L-carnitine supplementation and adipokines in patients with end-stage renal disease on regular hemodialysis.
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 resulted 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.
Csiky
B
B
FMC Dialysis Center Pécs, Faculty of Medicine, University of Pécs, Pécs, Hungary. botond.csiky@gmail.com
Nyul
Z
Z
Tóth
G
G
Wittmann
I
I
Melegh
B
B
Rauh
M
M
Rascher
W
W
Sulyok
E
E
D054392:Adipokines / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000517:prevention & control; D002331:Carnitine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors
D054392:Adipokines; D007328:Insulin; C116917:acylcarnitine; D002331:Carnitine