title: Effect of L-acetylcarnitine on body composition in HIV-related lipodystrophy. L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women. Oral carnitine supplementation influences mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial Two-Year Trends of Taxane-Induced Neuropathy in Women Enrolled in a Randomized Trial of Acetyl-L-Carnitine (SWOG S0715) l-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with Simvastatin Monotherapy: A Randomized Double-Blind Placebo-Controlled Study L-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial. Hemodynamic Stabilizing Effects of L-Carnitine in Chronic Hemodialysis Patients L-Carnitine supplementation reduces oxidized LDL cholesterol in patients with diabetes. L-carnitine as an ergogenic aid for patients with chronic obstructive pulmonary disease submitted to whole-body and respiratory muscle training programs. Data from a randomized and controlled trial of LCarnitine prescription for the treatment for Non- Alcoholic Fatty Liver Disease Carnitine does not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted, low-fat diet. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Effect of oral acetyl L-carnitine arginate on resting and postprandial blood biomarkers in pre-diabetics Effects of carnitine and coenzyme Q10 on lipid profile and serum levels of lipoprotein(a) in maintenance hemodialysis patients on statin therapy. Acetyl-L-carnitine (ALC) in attention-deficit/hyperactivity disorder: a multi-site, placebo-controlled pilot trial. L-Carnitine-supplementation in advanced pancreatic cancer (CARPAN) - a randomized multicentre trial Effects of Oral L-Carnitine Administration in Narcolepsy Patients: A Randomized, Double-Blind, Cross-Over and Placebo-Controlled Trial Effect of L-carnitine on the size of low-density lipoprotein particles in type 2 diabetes mellitus patients treated with simvastatin. The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus. Effects of L-carnitine supplementation on biomarkers of oxidative stress, antioxidant capacity and lipid profile, in patients with pemphigus vulgaris: a randomized, double-blind, placebo-controlled 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 Effect of lysine, vitamin B(6), and carnitine supplementation on the lipid profile of male patients with hypertriglyceridemia: a 12-week, open-label, randomized, placebo-controlled trial. Effects of simvastatin and carnitine versus simvastatin on lipoprotein(a) and apoprotein(a) in type 2 diabetes mellitus Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients. Effects of l-carnitine supplement on serum amyloid A and vascular inflammation markers in hemodialysis patients: a randomized controlled trial. L-carnitine supplementation decreases the left ventricular mass in patients undergoing hemodialysis. Levocarnitine Administration in Elderly Subjects with Rapid Muscle Fatigue L-carnitine infusions may suppress serum C-reactive protein and improve nutritional status in maintenance hemodialysis patients. Effects of Oral L-Carnitine Supplementation on Leptin and Adiponectin Levels and Body Weight of Hemodialysis Patients: a Randomized Clinical Trial. Sibutramine and L-carnitine compared to sibutramine alone on insulin resistance in diabetic patients. Randomised phase III clinical trial of 5 different arms of treatment on 332 patients with cancer cachexia. Randomized phase III clinical trial of five different arms of treatment in 332 patients with cancer cachexia. Effect of glycine propionyl-L-carnitine on aerobic and anaerobic exercise performance. Orlistat and L-carnitine compared to orlistat alone on insulin resistance in obese diabetic patients. L-Carnitine supplementation improved clinical status without changing oxidative stress and lipid profile in women with knee osteoarthritis. A double-blind, randomised, controlled clinical trial of acetyl-l-carnitine vs. amisulpride in the treatment of dysthymia Effects of L-Carnitine supplement on plasma coagulation and anticoagulation factors in hemodialysis patients Effect of PLC on functional parameters and oxidative profile in type 2 diabetes-associated PAD. 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: This study examined the impact of L-acetylcarnitine treatment on metabolic parameters and body composition in patients with lipodystrophy syndrome secondary to antiretroviral treatment in human immunodeficiency virus ( HIV ) infection . A total of 9 HIV-1 infected patients with lipodystrophy syndrome ( 4F/5 M , age 41+/-5 years , HIV duration 8+/-2 years , BMI 23.7+/-3.4 kg/m(2 ) , on protease inhibitors and nucleoside analogue Reverse Transcriptase inhibitors )  were evaluated before and after 8 months of therapy with L-acetylcarnitine ( 2 g/die ) and 9 matched healthy subjects served as control subjects . In all patients fasting plasma glucose , insulin concentrations ( for evaluation of surrogate indexes of insulin sensitivity ) , lipid profile , lipid oxidation ( by indirect calorimetry ) , body composition ( by DEXA ) , and intramyocellular triglyceride ( IMCL ) content of the calf muscles ( by (1)H NMR spectroscopy ) were assessed . After this therapy , in HIV-1 patients , the IMCL content of the soleus had significantly decreased ( p=0.03 ) . Plasma FFAs ( 0.79+/-0.31 to 0.64+/-0.25 ; p<0.05 ) and Respiratory Quotient ( 0.83+/-0.18 to 0.72+/-0.16 ; p<0.03 ) also decreased . Insulin sensitivity was significantly lower prior ( HOMA-IS 0.56+/-0.30 ) and nonstatistically different than controls after therapy ( 0.72+/-0.49 vs. 0.78+/-0.42 ) whilst the percentage of fat in the legs increased ( p=0.05 ) . Eight months of L-acetylcarnitine treatment increased lipid oxidation , decreased intramyocellular triglyceride content , and induced a more physiological distribution of fat deposits L-Carnitine ( L-C ) transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement . In a double-blind investigation to test the weight loss efficacy of L-C , 36 moderately overweight premenopausal women were pair matched on Body Mass Index ( BMI ) and r and omly assigned to two groups ( N = 18 ) . For 8 weeks the L-C group ingested 2 g twice daily of L-C , while the placebo ( P ) group ingested the same amount of lactose . All subjects walked for 30 min ( 60 - 70 % maximum heart rate ) 4 days/week . Body composition , resting energy expenditure ( REE ) and substrate utilization were estimated before and after treatment . For the subjects who completed the study ( 15 P , 13 L-C ) , no significant changes in mean total body mass ( TBM ) , fat mass FM , and resting lipid utilization occurred over time , nor were there any significant differences between groups for any variable . Conversely REE increased significantly for all subjects , but no between group differences existed . Five of the L-C group experienced nausea or diarrhea and consequently did not complete the study . Eight weeks of L-C ingestion and walking did not significantly alter the TBM or FM of overweight women , thereby casting