title: Long-chain acylcarnitine deficiency in patients with chronic fatigue syndrome. Potential involvement of altered carnitine palmitoyltransferase-I activity.
abstract: OBJECTIVE
  The underlying aetiology of chronic fatigue syndrome is currently unknown; however, in the light of carnitine's critical role in mitochondrial energy production, it has been suggested that chronic fatigue syndrome may be associated with altered carnitine homeostasis. This study was conducted to comparatively examine full endogenous carnitine profiles in patients with chronic fatigue syndrome and healthy controls.
  
  
  METHODS
  A cross-sectional, observational study.
  
  
  METHODS
  Forty-four patients with chronic fatigue syndrome and 49 age- and gender-matched healthy controls were recruited from the community and studied at the School of Pharmacy & Medical Sciences, University of South Australia.
  
  
  METHODS
  All participants completed a fatigue severity scale questionnaire and had a single fasting blood sample collected which was analysed for l-carnitine and 35 individual acylcarnitine concentrations in plasma by LC-MS/MS.
  
  
  RESULTS
  Patients with chronic fatigue syndrome exhibited significantly altered concentrations of C8:1, C12DC, C14, C16:1, C18, C18:1, C18:2 and C18:1-OH acylcarnitines; of particular note, oleyl-L-carnitine (C18:1) and linoleyl-L-carnitine (C18:2) were, on average, 30-40% lower in patients than controls (P < 0.0001). Significant correlations between acylcarnitine concentrations and clinical symptomology were also demonstrated.
  
  
  CONCLUSIONS
  It is proposed that this disturbance in carnitine homeostasis is reflective of a reduction in carnitine palmitoyltransferase-I (CPT-I) activity, possibly a result of the accumulation of omega-6 fatty acids previously observed in this patient population. It is hypothesized that the administration of omega-3 fatty acids in combination with l-carnitine would increase CPT-I activity and improve chronic fatigue syndrome symptomology.
authors.affiliation: From the School of Pharmacy & Medical Sciences, University of South Australia, Adelaide, SA, Australia. stephanie.reuter@unisa.edu.au
authors.forename: S E
authors.initials: SE
authors.lastname: Reuter
authors.forename: A M
authors.initials: AM
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D002331:Carnitine / Q000031:analogs & derivatives* / Q000097:blood / Q000172:deficiency / Q000502:physiology; D002334:Carnitine O-Palmitoyltransferase / Q000097:blood*; D004812:Epidemiologic Methods; D015673:Fatigue Syndrome, Chronic / Q000097:blood* / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: C116917:acylcarnitine; D002334:Carnitine O-Palmitoyltransferase; D002331:Carnitine