title: L-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled study.
abstract: BACKGROUND
  The present study aimed to determine that whether L-carnitine infusion could ameliorate fasting-induced adverse effects and improve outcomes.
  
  
  METHODS
  In this 7-day, randomized, single-blind, placebo-controlled, pilot study, 15 metabolic syndrome (MetS) patients (11/4 F/M; age 46.9 ± 9.14 years; body mass index [BMI] 28.2 ± 1.8 kg/m2) were in the L-carnitine group (LC) and 15 (10/5 F/M; age 46.8 ± 10.9 years; BMI 27.1 ± 2.3 kg/m2) were in the control group (CT). All participants underwent a 5-day modified fasting therapy introduced with 2-day moderate calorie restriction. Patients in the LC group received 4 g/day of intravenous L-carnitine, while patients in the CT group were injected with saline. Blood pressure (BP), anthropometric characteristics, markers of liver function, metabolic indices (plasma glucose, lipid profiles, uric acid, free fatty acid and insulin) and hypersensitivity C-reactive protein were measured. Perceived hunger was recorded daily by self-rating visual analogue scales. Fatigue was evaluated by Wessely and Powell scores.
  
  
  RESULTS
  In contrast to the CT group, total cholesterol, alanine aminotransferase, systolic and diastolic BP did not change significantly in the LC group after prolonged fasting. There were significant differences in weight loss (LC -4.6 ± 0.9 vs. CT -3.2 ± 1.1 kg, P = 0.03), and waist circumference (LC -5.0 ± 2.2 vs. CT -1.7 ± 1.16 cm, P < 0.001), waist hip ratio (LC -0.023 ± 0.017 vs. CT 0.012 ± 0.01, P < 0.001), insulin concentration (LC -9.9 ± 3.58 vs. CT -6.32 ± 3.44 µU/mL, P = 0.046), and γ-glutamyltransferase concentration (LC -7.07 ± 6.82 vs. CT -2.07 ± 4.18, P = 0.024). Perceived hunger scores were significantly increased (P < 0.05) in the CT group during starvation, which was alleviated with L-carnitine administration in the LC group. Physical fatigue (LC -3.2 ± 3.17 vs. CT 1.8 ± 2.04, P < 0.001) and fatigue severity (LC -11.6 ± 8.38 vs. CT 8.18 ± 7.32, P < 0.001) were significantly reduced in the LC group but were aggravated in the CT group.
  
  
  CONCLUSIONS
  Intravenous L-carnitine can ameliorate fasting-induced hunger, fatigue, cholesterol abnormalities and hepatic metabolic changes and facilitate fasting-induced weight loss in MetS patients.
  
  
  BACKGROUND
  ChiCTR-TNRC-12002835.
authors.forename: Jun-jie
authors.initials: JJ
authors.lastname: Zhang
authors.forename: Zhi-bing
authors.initials: ZB
authors.lastname: Wu
authors.forename: You-jin
authors.initials: YJ
authors.lastname: Cai
authors.forename: Bin
authors.initials: B
authors.lastname: Ke
authors.forename: Ying-juan
authors.initials: YJ
authors.lastname: Huang
authors.forename: Chao-ping
authors.initials: CP
authors.lastname: Qiu
authors.forename: Yu-bing
authors.initials: YB
authors.lastname: Yang
authors.forename: Lan-ying
authors.initials: LY
authors.lastname: Shi
authors.affiliation: Department of Traditional Chinese Medicine, First Affiliated Hospital of Sun Yat-Sen University, No, 58 Zhongshan 2nd Road, Guangzhou 510080, China. himybox@yeah.net.
authors.forename: Jian
authors.initials: J
authors.lastname: Qin
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002331:Carnitine / Q000008:administration & dosage*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D015444:Exercise; D005215:Fasting / Q000009:adverse effects*; D005221:Fatigue / Q000188:drug therapy*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D006801:Humans; D006815:Hunger / Q000187:drug effects*; D007328:Insulin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism*; D008875:Middle Aged; D010865:Pilot Projects; D016037:Single-Blind Method; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D055105:Waist Circumference; D015431:Weight Loss / Q000187:drug effects; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D014527:Uric Acid; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D002331:Carnitine