doubt on the efficacy of L-C supplementation for weight loss Abstract Introduction : Limited data are available assessing the effects of oral carnitine supplementation on mental health parameters and biomarkers of oxidative stress of women with polycystic ovary syndrome (PCOS).This study was design ed to determine the effects of oral carnitine supplementation on mental health parameters and biomarkers of oxidative stress in women with PCOS . Methods : In the current r and omized , double-blind , placebo-controlled trial , 60 patients diagnosed with PCOS were r and omized to take either 250 mg carnitine supplements ( n = 30 ) or placebo ( n = 30 ) for 12 weeks . Results : After 12 weeks ’ intervention , compared with the placebo , carnitine supplementation result ed in a significant improvement in Beck Depression Inventory total score ( −2.7 ± 2.3 versus −0.2 ± 0.7 , p < 0.001 ) , General Health Question naire scores ( −6.9 ± 4.9 versus −0.9 ± 1.5 , p < 0.001 ) and Depression Anxiety and Stress Scale scores ( −8.7 ± 5.9 versus −1.2 ± 2.9 , p = 0.001 ) . In addition , changes in plasma total antioxidant capacity ( TAC ) ( + 84.1 ± 151.8 versus + 4.6 ± 64.5 mmol/L , p = 0.01 ) , malondialdehyde ( MDA ) ( −0.4 ± 1.0 versus + 0.5 ± 1.5 μmol/L , p = 0.01 ) and MDA/TAC ratio ( −0.0005 ± 0.0010 versus + 0.0006 ± 0.0019 , p = 0.003 ) in the supplemented group were significantly different from the changes in these indicators in the placebo group . Conclusions : Overall , our study demonstrated that carnitine supplementation for 12 weeks among patients with PCOS had favorable effects on parameters of mental health and biomarkers of oxidative stress Background Chemotherapy-induced peripheral neuropathy ( CIPN ) is a common and disabling side effect of taxanes . Acetyl-L-carnitine ( ALC ) was unexpectedly found to increase CIPN in a r and omized trial . We investigated the long-term patterns of CIPN among patients in this trial . Methods S0715 was a r and omized , double-blind , multicenter trial comparing ALC ( 1000 mg three times a day ) with placebo for 24 weeks in women undergoing adjuvant taxane-based chemotherapy for breast cancer .  CIPN was measured by the 11-item neurotoxicity ( NTX ) component of the FACT-Taxane scale at weeks 12 , 24 , 36 , 52 , and 104 . We examined NTX scores over two years using linear mixed models for longitudinal data . Individual time points were examined using linear regression . Regression analyses included stratification factors and the baseline score as covariates . All statistical tests were two-sided . Results Four-hundred nine subjects were eligible for evaluation . Patients receiving ALC  had a statistically significantly ( P = .01 ) greater reduction in NTX scores ( worse CIPN ) of -1.39 points ( 95 % confidence interval [ CI ] = -2.48 to -0.30 ) than the placebo group . These differences were particularly evident at weeks 24 ( -1.68 , 95 % CI = -3.02 to -0.33 ) , 36 ( -1.37 , 95 % CI = -2.69 to -0.04 ) , and 52 ( -1.83 , 95 % CI = -3.35 to -0.32 ) . At 104 weeks , 39.5 % on the ALC arm and 34.4 % on the placebo arm reported a five-point ( 10 % ) decrease from baseline . For both treatment groups , 104-week NTX scores were statistically significantly different compared with baseline ( P < .001 ) . Conclusions For both groups , NTX scores were reduced from baseline and remained persistently low . Twenty-four weeks of ALC therapy result ed in statistically significantly worse CIPN over two years . Underst and ing the mechanism of this persistent effect may inform prevention and treatment strategies . Until then , the potential efficacy and harms of commonly used supplements should be rigorously studied Lipoprotein ( a ) [ Lp(a ) ] is an independent risk factor for cardiovascular disease . There are currently limited therapeutic options to lower Lp(a ) levels . l-Carnitine has been reported to reduce Lp(a ) levels . The aim of this study was to compare the effect of l-carnitine/simvastatin co-administration with that of simvastatin monotherapy on Lp(a ) levels in subjects with mixed hyperlipidemia and elevated Lp(a ) concentration . Subjects with levels of low-density lipoprotein cholesterol ( LDL-C ) > 160 mg/dL , triacylglycerol ( TAG ) > 150 mg/dL and Lp(a ) > 20 mg/dL were included in this study . Subjects were r and omly allocated to receive l-carnitine 2 g/day plus simvastatin 20 mg/day ( N = 29 ) or placebo plus simvastatin 20 mg/day ( N = 29 ) for a total of 12 weeks . Lp(a ) was significantly reduced in the l-carnitine/simvastatin group [ −19.4 % , from 52 ( 20–171 ) to 42 ( 15–102 ) mg/dL ; p = 0.01 ] , but not in the placebo/simvastatin group [ −6.7 % , from 56 ( 26–108 ) to 52 ( 27–93 ) mg/dL , p = NS versus baseline and p = 0.016 for the comparison between groups ] . Similar significant reductions in total cholesterol , LDL-C , apolipoprotein ( apo ) B and TAG were observed in both groups . Co-administration of l-carnitine with simvastatin was associated with a significant , albeit modest , reduction in Lp(a )  compared with simvastatin monotherapy in subjects with mixed hyperlipidemia and elevated baseline Lp(a ) levels BACKGROUND Centenarians are characterized by weakness , decreasing mental health , impaired mobility , and poor endurance . L-Carnitine is an important contributor to cellular energy metabolism . OBJECTIVE This study evaluated the efficacy of L-carnitine on physical and mental fatigue and on cognitive functions of centenarians . DESIGN This was a placebo-controlled , r and omized , double-blind , 2-phase study . Sixty-six centenarians with onset of fatigue after even slight physical activity were recruited to the study . The 2 groups received either 2 g levocarnitine once daily ( n = 32 ) or placebo ( n = 34 ) . Efficacy measures included changes in total fat mass , total muscle mass , serum triacylglycerol , total cholesterol , HDL cholesterol , LDL cholesterol , Mini-Mental State Examination ( MMSE ) , Activities of Daily Living , and a 6-min walking corridor test . RESULTS At the end of the study period , the levocarnitine-treated centenarians , compared with the placebo group , showed significant improvements in the following markers : total fat mass ( -1.80 compared with 0.6 kg ; P < 0.01 ) , total muscle mass ( 3.80 compared with 0.8 kg ; P < 0.01 ) , plasma concentrations of total carnitine ( 12.60 compared with -1.70 mumol ; P < 0.05 ) , plasma long-chain acylcarnitine ( 1.50 compared with -0.1 micromol ; P < 0.001 ) , and plasma short-chain acylcarnitine ( 6.0 compared with -1.50 micromol ; P < 0.001 ) . Significant differences were also found in physical fatigue ( -4.10 compared with -1.10 ; P < 0.01 ) , mental fatigue ( -2.70 compared with 0.30 ; P < 0.001 ) , fatigue severity ( -23.60 compared with 1.90 ; P < 0.001 ) , and MMSE ( 4.1 compared with 0.6 ; P < 0.001 ) . CONCLUSIONS Our study indicates that oral administration of levocarnitine produces a reduction of total fat mass , increases total muscular mass , and