title: Free carnitine and acylcarnitines in obese patients with polycystic ovary syndrome and effects of pioglitazone treatment.
abstract: OBJECTIVE
  To determine fasting and insulin-stimulated levels of carnitine precursors, total and free carnitine, and acylcarnitines, and evaluate the impact of pioglitazone treatment in obese patients with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  The present study is a secondary analysis of a previously published case-control study, followed by a double-blind randomized clinical trial.
  
  
  METHODS
  Academic tertiary care medical center.
  
  
  METHODS
  Thirty obese premenopausal patients with PCOS and 14 healthy women.
  
  
  METHODS
  Sixteen weeks of blinded treatment with pioglitazone (30 mg/d) or placebo.
  
  
  METHODS
  Total and free carnitine and acylcarnitines.
  
  
  RESULTS
  Contrary to controls, patients with PCOS were characterized with slightly lower levels of fasting total and free carnitine, its precursors, and derivatives. Total and free carnitine correlated inversely to sex hormone-binding globulin (SHBG) in patients with PCOS, whereas no associations were found between acylcarnitines and androgenes. Insulin stimulation-induced changes in the levels of total and free carnitine, carnitine precursors, and acylcarnitines in the PCOS group followed the same trends as in the control group. Pioglitazone treatment significantly increased fasting levels of serum-free carnitine, propionyl carnitine, and total carnitine. The analysis of between group differences revealed significant changes in the isovaleryl carnitine levels and lipid oxidation rates after pioglitazone treatment compared with placebo.
  
  
  CONCLUSIONS
  Acute insulin stimulation was associated with increased serum levels of free carnitine in both patients and healthy controls. Treatment with pioglitazone is able to redistribute free fatty acids from insulin-sensitive tissues, diminish demand for carnitine, and influence the overall carnitine turnover.
  
  
  BACKGROUND
  NCT00145340.
authors.affiliation: Institute of Medicine, University of Bergen, Bergen, Norway. Natalya.Vigerust@med.uib.no
authors.forename: Natalya Filipchuk
authors.initials: NF
authors.lastname: Vigerust
authors.forename: Pavol
authors.initials: P
authors.lastname: Bohov
authors.forename: Bodil
authors.initials: B
authors.lastname: Bjørndal
authors.forename: Reinhard
authors.initials: R
authors.lastname: Seifert
authors.forename: Ottar
authors.initials: O
authors.lastname: Nygård
authors.forename: Asbjørn
authors.initials: A
authors.lastname: Svardal
authors.forename: Dorte
authors.initials: D
authors.lastname: Glintborg
authors.forename: Rolf Kristian
authors.initials: RK
authors.lastname: Berge
authors.forename: Michael
authors.initials: M
authors.lastname: Gaster
mesh_terms: D000328:Adult; D002331:Carnitine / Q000031:analogs & derivatives* / Q000097:blood*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D009765:Obesity / Q000097:blood* / Q000188:drug therapy*; D000077205:Pioglitazone; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000188:drug therapy*; D016037:Single-Blind Method; D045162:Thiazolidinediones / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; C116917:acylcarnitine; D002331:Carnitine; D000077205:Pioglitazone