Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome

Nutrition & Metabolism

Daren K. Heyland¹  Shawna Froese¹  Jennifer Korol¹  Marie-France Hétu²  Julia E. Herr²  Amer M. Johri²  Stephen A. LaHaye³  Erin D. Michos⁴  Andrew G. Day⁵  Patrick A. Norman⁵  Fraser W. Saunders⁶  J. David Spence⁷  Murray F. Matangi⁸ 

[1] Department of Critical Care Medicine, Clinical Evaluation Research Unit;Department of Medicine, Cardiovascular Imaging Network at Queen’s University;Department of Medicine, Queen’s University;Division of Cardiology, Johns Hopkins University School of Medicine;Kingston Health Sciences Centre;Southeastern Ontario Vascular Laboratory, Kingston Health Sciences Centre;Stroke Prevention and Atherosclerosis Research Centre, University of Western Ontario;The Kingston Heart Clinic;

关键词: L-carnitine;    Cardiovascular;    Carotid;    Plaque;    Ultrasound;   

DOI  :  10.1186/s12986-022-00661-9

来源: DOAJ

【 摘 要 】

Abstract Background L-carnitine (L-C), a ubiquitous nutritional supplement, has been investigated as a potential therapy for cardiovascular disease, but its effects on human atherosclerosis are unknown. Clinical studies suggest improvement of some cardiovascular risk factors, whereas others show increased plasma levels of pro-atherogenic trimethylamine N-oxide. The primary aim was to determine whether L-C therapy led to progression or regression of carotid total plaque volume (TPV) in participants with metabolic syndrome (MetS). Methods This was a phase 2, prospective, double blinded, randomized, placebo-controlled, two-center trial. MetS was defined as ≥ 3/5 cardiac risk factors: elevated waist circumference; elevated triglycerides; reduced HDL-cholesterol; elevated blood pressure; elevated glucose or HbA1c; or on treatment. Participants with a baseline TPV ≥ 50 mm3 were randomized to placebo or 2 g L-C daily for 6 months. Results The primary outcome was the percent change in TPV over 6 months. In 157 participants (L-C N = 76, placebo N = 81), no difference in TPV change between arms was found. The L-C group had a greater increase in carotid atherosclerotic stenosis of 9.3% (p = 0.02) than the placebo group. There was a greater increase in total cholesterol and LDL-C levels in the L-C arm. Conclusions Though total carotid plaque volume did not change in MetS participants taking L-C over 6-months, there was a concerning progression of carotid plaque stenosis. The potential harm of L-C in MetS and its association with pro-atherogenic metabolites raises concerns for its further use as a potential therapy and its widespread availability as a nutritional supplement. Trial registration: ClinicalTrials.gov, NCT02117661, Registered April 21, 2014, https://clinicaltrials.gov/ct2/show/NCT02117661 .

【 授权许可】

Unknown