facilitates an increased capacity for physical and cognitive activity by reducing fatigue and improving cognitive functions Background : The effects of L-carnitine on the hemodynamic state of chronic hemodialysis patients have been debated . In order to clarify the effect of administered L-carnitine on cardiac function and hypotensive episodes during the hemodialysis procedure , a r and omized double-blind placebo-controlled study was performed for 3 months . Methods and Results : Twenty stable out patients undergoing hemodialysis treatment were divided into two groups : controls ( placebo ) and treated patients ( L-carnitine 900 mg p.o . daily ) . After 3 months , cardiac function was reevaluated by echocardiography , and hypotensive episodes during hemodialysis were assessed . Free and acyl carnitine levels increased significantly from 22.3 ± 7.1 to 140.3 ± 57.5 μmol/l and from 15.8 ± 2.8 to 94.8 ± 50.4 μmol/l , respectively , in the treated group . The ejection fraction significantly increased from 61.8 ± 16.0 to 64.4 ± 13.8 % ( p < 0.05 ) in the treated group . However , there was no difference in other echocardiographic parameters between the two groups . Hypotensive episodes significantly decreased from 4.0 ± 1.7 to 1.3 ± 0.9 times per month ( p < 0.05 ) , although patients ' body weight did not change significantly . Conclusions : Beneficial effects of L-carnitine on the hemodynamic state of chronic hemodialysis patients were observed . L-Carnitine supplementation might be considered especially for chronic hemodialysis patients with unstable hemodynamic conditions BACKGROUND Patients with type 2 diabetes are under high oxidative stress , and levels of hyperglycemia correlate strongly with levels of LDL oxidation . Carnitine favorably modulates oxidative stress . OBJECTIVE This objective of this study was to evaluate the efficacy of L-carnitine on the reduction of oxidized LDL cholesterol in patients with type 2 diabetes . DESIGN Eighty-one patients with diabetes were r and omly assigned to 1 of 2 treatment groups for 3 mo . The 2 groups received either 2 g L-carnitine once daily ( n = 41 ) or placebo ( n = 40 ) . The following variables were assessed at baseline , after washout , and at 1 , 2 , and 3 mo of treatment : body mass index , fasting plasma glucose , glycosylated hemoglobin , total cholesterol , LDL cholesterol , HDL cholesterol , triglycerides , apolipoprotein A1 , apolipoprotein B-100 , oxidized LDL cholesterol , thiobarbituric acid-reactive substances , and conjugated dienes . RESULTS At the end of the study period , the L-carnitine-treated patients showed significant improvements compared with the placebo group in the following markers : oxidized LDL levels decreased by 15.1 compared with 3.0 U/L ( P < 0.001 ) ; LDL cholesterol decreased by 0.45 compared with 0.16 mmol/L ( P < 0.05 ) ; triglycerides decreased by 1.02 compared with 0.09 mmol/L ( P < 0.001 ) ; apolipoprotein A1 concentrations decreased by 0.12 compared with 0.03 mg/dL ( P < 0.05 ) ; apolipoprotein B-100 concentrations decreased by 0.13 compared with 0.04 mg/dL ( P < 0.05 ) ; thiobarbituric acid-reactive substance concentrations decreased by 1.92 compared with 0.05 ( P < 0.001 ) , and conjugated diene concentrations decreased by 0.72 compared with 0.11 in the placebo group ( P < 0.001 ) . CONCLUSION Our study indicates that oral administration of L-carnitine reduces oxidized LDL cholesterol levels in patients with type 2 diabetes The effects of adding L-carnitine to a whole-body and respiratory training program were determined in moderate-to-severe chronic obstructive pulmonary disease ( COPD ) patients . Sixteen COPD patients ( 66 + /- 7 years ) were r and omly assigned to L-carnitine ( CG ) or placebo group ( PG ) that received either L-carnitine or saline solution ( 2 g/day , orally ) for 6 weeks ( forced expiratory volume on first second was 38 + /- 16 and 36 + /- 12 % , respectively ) . Both groups participated in three weekly 30-min treadmill and threshold inspiratory muscle training sessions , with 3 sets of 10 loaded inspirations ( 40 % ) at maximal inspiratory pressure . Nutritional status , exercise tolerance on a treadmill and six-minute walking test , blood lactate , heart rate , blood pressure , and respiratory muscle strength were determined as baseline and on day 42 . Maximal capacity in the incremental exercise test was significantly improved in both groups ( P < 0.05 ) . Blood lactate , blood pressure , oxygen saturation , and heart rate at identical exercise levels were lower in CG after training ( P < 0.05 ) . Inspiratory muscle strength and walking test tolerance were significantly improved in both groups , but the gains of CG were significantly higher than those of PG ( 40 + /- 14 vs 14 + /- 5 cmH2O , and 87 + /- 30 vs 34 + /- 29 m , respectively ; P < 0.05 ) . Blood lactate concentration was significantly lower in CG than in PG ( 1.6 + /- 0.7 vs 2.3 + /- 0.7 mM , P < 0.05 ) . The present data suggest that carnitine can improve exercise tolerance and inspiratory muscle strength in COPD patients , as well as reduce lactate production Non-alcoholic fatty liver disease ( NAFLD ) consists of a range of complication . The disease describes clinical , para clinical and pathological conditions from simple steatosis in non-alcoholic steato hepatitis ( NASH ) to fibrosis , cirrhosis and hepato cellular carcinoma . Therefore , it is of interest to evaluate the grade of fatty liver and Liver Function Test in NAFLD patients . We collected sample s and data from 80 patients referred to gastrointestinal clinic of Emam Reza hospital with sonography diagnosed NAFLD and were evaluated in two groups in a r and omized clinical trial . The effects of L-Carnitine ( 500 mg ) prescription twice a day on liver enzymes and echogenicity changes in case group was documented and compared with the control group . The mean age of the patients was 40.7±8 in the age range of 25 to 62 years old with 66 ( 82.5 % ) male and 14 ( 17.5 % ) female patients . Data show that fatty liver changes were not significantly different in the two groups ( P=0.23 ) . It is observed that the ALT was the only enzyme with significant changes ( P=0.01 ) after a 24-week interval . It is also noted that the difference in fatty liver sonographic grading was also significant in the two groups ( P=0.0001 ) . Thus , proper therapeutic protocol s can be adopted beside diet and weight loss to control the disease trend in consideration to the significant changes observed both in enzymatic levels and sonographic grading between the two groups of patients with NAFLD OBJECTIVES Carnitine deficiency impairs fatty acid beta-oxidation and may partly explain weight gain in valproate-treated patients . The aim of this study was to determine whether l-carnitine supplementation improves weight loss outcomes in bipolar patients taking sodium valproate .  