both groups , even when the values obtained with sibutramine plus L-carnitine were lower than the values obtained in sibutramine group . There was a faster decrease of FPG , PPG , TC , LDL-C , resistin and Hs-CRP with sibutramine plus L-carnitine even when no differences between the two groups were obtained . Furthermore , only sibutramine plus L-carnitine improved Tg , and visfatin . CONCLUSION Sibutramine plus L-carnitine gave a faster improvement of lipid profile , insulin resistance parameters , glycemic control , and body weight compared to sibutramine Probiotic therapies are going to be an effective alternative therapeutic strategy in the treatment and management of diabetes . The mechanism behind the essential effects of probiotic therapies in diabetic patients was not fully understood . The objective of this study was to evaluate the effects of probiotic soy milk containing Lactobacillus planetarum A7 on inflammation , lipid profile , fasting blood glucose , and serum adiponectin among patients with type 2 diabetes mellitus . Forty patients with type 2 diabetes , at the age of 35–68 years old , were assigned to two groups in this r and omized , double-blind , controlled clinical trial . The patients in the intervention group consumed 200 ml/day of probiotic soy milk containing L. planetarum A7 and those in control group consumed 200 ml/day of pure soy milk for 8 weeks  . Serum TNF-α , C reactive protein , adiponectin , lipid profile , and fasting blood glucose were determined before and after intervention . In intervention group , serum adiponectin in pre- and post-treatment did not show any significant changes ( 2.52 ± 0.74 vs 2.84 ± 0.61 , P = 0.658 ) , as well as changes in serum TNF-α and C reactive protein ( 172.44 ± 5.7 vs 172.83 ± 7.6 , P = 0.278 , 4.2 ± 1.4 vs 4.5 ± 1.9 , P = 0.765 , respectively ) . Low-density cholesterol and high-density cholesterol changed significantly ( P = 0.023 , P = 0.017 , respectively ) , but fasting blood glucose did not show any significant changes . The results of this study showed that consumption of probiotic soy milk and soy milk has no effect on serum adiponectin and inflammation , but it can change lipid profile among type 2 diabetic patients Our study wants to evaluate the effects of one year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight , glycemic and lipid control , and insulin resistance state in type 2 diabetic patients . Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus ( T2DM ) [ glycated hemoglobin ( HbA(1c ) ) > 8.0 % ] in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omised to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day . We evaluated at baseline , and after 3 , 6 , 9 , and 12 months these parameters : body weight , body mass index ( BMI ) , HbA(1c ) , fasting plasma glucose ( FPG ) , post-pr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , total cholesterol ( TC ) , low density lipoprotein-cholesterol ( LDL-C ) , high density lipoprotein-cholesterol ( HDL-C ) , triglycerides ( Tg ) , retinol binding protein-4 ( RBP-4 ) , resistin , visfatin , high sensitivity-C reactive protein ( Hs-CRP ) . We observed a faster , and better decrease of body weight , HbA(1c ) , FPG , PPG , LDL-C , HOMA-IR with orlistat plus L-carnitine compared to orlistat . A faster improvement of TC , Tg , FPI , resistin , RBP-4 , visfatin , and Hs-CRP was reached with orlistat plus L-carnitine compared to orlistat . We can safely conclude that the association of orlistat plus L-carnitine was better than orlistat in improving body weight , glycemic and lipid profile , insulin resistance , and inflammatory parameters and no significant adverse events were recorded Abstract Herbal medicines with high amounts of phytochemicals have been shown to have beneficial effects on blood pressure ( BP ) , endothelial function and anthropometric measures . This study aim ed to determine the effect of herbal treatment on BP , endothelial function and anthropometric measures in patients with type 2 diabetes mellitus ( T2DM ) . This clinical trial included 204 T2DM patients r and omly assigned to four intervention groups receiving 3 g cinnamon , 3 g cardamom , 1 g saffron or 3 g ginger with three glasses of black tea , and one control group consuming only three glasses of tea without any herbals , for 8 weeks . Intercellular adhesion molecule-1 ( ICAM-1 ) , systolic and diastolic BP and anthropometric measures were collected at baseline and after 8 weeks . No significant difference was found between various medicinal plants in terms of influencing BP , serum soluble (s)ICAM-1 concentrations and anthropometric measures . However , in within-group comparison saffron and ginger intakes significantly reduced sICAM-1 concentrations ( 340.9 ± 14.4 vs 339.69 ± 14.4 ng/ml , p = 0.01 , and 391.78 ± 16.0 vs 390.97 ± 15.8 ng/ml , p = 0.009 , respectively ) and ginger intake affected systolic BP ( 143.06 ± 0.2 vs 142.07 ± 0.2 mmHg , p = 0.02 ) . Although administration of these herbal medicines as supplementary remedies could affect BP and sICAM-1 concentrations , there was no significant difference between the plants in terms of influencing anthropometric measures , BP and endothelial function Background : Hypercoagulability is an important risk factor for thrombosis and its complications in hemodialysis patients . This study was design ed to investigate the effects of l-carnitine supplement on plasma coagulation and anticoagulation factors in hemodialysis patients . Methods : Thirty-six hemodialysis patients were r and omly assigned to either a carnitine or a placebo group . Patients in the carnitine group received 1000 mg/day oral l-carnitine for 12 weeks , whereas patients in the placebo group received a corresponding placebo . At baseline and the end of week 12 , 5 mL blood was collected after a 12- to 14-hour fast and plasma fibrinogen concentration , activity of