title: Ameliorating Hypertension and Insulin Resistance in Subjects at Increased Cardiovascular Risk: Effects of Acetyl-l-Carnitine Therapy L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women. Influence of L-carnitine on the Expression Level of Adipose Tissue miRNAs Related to Weight Changes in Obese Rats. The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus. Effects of combination of sibutramine and L-carnitine compared with sibutramine monotherapy on inflammatory parameters in diabetic patients. Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients. Effects of Oral L-Carnitine Supplementation on Leptin and Adiponectin Levels and Body Weight of Hemodialysis Patients: a Randomized Clinical Trial. Safety Measures of L‐Carnitine L‐Tartrate Supplementation in Healthy Men L-carnitine supplementation and adipokines in patients with end-stage renal disease on regular hemodialysis.
abstract: Insulin resistance , a key component of the metabolic syndrome , is a risk factor for diabetes mellitus and cardiovascular disease .  Acetyl-l-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance . In this sequential off-on-off pilot study , we prospect ively evaluated the effects of 24-week oral acetyl-l-carnitine ( 1 g twice daily ) therapy on the glucose disposal rate ( GDR ) , assessed by hyperinsulinemic euglycemic clamps , and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori segregated into 2 groups with GDR ≤7.9 ( n=16 ) or > 7.9 ( n=16 ) mg/kg per minute , respectively .  Baseline GDR and systolic blood pressure were negatively correlated ( n=32 ; P=0.001 ; r=−0.545 ) , and patients with GDR ≤7.9 mg/kg per minute had higher systolic/diastolic blood pressure than those with higher GDR . Acetyl-l-carnitine increased GDR from 4.89±1.47 to 6.72±3.12 mg/kg per minute ( P=0.003 , Bonferroni-adjusted ) and improved glucose tolerance in patients with GDR ≤7.9 mg/kg per minute , whereas it had no effects in those with higher GDRs . Changes in GDR were significantly different between groups ( P=0.017 , ANCOVA ) . Systolic blood pressure decreased from 144.0±13.6 to 135.1±8.4 mm Hg and from 130.8±12.4 to 123.8±10.8 mm Hg in the lower and higher GDR groups , respectively ( P<0.05 for both ; P<0.001 overall ) and progressively recovered toward baseline over 8 weeks posttreatment . Total and high molecular weight adiponectin levels followed specular trends . Diastolic blood pressure significantly decreased only in those with higher GDRs . Treatment was well tolerated in all of the patients . Acetyl-l-carnitine safely ameliorated arterial hypertension , insulin resistance , impaired glucose tolerance , and hypoadiponectinemia in subjects at increased cardiovascular risk . Whether these effects may translate into long-term cardioprotection is worth investigating 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 BACKGROUND AND OBJECTIVE Molecular mechanisms of most anti-obesity drugs are remained to be clear . MicroRNAs that are noncoding RNA molecules supposed to regulate biological processes concomitant to obesity and have attracted a lot of attention to themselves . The miR-27a and miR-143 expression levels in obese and non-obese rats during weight changes and L-carnitine ( LC ) effects on them was investigated in this study . MATERIAL S AND METHODS In the present study 12 male Wistar rats were r and omly divided into  normal fat diet and high fat diet groups to develop obesity . After 8 weeks rats were weighted and half of diet induced obese rats were r and omly selected to receive 200 mg LC kg -1 b.wt . for 4 weeks . At the end epididymal fat was isolated to investigate expression level of microRNAs by real-time PCR . RESULTS After 12 weeks , high fat diet in comparison with normal fat diet mediated significant decrease and increase in expression levels of miR-27a and miR-143 , respectively . These changes were modified in groups , which had received LC in a 4 weeks period . Furthermore , rats in this group gained less weight . CONCLUSION Findings of this study suggest that the changes of microRNAs expression probably play a role in pathogenesis of obesity , might be modulated by means of dietary agents and supplements and modify weight gain trend 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 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 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 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 The purpose of this investigation was to examine the effects of ingestion of L-CARNIPURE ( L-carnitine L-tartrate [ LCLT ] ) on alterations in a complete blood cell profile and in circulating metabolic enzymes . Using a balanced , placebo ( P ) , cross-over design ( 1 week washout ) , 10 healthy , active men volunteered and acted as their own control taking either a  P or LCLT supplement ( 3 gday−1 ) for 3 weeks  . Postabsorptive morning blood sample s were obtained both before and after 21 days of P and LCLT supplementation . Serum sample s were analyzed for clinical chemistries including a complete chemistry panel with markers of liver and renal function along with various minerals and electrolytes . In addition , whole blood was analyzed for a complete blood count with differential . It was determined that there were no statistically significant differences between the LCLT and the placebo conditions for any of the variables examined . The results of this study suggest that LCLT , when used as a dietary supplement , has no adverse effects on metabolic and hemato-logical safety variables in normally healthy en Chronic hemodialysis ( HD ) patients frequently encounter carnitine depletion , elevated adipose tissue-derived hormones/cytokines , that may contribute to accelerated arteriosclerosis . 10 non-diabetic HD patients were studied over 28 weeks . In the 12 weeks treatment period 1 g L-carnitine was given iv after each HD session . Measurements of plasma free- and acylcarnitines , insulin , leptin , adiponectin , resistin and ghrelin were performed at baseline , at weeks 2 , 4 , 8 , 12 ( treatment period ) and at weeks 24 - 28 ( post-treatment period ) . L-carnitine supplementation result ed in progressive increase of free- and acylcarnitine levels . Plasma levels of insulin , resistin , leptin and ghrelin remained at the already elevated baseline values . L-carnitine therapy induced a significant increase in plasma adiponectin from 20.2 ± 12.7 μg/ml ( baseline ) to 32.7 ± 20.2 μg/ml in week 2 ( p<0.05 ) and 35.4 ± 19.6 μg/ml in week 12 ( p < 0.03 ) , which remained unchanged in the post-carnitine period . Plasma insulin levels correlated positively with leptin ( r = 0.525 , p<0.0001 ) and resistin ( r = 0.284 , p<0.005 ) ; adiponectin levels correlated inversely with leptin ( r = -0.255 , p<0.02 ) and resistin ( r = -0.213 , p<0.04 ) irrespective of carnitine status . Plasma levels of adipokines and related hormones are greatly elevated in patients on regular HD  . L-carnitine administration further augmented the plasma levels of protective adiponectin , therefore it may have a role in preventing cardiovascular complications of uremia
target: Conclusion l-carnitine consumption does not reduce serum leptin significantly .
  However , a significant effect on leptin was observed in diabetic patients and patients who received doses more than 3 mg per day in the course of < 12 weeks
background: Purpose The actual effects of l-carnitine administration on leptin serum level is inconsistent .
  In order to assess the efficacy of l-carnitine supplementation on serum leptin we conducted a meta- analysis of r and omized controlled trials ( RCTs ) .