METHODS Sixty bipolar patients with clinical ly significant weight gain thought to be related to sodium valproate , who had been taking sodium valproate for > or=6 months , were r and omized to l-carnitine ( 15 mg/kg/day ) or placebo for 26 weeks , in conjunction with a moderately energy-restricted , low-fat diet . The primary outcome measure was weight change . RESULTS l-carnitine had no effect on mean weight loss compared with placebo ( -1.9 kg versus - 0.9 kg ) ( F = 0.778 , df = 1,58 , p = 0.381 ) . The number of people in each group able to lose any weight was identical ( = 0 , p = 1.0 ) ; more patients in the carnitine group ( nine versus five ) achieved a clinical ly significant weight loss ( > or=5 % ) but this was not statistically significant ( p = 1.0 , Fisher 's exact test ) . CONCLUSIONS At the dose prescribed in this study carnitine supplementation did not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted , low-fat diet Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more 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 INTRODUCTION Dyslipidemia and high serum lipoprotein(a ) are among the risk factors for cardiovascular diseases in hemodialysis patients .  Statins as a first line of therapy in hyperlipidemia does not always reduce the serum lipoprotein(a ) level . Several studies have reported the lipid-lowering effects of carnitine and coenzyme Q10 in hemodialysis patients . This study was design ed to investigate the effects of carnitine and coenzyme Q10 on serum lipid profile and lipoprotein(a ) level in maintenance hemodialysis patients . MATERIAL S AND METHODS This was a r and omized placebo-controlled trial . We studied on hemodialysis patients who were on treatment with atorvastatin or lovastatin to assess the efficacy of supplement therapy . They were divided into 4 groups to receive carnitine , coenzyme Q10 , both carnitine and coenzyme Q10 , and placebo . After a 3-month experiment , blood sample s were collected to measure serum levels of lipoprotein(a ) , triglyceride , total cholesterol , high-density lipoprotein cholesterol and low-density lipoprotein cholesterol . RESULTS Fifty-two hemodialysis patients , 27 men and 25 women , completed the course of the study . Three months after supplement therapy , serum levels of lipoprotein(a ) reduced significantly in the carnitine , coenzyme Q10 , and combination groups compared to the baseline values and the 3-month value of lipoprotein(a ) in the placebo group ( P = .01 ) . Serum levels of triglyceride and other lipoproteins did not significantly alter . CONCLUSIONS Our study showed that supplementation with carnitine and coenzyme Q10 could reduce serum levels of lipoprotein(a ) in maintenance hemodialysis patients treated with statins OBJECTIVE To determine whether acetyl-L-carnitine ( ALC ) , a metabolite necessary for energy metabolism and essential fatty acid anabolism , might help attention-deficit/hyperactivity disorder ( ADHD ) . Trials in Down 's syndrome , migraine , and Alzheimer 's disease showed benefit for attention . A preliminary trial in ADHD using L-carnitine reported significant benefit . METHOD A multi-site 16-week pilot study r and omized 112 children ( 83 boys , 29 girls ) age 5 - 12 with systematic ally diagnosed ADHD to placebo or ALC in weight-based doses from 500 to 1500 mg b.i.d . The 2001 revisions of the Conners ' parent and teacher scales ( including DSM-IV ADHD symptoms ) were administered at baseline , 8 , 12 , and 16 weeks . Analyses were ANOVA of change from baseline to 16 weeks with treatment , center , and treatment-by-center interaction as independent variables . RESULTS The primary intent-to-treat analysis , of 9 DSM-IV teacher-rated inattentive symptoms , was not significant . However , secondary analyses were interesting . There was significant ( p = 0.02 ) moderation by subtype : superiority of ALC over placebo in the inattentive type , with an opposite tendency in combined type . There was also a geographic effect ( p = 0.047 ) . Side effects were negligible ; electrocardiograms , lab work , and physical exam unremarkable . CONCLUSION ALC appears safe , but with no effect on the overall ADHD population ( especially combined type ) . It deserves further exploration for possible benefit specifically in the inattentive type Background Cachexia , a > 10 % loss of body-weight , is one factor determining the poor prognosis of pancreatic cancer . Deficiency of L-Carnitine has been proposed to cause cancer cachexia . Findings We screened 152 and enrolled 72 patients suffering from advanced pancreatic cancer in a prospect i ve , multi-centre , placebo-controlled , r and omized and double-blinded trial to receive oral L-Carnitine ( 4 g ) or placebo for 12 weeks . At entry patients reported a mean weight loss of 12 ± 2,5 ( SEM ) kg . During treatment body-mass-index increased by 3,4 ± 1,4 % under L-Carnitine and decreased ( −1,5 ± 1,4 % ) in controls ( p < 0,05 ) . Moreover , nutritional status ( body cell mass , body fat ) and quality -of-life parameters improved under L-Carnitine . There was a trend towards an increased overall survival in the L-Carnitine group ( median 519 ± 50 d versus 399 ± 43 d , not significant ) and towards a reduced hospital-stay ( 36 ± 4d versus 41 ± 9d , n.s . ) . Conclusion While these data are preliminary and need confirmation they indicate that patients with pancreatic cancer may have a clinical ly relevant benefit from the inexpensive and well tolerated oral supplementation of L-Carnitine Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness , cataplexy , and rapid eye movement ( REM ) sleep abnormalities . A genome-wide association study ( GWAS ) identified a novel narcolepsy-related single nucleotide polymorphism ( SNP ) , which is located adjacent to the carnitine palmitoyltransferase 1B ( CPT1B ) gene encoding an enzyme involved in β-oxidation of long-chain fatty acids . The mRNA expression levels of CPT1B were associated with this SNP . In addition , we recently reported that acylcarnitine levels were abnormally low in narcolepsy patients . To assess the efficacy of oral l-carnitine for the treatment of narcolepsy , we performed a clinical trial administering l-carnitine ( 510 mg/day ) to patients with the disease . The study design was a r and omized , double-blind , cross-over and placebo-controlled trial . Thirty narcolepsy patients were enrolled in our study . Two patients were withdrawn and 28 patients were included in the statistical analysis ( 15 males and 13 females , all with HLA-DQB1 * 06:02 ) . l-carnitine treatment significantly improved the total time for dozing off during the daytime , calculated from the sleep logs , compared with that of placebo-treated periods . l-carnitine efficiently increased serum acylcarnitine levels , and reduced serum triglycerides concentration . Differences in the Japanese version of the Epworth Sleepiness Scale ( ESS ) and the Medical Outcomes Study 36-Item Short-Form Health Survey ( SF-36 ) vitality and mental health subscales did not reach statistical significance between l-carnitine and placebo . This study suggests that oral l-carnitine can be effective in reducing excessive daytime sleepiness in narcolepsy patients . Trial Registration University hospital Medical Information Network ( UMIN ) Therapeutic modulation of low-density lipoprotein ( LDL ) size could be of benefit in reducing the risk of cardiovascular events in diabetic patients . This study evaluated the efficacy of L-carnitine on the size of LDL particles in type 2 diabetes mellitus patients treated with simvastatin . Eighty diabetic patients were r and omly assigned to 1 of 2 treatment groups for 3 months . The 2 groups received either simvastatin monotherapy 20 mg ( n = 40 ) or L-carnitine 2 g/d and simvastatin 20 mg ( n = 40 ) . The following variables were assessed at baseline ; after washout ; and at 1 , 2 , and 3 months of treatment : body mass index , fasting plasma glucose , glycosylated hemoglobin , total cholesterol , LDL cholesterol , LDL subclasses , LDL size , high-density lipoprotein cholesterol , triglycerides , apolipoprotein A-1 , and apolipoprotein B-100 . After 12 weeks , comparing the 2 groups , we observed a decrease in fasting plasma glucose ( 1.45 vs 0.61 mmol/L , P < .001 ) and an increase in glycosylated hemoglobin ( 0.2 % vs 0.4 % , P < .05 ) . Moreover , there was a decrease in total cholesterol ( 2.07 vs 1.45 mmol/L , P < .001 ) , LDL ( 1.65 vs 1.29 mmol/L , P < .001 ) , triglycerides ( 1.36 vs 0.41 mmol/L , P < .001 ) , apo B-100 ( 49 vs 9 g/L , P < .001 ) , and small-sized LDL proportion ( 10.8 % vs 4.9 % , P < .001 ) , whereas LDL particle size increased ( 6 vs 3 A , P < .001 ) and HDL increased ( 0.2 vs 0.11 mmol/L , P < .001 ) . We observed that patients treated with carnitine and simvastatin showed a reduction in small-sized LDL proportion and an increase in LDL particle size BACKGROUND A previous study has demonstrated that L-carnitine reduces plasma lipoprotein(a ) ( Lp[a ] ) levels in patients with hypercholesterolemia . OBJECTIVE To test a tolerable Lp(a)-reducing agent in diabetic patients , we assessed the effect of a dietary supplementation of L-carnitine on plasma lipid levels , particularly Lp(a ) , of patients with type 2 diabetes mellitus ( DM ) and hypercholesterolemia . METHODS In this 6-month , r and omized , double-masked , placebo-controlled clinical trial , patients were enrolled , assessed , and followed up at the Diabetic and Metabolic Diseases Center of the Department of Internal Medicine and Therapeutics at the University of Pavia , Pavia , Italy . All study patients had newly diagnosed type 2 DM that was managed through dietary restriction alone throughout the study , as well as hypercholesterolemia . Patients were r and omized to 1 of 2 groups . One group received L-carnitine , one 1-g tablet BID . The other group received a corresponding placebo . We assessed body mass index , fasting plasma glucose , postpr and ial plasma glucose , glycosylated hemoglobin , fasting plasma insulin , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , apolipoprotein ( apo ) A-I , apo B , and Lp(a ) at baseline and at 1 , 3 , and 6 months of treatment . RESULTS This study included 94 patients . The treatment group included 24 men and 22 women ( mean [ SD ] age , 52 [ 6 ] years ) . The placebo group included 23 men and 25 women ( mean [ SD ] age , 50 [ 7 ] years ) . The baseline characteristics of the groups did not differ significantly . The mean ( SD ) body weight , height , and body mass index were 78.2 ( 5.8 ) kg , 1.70 ( 0.04 ) m , and 27.3 ( 2.5 ) kg/m(2 ) , respectively , in the L-carnitine group and 77.6 ( 6.4 ) kg , 1.71 ( 0.05 ) m , and 26.8 ( 2.2 ) kg/m(2 ) , respectively , in the placebo group . In the treatment group , Lp(a ) was significantly reduced at 3 and 6 months compared with baseline ( P < 0.05 ) and P < 0.01 , respectively ) . We observed a significant improvement after 6 months ( P < 0.05 ) in the Lp(a ) value in patients taking L-carnitine compared with those taking placebo . Between-group differences in other variables did not reach a level of significance at months 3 and 6 . No drug-related adverse events were reported or observed . CONCLUSION In this preliminary study , after 3 and 6 months , L-carnitine significantly lowered the plasma Lp(a ) level compared with placebo in selected hypercholesterolemic patients with newly diagnosed type 2 DM Background / Objectives : Pemphigus vulgaris ( PV ) , as an autoimmune disease including mucosa and the skin , is associated with several complications and comorbidities . The present study planned to determine the effect of L-carnitine ( LC ) supplementation on biomarkers of oxidative stress ( OS ) , antioxidant capacity and lipid profile in PV patients .Subjects/ Methods Fifty two control and patients with PV , participated in the current r and omized , double-blind , placebo-controlled clinical trial . The patients were allocated r and omly to receive 2 g per day LC tartrate subdivided into two equal doses of 1 g before breakfast and dinner ( n=26 ) or placebo ( n=26 ) for 8 weeks . Anthropometric , lipid profile and OS values were determined at baseline and end of intervention period . Results : LC intake significantly reduced serum levels of triglycerides , total- , LDL- cholesterol and oxidative stress index ( OSI ; P<0.05 ) . In addition , supplementation with LC result ed to a meaningful increase in levels of total antioxidant capacity ( TAC ) ( P=0.05 ) and serum carnitine ( P<0.001 ) . LC intake revealed non-significant change in serum total oxidant capacity ( P=0.15 ) and HDL- cholesterol ( P=0.06 ) in comparison to the placebo . Conclusions : LC consumption may have favorable results on TAC , OSI and lipid profiles in patients with PV . The results were in line with the idea that LC supplementation can be associated with positive effects on metabolic status and OS of patients with PV 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 BACKGROUND Fat metabolism is known to be altered in hypertriglyceridemia . Fat oxidation requires carnitine , which can be obtained either from the diet ( animal or dairy products ) or through synthesis in the body using both lysine and vitamin B(6 ) . OBJECTIVE The goal of this study was to investigate the effect of lysine , vitamin B(6 ) , and carnitine supplementation on both glycemia and the lipid profiles , specifically triglyceride ( TG ) levels , in men with hypertriglyceridemia . METHODS This 12-week , r and omized , placebo-controlled clinical trial was conducted at a Lebanese medical center . A total of 85 hypertriglyceridemic ( TG > 150 mg/dL ) male patients were r and omized to 1 of 5 groups and given supplements of lysine ( 1 g/d ) , vitamin B(6 ) ( 50 mg/d ) , lysine ( 1 g/d ) + vitamin B(6 ) ( 50 mg/d ) , carnitine ( 1 g/d ) , or placebo for 12 weeks . The lipid profile ( TG , total cholesterol , LDL-C , and HDL-C ) and fasting plasma glucose levels were assessed at baseline and at 6 and 12 weeks . RESULTS Adults ( ∼50 years ) Lebanese males from a