plasma protein C , coagulation factors V , VII , IX , and serum concentrations of tissue plasminogen activator ( tPA ) , plasminogen activator inhibitor type-1 ( PAI-1 ) , free carnitine , and C-reactive protein ( CRP ) were measured . Results : In the carnitine group , mean serum free carnitine concentration increased significantly to 150 % of baseline ( p < 0.001 ) , whereas plasma fibrinogen and serum CRP had 98 mg/dL ( p < 0.01 ) and 41 % ( p < 0.01 ) significant decreases , respectively , at the end of week 12 compared with baseline . The reductions were significant compared with the placebo group ( p < 0.05 ) . No significant differences were observed between the two groups with regard to mean changes of the activity of plasma protein C , coagulation factors V , VII , IX , and serum PAI-1 to tPA ratio . Conclusion : l-Carnitine supplement reduces serum CRP , a marker of systemic inflammation , and plasma fibrinogen , an inflammation-related coagulation factor , in hemodialysis patients . Therefore , l-carnitine may play an effective role in preventing cardiovascular diseases in these patients Atrial  fibrillation ( AF )  is one of the most common complications in patients who undergo coronary artery bypass graft surgery ( CABG ) . The aim of this study was to evaluate the effect of L-carnitine administration on postoperative AF and the levels of C-reactive protein ( CRP ) following CABG . The effects of L-carnitine on the incidence of acute kidney injury after CABG were also assessed . One hundred thirty-four patients undergoing elective CABG , without a history of AF or previous L-carnitine treatment , were r and omly assigned to an L-carnitine group ( 3000 mg/d L-carnitine ) or a control group .  CRP levels , as a biomarker of inflammation , were assessed in all the patients before surgery as baseline levels and 48 hours postoperatively . Neutrophil gelatinase-associated lipocalin , as a kidney biomarker , was also measured in the patients before surgery and 2 hours thereafter . The incidence of AF was 13.4 % in our population . The incidence of AF was decreased in the L-carnitine group ( 7.5 % in the L-carnitine group vs 19.4 % in the control group ; P = 0.043 ) and the postoperative CRP level ( 8.79 ± 6.9 in the L-carnitine group , and 10.83 ± 5.7 in the control group ; P = 0.021 ) . The postoperative neutrophil gelatinase-associated lipocalin concentration demonstrated no significant rise after surgery compared with the preoperative concentration ( 72.54 ± 20.30 in the L-carnitine group vs 67.68 ± 22.71 in the placebo group ; P = 0.19 ) . Our study showed that L-carnitine administration before CABG might inhibit and reduce the incidence of AF after CABG . It seems that a rise in the CRP level , as an inflammation marker , may be associated with the incidence of AF . Inflammation as measured by CRP was also reduced in the carnitine group , compared with the control group Acetyl-L-carnitine ( ALC ) , a drug for the treatment of ageing-related neuroendocrine dysfunctions , was orally administered--2 gm/day for 30 days -- to 10 patients with active pulmonary tuberculosis ( TBC ) .  Lymphocyte-mediated antibacterial activity and serum levels of tumor necrosis factor (TNF)-alpha were evaluated before and after treatment , comparing the values with those of 10 TBC patients receiving placebo . Results show that by day 30 , antibacterial activity remained unmodified or increased in ALC-treated subjects , while decreased in the placebo group . No influence of ALC on TNF-alpha levels was detectable . These data suggest that the host 's immune responses to M. tuberculosis infection can be selectively modulated by drugs acting on the neuroendocrine axis Inflammation , oxidative stress , and high concentration of serum lipoprotein ( a ) [ Lp ( a ) ] are common complications in hemodialysis patients . The present study was design ed to investigate the effects of L-carnitine supplement on serum inflammatory cytokines , C-reactive protein ( CRP ) , Lp ( a ) , and oxidative stress in hemodialysis patients with Lp ( a ) hyperlipoproteinemia [ hyper Lp ( a ) ] . This was an unblinded , r and omized clinical trial . Thirty-six hyper Lp ( a ) hemodialysis patients ( 23 men and 13 women ) were r and omly assigned to either a carnitine or control group . Patients in the carnitine group received 1000 mg/d oral L-carnitine for 12 weeks , whereas patients in the control group did not receive any L-carnitine supplement . At baseline and the end of week 12 , 5 mL of blood were collected after a 12- to 14-hours fast and serum free carnitine , CRP , interleukin-1β , interleukin-6 ( IL-6 ) , tumor necrosis factor-α , Lp ( a ) , and oxidized low-density lipoprotein were measured . Serum free carnitine concentration increased significantly by 86 % in the carnitine group at the end of week 12 compared with baseline ( P<0.001 ) , while serum CRP and IL-6 showed a significant decrease of 29 % ( P<0.05 ) and 61 % ( P<0.001 ) , respectively . No significant changes were observed in serum free carnitine , CRP , and IL-6 in the control group . There were no significant differences between the two groups in mean changes of serum interleukin-1β , tumor necrosis factor-α , Lp ( a ) , and oxidized low-density lipoprotein concentrations . L-carnitine supplement  reduces inflammation in hemodialysis patients , but has no effect on hyper Lp ( a ) and oxidative stress
target: Conclusion Our results indicate  that L-carnitine  reduced inflammatory mediators , especially in studies with a duration of more than 12 weeks .
background: Aim and background Reducing inflammation by nutritional supplements may help to reduce the risk of many chronic diseases .
  Our aim in this meta- analysis was to determine the effect of L-carnitine on inflammatory mediators including C-reactive protein ( CRP ) , tumor necrosis factor-α ( TNF-α ) , and interleukin-6 ( IL-6 ) .