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


METHODS
In patients with NASH and control subjects, we randomly dispensed one 1-g L-carnitine tablet after breakfast plus diet and one 1 g tablet after dinner plus diet for 24 weeks or diet alone at the same dosage and regimen. We evaluated liver enzymes, lipid profile, fasting plasma glucose, C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha, 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), gamma-glutamyl-transpeptidase (gamma-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-alpha (P=0.000), and histological scores (P=0.000).


CONCLUSIONS
L-carnitine supplementation to diet is useful for reducing TNF-alpha and CRP, and for improving liver function, glucose plasma level, lipid profile, HOMA-IR, and histological manifestations of NASH.
Malaguarnera
Mariano
M
Department of Senescence, Urological and Neurological Sciences, University of Catania, Catania, Italy. malaguar@unict.it
Gargante
Maria Pia
MP
Russo
Cristina
C
Antic
Tijana
T
Vacante
Marco
M
Malaguarnera
Michele
M
Avitabile
Teresio
T
Li Volti
Giovanni
G
Galvano
Fabio
F
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002331:Carnitine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005234:Fatty Liver / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014803:Vitamin B Complex / Q000627:therapeutic use*
D015415:Biomarkers; D014803:Vitamin B Complex; D002331:Carnitine