low socioeconomic status in Beirut were given the appropriate supplements . Vitamin B(6 ) supplementation was associated with a significant reduction in total cholesterol and HDL-C of ∼10 % . In addition , plasma TG was reduced by 36.6 mg/dL at 6 weeks , whereas levels in the placebo group increased by 18 mg/dL ; this difference failed to reach statistical significance . No major changes in the lipid profile were observed in the lysine and carnitine groups or when lysine was added to vitamin B(6 ) . CONCLUSION Vitamin B(6 ) supplementation in these male patients with hypertriglyceridemia reduced plasma total cholesterol and HDL-C concentrations Aim : The aim of the present study was to compare the effects of simvastatin and L-carnitine coadministration versus simvastatin monotherapy on lipid profile , lipoprotein(a ) ( Lp(a ) ) and apoprotein(a ) ( Apo(a ) ) levels in type II diabetic patients . Patients / methods : In this double-blind , r and omized clinical trial , 75 patients were assigned to one of two treatment groups for 4 months . Group A received simvastatin monotherapy ; group B received L-carnitine and simvastatin . The following variables were assessed at baseline , after washout and at 1 , 2 , 3 and 4 months of treatment : body mass index , fasting plasma glucose , glycated hemoglobin , total cholesterol , low-density lipoprotein ( LDL ) cholesterol , high-density lipoprotein ( HDL ) cholesterol , triglycerides , Apolipoprotein A1 , Apo B , lipoprotein(a ) and apoprotein(a ) . Results : At the end of treatment in the carnitine and simvastatin combined group compared with the simvastatin alone group , we observed a significant decrease in glycemia ( p < 0.001 ) , tryglicerides ( p < 0.001 ) , Apo B ( p < 0.05 ) , Lp(a ) ( p < 0.05 ) , apo(a ) ( p < 0.05 ) , while HDL significantly increased ( p < 0.05 ) . Conclusions : The coadministration of carnitine and simvastatin result ed in a significant reduction in Lp(a ) and apo(a ) and may represent a new therapeutic option in reducing plasma Lp(a ) levels , LDL cholesterol and Apo B100 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 OBJECTIVE We studied the effects of l-carnitine supplement on serum amyloid A ( SAA ) , a systemic inflammation marker , and vascular inflammation markers in hemodialysis patients . DESIGN This was a r and omized , double-blind , placebo-controlled trial . SETTING The study was performed in Soodeh Hemodialysis Center in Islamshahr , Iran . PATIENTS We included 36 hemodialysis patients ( 15 men and 21 women ) . INTERVENTION The patients on hemodialysis were r and omly assigned to either a carnitine or a placebo group . Patients in the carnitine group received 1,000 mg/day oral l-carnitine for 12 weeks , whereas patients in the placebo group received a corresponding placebo during the study . MAIN OUTCOME MEASURES Serum free carnitine , SAA , soluble intercellular adhesion molecule type 1 , soluble intercellular adhesion molecule type 2 , soluble vascular cell adhesion molecule type 1 , sE-selectin , sP-selectin , and oxidized low-density lipoprotein were measured at baseline and at the end of week 12 of the study . RESULTS Mean serum free carnitine concentration increased significantly to 150 % of baseline in the carnitine group at the end of week 12 ( P < .001 ) , whereas serum SAA showed a significant 32 % decrease ( P < .001 ) . No significant changes were observed in the serum concentrations of free carnitine and SAA in the placebo group during the study . There were no significant differences between the two groups in mean changes in serum soluble intercellular adhesion molecule type 1 , soluble intercellular adhesion molecule type 2 , soluble vascular cell adhesion molecule type 1 , sE-selectin , sP-selectin , and oxidized low-density lipoprotein concentrations . CONCLUSION The study indicates that l-carnitine supplement reduces serum SAA , which is a risk factor for cardiovascular diseases in hemodialysis patients , but has no effect on vascular inflammation markers BACKGROUND Patients on long-term hemodialysis become deficient in carnitine and are frequently treated with carnitine supplementation to offset their renal anemia , lipid abnormality and cardiac dysfunction . The therapeutic value of carnitine supplementation on left ventricular hypertrophy ( LVH ) in patients with normal cardiac systolic function remains uncertain . METHODS AND RESULTS The cardiac morphology and function of 10 patients given 10 mg/kg of L-carnitine orally  , immediately after hemodialysis sessions  3 times per week for a 12-month period were compared with 10 untreated control patients  . Using echocardiography , left ventricular fractional shortening ( LVFS ) and left ventricular mass index ( LVMI ) were measured before and after the study period . As a result , amounts of serum-free carnitine increased from 28.4+/-4.7 to 58.5+/-12.1 micromol/L. The LVMI decreased significantly from 151.8+/-21.2 to 134.0+/-16.0 g/m(2 ) in treated patients ( p<0.01 ) , yet the LVMI in untreated control patients did not change significantly ( ie , from 153.3+/-28.2 to 167.1+/-43.1 g/m(2 ) ) . However , LVFS values remained unchanged in both groups . Although L-carnitine promoted a 31 % reduction in erythropoietin requirements , hematocrit and blood pressure did not change during the study period . CONCLUSIONS Supplementation with L-carnitine induced regression of LVH in patients on hemodialysis , even for those with normal systolic function Aim Levocarnitine is an important contributor to cellular energy metabolism . This study aims to evaluate the effects of levocarnitine supplementation on body composition , lipid profile and fatigue in elderly subjects with rapid muscle fatigue . Method This was a placebo-controlled , r and omised , double-blind , two-phase study . Eighty-four elderly subjects with onset of fatigue following slight physical activity were recruited to the study . Prior to r and omisation all patients entered a 2-week normalisation phase where they were given an ‘ ad libitum ’ diet , according to the National Cholesterol Education Program ( Step 2 ) . Subjects were asked to record their daily food intake every 2 days . Before the 30-day treatment phase , subjects were r and omly assigned to two groups ( matched for male/female ratio , age and body mass index ) . One group received levocarnitine 2 g twice daily ( n = 42 ) and the other placebo ( n = 42 ) . Efficacy measures included changes in total fat mass , total muscle mass , serum triglyceride , total cholesterol , high-density lipoprotein-cholesterol ( HDL-C ) , low-density lipoprotein-cholesterol ( LDL-C ) , apolipoprotein (apo)A1 , and apoB levels . The Wessely and Powell scale was used to evaluate physical and mental fatigue . Subjects were assessed at the beginning and end of the study period . Results At the end of the study , compared with placebo , the levocarnitine-treated patients showed significant improvements in the following parameters : total fat mass ( −3.1 vs −0.5 kg ) , total muscle mass ( + 2.1 vs + 0.2 kg ) , total cholesterol ( −1.2 vs + 0.1 mmol/L ) , LDL-C ( −1.1 vs −0.2 mmol/L ) , HDL-C ( + 0.2 vs + 0.01 mmol/ L ) , triglycerides ( −0.3 vs 0.0 mmol/L ) , apoA1 ( −0.2 vs 0.0 g/L ) , and apoB ( −0.3 vs −0.1 g/L ) . Wessely and Powell scores decreased significantly by 40 % ( physical fatigue ) and 45 % ( mental fatigue ) in subjects taking levocarnitine , compared with 11 % and 8 % , respectively , in the placebo group ( p < 0.001 vs placebo for both parameters ) . No adverse events were reported in any treatment group . Conclusion Administration of levocarnitine to healthy elderly subjects result ed in a reduction of total fat mass , an increase of total muscle mass , and appeared to exert a favourable effect on fatigue and serum lipids Scattered reports indicate that L-carnitine may suppress proinflammatory cytokines in sick individuals without renal disease and may improve protein synthesis or nitrogen balance either in patients without renal disease or in maintenance hemodialysis ( MHD ) or chronic peritoneal dialysis patients . We conducted an experimental study in MHD patients to evaluate the effects of L-carnitine treatment on inflammatory and protein-energy nutritional status .  MHD patients were assigned to receive intravenous injections of L-carnitine 20 mg/kg ( n = 48 ) or placebo ( n = 65 ) thrice weekly at the end of each hemodialysis treatment for 6 months . The carnitine-treated group showed a statistically significant decrease in serum C-reactive protein and increase in serum albumin and transferrin , blood hemoglobin , and body mass index . Conversely , in the placebo-treated group , a significant decrease was reported for serum albumin , serum transferrin , and body mass index , whereas the other considered measures did not change significantly . These preliminary findings suggest that in MHD patients , L-carnitine therapy may suppress inflammation , particularly among those patients with C-reactive protein > or =3 mg/dL , and may improve protein-energy nutritional status INTRODUCTION Carnitine supplementation may improve the general health and quality of life of hemodialysis patients by improving adipokines levels . The aim of the study was to investigate the effects of L-carnitine supplementation on leptin levels , adiponectin levels , and body weight of hemodialysis patients . MATERIAL S AND METHODS Fifty hemodialysis patients were r and omly divided into the carnitine group , who received oral L-carnitine , 1 g/L for 3 months , and the control group . Anthropometric measurements and serum levels of adipokines were measured at baseline and at the end of the intervention . RESULTS Forty-two participants completed the study . Serum leptin concentrations decreased after 12 weeks of the intervention in both groups , but these changes were not significant . The mean change of leptin concentration were , -1.7 ± 19.0 µg/mL and -7.1 ± 20.0 µg/mL in the carnitine group and the control group , respectively ( P = .39 ) . The mean adiponectin levels at baseline and after the intervention were 8.6 ± 11.19 µg/mL and 9.8 ± 4.1 µg/mL in the carnitine group ( P = .67 ) and 5.0 ± 2.5 µg/mL and 11.2 ± 5.4 µg/mL in the control group , respectively ( P < .001 ) . Serum adiponectin levels increased significantly in the control group only . The decrease in body mass index was not significant . CONCLUSIONS This study showed that a daily supplementation of 1000 mg oral syrup of L-carnitine for 12 weeks did not affect leptin and adiponectin levels or the body weight or body mass index of hemodialysis patients 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 BACKGROUND AND OBJECTIVE A phase III r and omised study was carried out to establish the most effective and safest treatment to improve the primary endpoints of cancer cachexia : lean body mass ( LBM ) , resting energy expenditure ( REE ) , fatigue ; and relevant secondary endpoints : appetite , quality of life , grip strength , Glasgow Prognostic Score ( GPS ) and proinflammatory cytokines . PATIENTS Three hundred and thirty-two assessable patients with cancer-related anorexia/cachexia syndrome ( CACS ) were r and omly assigned to one of five arms of treatment : 1 - -medroxyprogesterone 500 mg/d or megestrol acetate 320 mg/d ; 2 - -oral supplementation with eicosapentaenoic acid ( EPA ) ; 3 - -L-carnitine 4 g/d ; 4 - -thalidomide 200 mg/d ; 5 - -a combination of the above . Treatment duration : 4 months . RESULTS Analysis of variance showed a significant difference between the treatment arms . A post hoc analysis showed the superiority of arm 5 over the others for all primary endpoints . An analysis of changes from baseline showed that LBM ( by dual-energy X-ray absorptiometry and by L3 computed tomography ) significantly increased in arm 5 . REE decreased significantly and fatigue improved significantly in arm 5 . Appetite increased significantly in arm 5 . IL-6 decreased significantly in arm 5 and 4 . GPS significantly decreased in arms 5 , 4 and 3 . Total daily physical activity showed that total energy and active energy expenditure increased significantly in arm 5 . Eastern Cooperative Oncology group-Performance Status ( ECOG-PS ) significantly decreased in arms 5 , 4 and 3 . Toxicity was substantially negligible , comparable between treatment arms . CONCLUSIONS The most effective treatment for all three primary efficacy endpoints as well as secondary endpoints appetite , IL-6 , GPS and ECOG PS was the combination regimen that included all selected agents PURPOSE A phase III , r and omized study was carried out to establish the most effective and safest treatment to improve the primary endpoints of cancer cachexia-lean body mass ( LBM ) , resting energy expenditure ( REE ) , and fatigue- and relevant secondary endpoints : appetite , quality of life , grip strength , Glasgow Prognostic Score ( GPS ) and proinflammatory cytokines . PATIENTS AND METHODS Three hundred thirty-two assessable patients with cancer-related anorexia/cachexia syndrome were r and omly assigned to one of five treatment arms : arm 1 , medroxyprogesterone ( 500 mg/day ) or megestrol acetate ( 320 mg/day ) ; arm 2 , oral supplementation with eicosapentaenoic acid ; arm 3 , L-carnitine ( 4 g/day ) ; arm 4 , thalidomide ( 200 mg/day ) ; and arm 5 , a combination of the above . Treatment duration was 4 months . RESULTS Analysis of variance showed a significant difference between treatment arms . A post hoc analysis showed the superiority of arm 5 over the others for all primary endpoints . An analysis of changes from baseline showed that LBM ( by dual-energy X-ray absorptiometry and by L3 computed tomography ) significantly increased in arm 5 . REE decreased significantly and fatigue improved significantly in arm 5 . Appetite increased significantly in arm 5 ; interleukin (IL)-6 decreased significantly in arm 5 and arm 4 ; GPS and Eastern Cooperative Oncology Group performance status ( ECOG PS ) score decreased significantly in arm 5 , arm 4 , and arm 3 . Toxicity was quite negligible , and was comparable between arms . CONCLUSION The most effective treatment in terms of all three primary efficacy endpoints and the secondary endpoints appetite , IL-6 , GPS , and ECOG PS score was the combination regimen that included all selected agents The purpose of this study was to evaluate the effect of glycine propionyl-L-carnitine ( GPLC ) supplementation and endurance training for 8 wk on aerobic- and anaerobic-exercise performance in healthy men and women ( age 18 - 44 yr ) . Participants were r and omly assigned to 1 of 3 groups : placebo ( n=9 ) , 1 g/d GPLC ( n=11 ) , or 3 g/d GPLC ( n=12 ) , in a double-blind fashion . Muscle carnitine ( vastus lateralis ) , VO(2peak ) , exercise time to fatigue , anaerobic threshold , anaerobic power , and total work were measured at baseline and after an 8-wk aerobic-training program . There were no statistical differences ( p > .05 ) between or within the 3 groups for any performance-related variable or muscle carnitine concentrations after 8 wk of supplementation and training . These results suggest that up to 3 g/d GPLC for 8 wk in conjunction with aerobic-exercise training is ineffective for increasing muscle carnitine content and has no significant effects on aerobic- or anaerobic-exercise performance 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 Considering the pathologic importance of oxidative stress and altered lipid metabolism in osteoarthritis ( OA ) , this study aim ed to investigate the effect of l-carnitine supplementation on oxidative stress , lipid profile , and clinical status in women with knee OA . We hypothesized that l-carnitine would improve clinical status by modulating serum oxidative stress and lipid profile . In this r and omized double-blind , placebo-controlled trial , 72 overweight or obese women with mild to moderate knee OA were r and omly allocated into 2 groups to receive 750 mg/d l-carnitine or placebo for 8 weeks . Dietary intake was evaluated using 24-hour recall for 3 days . Serum malondialdehyde ( MDA ) , total antioxidant capacity ( TAC ) and lipid profile , visual analog scale for pain intensity , and patient global assessment of severity of disease were assessed before and after supplementation . Only 69 patients ( 33 in the l-carnitine group and 36 in the placebo group ) completed the study . l-Carnitine supplementation result ed in significant reductions in serum MDA ( 2.46 ± 1.13 vs 2.16 ± 0.94 nmol/mL ) , total cholesterol ( 216.09 ± 34.54 vs 206.12 ± 39.74 mg/dL ) , and low-density lipoprotein cholesterol ( 129.45 ± 28.69 vs 122.05 ± 32.76 mg/dL ) levels compared with baseline ( P < .05 ) , whereas these parameters increased in the placebo group . Serum triglyceride , high-density lipoprotein cholesterol , and TAC levels did not change significantly in both groups ( P > .05 ) . No significant differences were observed in dietary intake , serum lipid profile , MDA , and TAC levels between groups after adjusting for baseline values and covariates ( P > .05 ) . There were significant intragroup and intergroup differences in pain intensity and patient global assessment of disease status after supplementation ( P < .05 ) . Collectively , l-carnitine improved clinical status without changing oxidative stress and lipid profile significantly in women with knee OA AIM Evaluation of the effect of acetyl-L-carnitine ( ALCAR ) vs. amisulpride measured by total Hamilton Depression Rating Scale score ( HAM-D(21 ) ) in patients with pure dysthymia ( DSM IV ) . Two hundred and four patients were r and omised and treated with ALCAR 500 mg b.i.d . or amisulpride 50 mg u.i.d . in a double-blind study , for 12 weeks . RESULTS A solid improvement of HAM-D(21 ) was observed in both treatment groups throughout the study . The results did not disclose statistically significant differences between treatments , although the confidence interval for the non-inferiority of the primary end-point exceeded the pre-established limit of 2 by 0.46 points . According to a non-inferiority margin of 3 ( considered acceptable by recent published data ) the primary end-point could have been fully satisfied . CDRS , MADRS and CGI , employed to further measure the clinical outcome , reported similar results in both treatment groups . The greater tolerability of ALCAR is of clinical relevance considering the chronicity of  dysthymia  , which often requires prolonged treatment 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 OBJECTIVE To investigate the effects of propionyl l-carnitine ( PLC ) on clinical and functional parameters , and markers of the overall oxidation state in patients with peripheral arterial disease ( PAD ) associated with non-insulin-dependent diabetes mellitus ( NIDDM ) . DESIGN AND SETTING R and omised , double-blind , clinical trial , conducted in the Unit of Medical Angiology of the University of Catania . PATIENTS AND INTERVENTIONS Seventy-four patients with NIDDM-associated PAD were treated with PLC ( 2 g/day ) or placebo for 12 months . MAIN OUTCOME MEASURES Ankle/brachial index ( ABI ) and the distance of pain-free walking were evaluated at baseline , 6 and 12 months . Malondialdehyde , 4-hydroxynonenal , oxidation time of low-density lipoproteins , and nitrite/nitrate ratio were measured as indices of the overall oxidation profiles at baseline and 12 months . RESULTS In the PLC group , ABI progressively increased ( 0.78 , 0.83 , and 0.88 at 0 , 6 and 12 months , respectively ) . The distance of pain-free walking also improved ( 366.4 , 441.9 and 519.8 m , respectively ) . In the placebo group , these parameters were relatively unchanged . Significant improvements in all parameters of the oxidative profile were seen in the PLC-treated group , with only minor variations observed in the placebo group . CONCLUSIONS These results suggest that adjunct therapy with PLC may be warranted in type 2 diabetes-associated PAD 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: No significant effect was seen for waist circumference ( WC ) and body fat percent .
  A non-linear dose-response association was seen between l-carnitine supplementation and body weight reduction ( P < 0.001 ) suggesting that ingestion of 2000 mg l-carnitine per day provides the maximum effect in adults .
  This association was not seen for BMI , WC and body fat percent .
  CONCLUSIONS l-carnitine supplementation provides a modest reducing effect on body weight , BMI and fat mass , especially among adults with overweight/obesity
background: BACKGROUND AND AIM Clinical evidence which investigated the effects of l-carnitine , a vitamin-like substance , on weight loss had led to inconsistent results .
  This study therefore aim ed to examine the effect of l-carnitine supplementation on body weight and composition by including the maximum number of r and omized controlled trials ( RCTs ) and to conduct a dose-response analysis , for the first time .