PMID 32359762 Effects of l-carnitine supplementation on weight loss and body composition: A systematic review and meta-analysis of 37 randomized controlled clinical trials with dose-response analysis 메타분석 · Clin Nutr ESPEN, 2020 무작위 시험 37건 2,292명 - 체중 -1.21 kg, 허리둘레·체지방률은 유의한 차이 없음, 하루 2,000 mg에서 최대.
핵심요약
L-카르니틴 보충이 체중과 체성분에 미치는 영향을 가능한 많은 무작위 시험을 모아 분석하고 처음으로 용량 반응까지 본 메타분석여러 개별 연구의 결과를 통계적으로 합쳐 하나의 종합 결론을 내는 분석.. 2019년 1월까지 검색해 시험 37건(2,292명)을 포함했다. 체중 -1.21 kg(95% CI -1.73~-0.68), BMI -0.24 kg/m2(95% CI -0.37~-0.10), 지방량 -2.08 kg(95% CI -3.44~-0.72)이었고 허리둘레와 체지방률은 유의한 차이가 없었다. 질 높은 시험만 분석하면 체중 효과만 확인됐다. 체중 감소에는 비선형 용량 반응 관계가 있었고 하루 2,000 mg에서 최대였다. 저자들은 특히 과체중·비만 성인에서 완만한 감소 효과라고 결론지었고 이해상충이 없다고 밝혔다.
원문 초록 보기
BACKGROUND AND AIM: Clinical evidence which investigated the effects of l-carnitine, a vitamin-like substance, on weight loss had led to inconsistent results. This study therefore aimed to examine the effect of l-carnitine supplementation on body weight and composition by including the maximum number of randomized controlled trials (RCTs) and to conduct a dose-response analysis, for the first time. METHODS AND RESULTS: Online databases were searched up to January 2019. In total, 37 RCTs (with 2292 participants) were eligible. Meta-analysis showed that l-carnitine supplementation significantly decreased body weight [Weighted mean difference (WMD) = -1.21 kg, 95% confidence interval (CI): -1.73, -0.68; P < 0.001], body mass index (BMI) (WMD = -0.24 kg/m2, 95% CI: -0.37, -0.10; P = 0.001), and fat mass (WMD = -2.08 kg, 95% CI: -3.44, -0.72; P = 0.003). No significant effect was seen for waist circumference (WC) and body fat percent. The meta-analysis of high-quality RCTs only confirmed the effect on body weight. A non-linear dose-response association was seen between l-carnitine supplementation and body weight reduction (P < 0.001) suggesting that ingestion of 2000 mg l-carnitine per day provides the maximum effect in adults. This association was not seen for BMI, WC and body fat percent. CONCLUSIONS: l-carnitine supplementation provides a modest reducing effect on body weight, BMI and fat mass, especially among adults with overweight/obesity. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 27335245 The effect of (L-)carnitine on weight loss in adults: a systematic review and meta-analysis of randomized controlled trials 메타분석 · Obes Rev, 2016 시험 9건 911명 - 체중 -1.33 kg, 복용 기간이 길수록 감소 폭이 줄어듦(p=0.002).
핵심요약
성인 체중 감소에 대한 카르니틴 무작위 시험의 체계적 문헌고찰·메타분석여러 개별 연구의 결과를 통계적으로 합쳐 하나의 종합 결론을 내는 분석.. PubMed·Embase·Cochrane 등을 검색해 방법론이 적절한 시험 9건(911명)을 포함했다. 카르니틴 군이 체중 -1.33 kg(95% CI -2.09~-0.57), BMI -0.47 kg/m2(95% CI -0.88~-0.05) 더 줄었다. 복용 기간에 대한 메타회귀에서 감소 폭은 시간이 갈수록 유의하게 줄었다(p=0.002).
원문 초록 보기
This study provides a systematic review and meta-analysis of randomized controlled trials, which have examined the effect of the carnitine on adult weight loss. Relevant studies were identified by systematic search of PubMed, Embase, Cochrane Central Register of Controlled Trials and reference lists of relevant marker studies. Nine studies (total n = 911) of adequate methodological quality were included in the review. Trials with mean difference (MD) of 95% confidence interval (CI) were pooled using random effect model. Results from meta-analysis of eligible trials revealed that subjects who received carnitine lost significantly more weight (MD: -1.33 kg; 95% CI: -2.09 to -0.57) and showed a decrease in body mass index (MD: -0.47 kg m(-2) ; 95% CI: -0.88 to -0.05) compared with the control group. The results of meta-regression analysis of duration of consumption revealed that the magnitude of weight loss resulted by carnitine supplementation significantly decreased over time (p = 0.002). We conclude that receiving the carnitine resulted in weight loss. Using multiple-treatments meta-analysis of the drugs and non-pharmacotherapy options seem to be insightful areas for research. © 2016 World Obesity. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 11880112 Long-term administration of L-carnitine to humans: effect on skeletal muscle carnitine content and physical performance 임상시험 · Clin Chim Acta, 2002 건강한 남성 8명, 2 g씩 하루 두 번 3개월 - 근육 카르니틴·미토콘드리아·운동 능력 모두 유의한 변화 없음.
핵심요약
건강한 성인 남성 8명에게 L-카르니틴 2 g을 하루 두 번, 3개월 투여하고 복용 전, 직후, 중단 2개월 뒤에 근육 생검과 운동 검사를 한 시험. 초록에 위약유효 성분이 없는 가짜 약(플라시보). 효과 비교의 기준으로 쓴다.군 언급은 없다. 근육 총카르니틴은 4.10에서 4.79, 중단 뒤 4.19 µmol/g으로 유의한 차이가 없었고, 최대 산소섭취량과 최대 출력, 미토콘드리아 효소 활성, 근섬유 구성도 변하지 않았다. 저자들은 건강한 성인의 장기 경구 복용이 근육 카르니틴, 미토콘드리아 증식, 신체 수행의 유의한 증가와 관련이 없다고 결론지었다.
원문 초록 보기
BACKGROUND: Long-term administration of high oral doses of L-carnitine on the skeletal muscle composition and the physical performance has not been studied in humans. METHODS: Eight healthy male adults were treated with 2 x 2 g of L-carnitine per day for 3 months. Muscle biopsies and exercise tests were performed before, immediately after, and 2 months after the treatment. Exercise tests were performed using a bicycle ergometer for 10 min at 20%, 40%, and 60% of the individual maximal workload (P(max)), respectively, until exhaustion. RESULTS: There were no significant differences between V(O(2)max), RER(max), and P(max) between the three time points investigated. At submaximal intensities, the only difference to the pretreatment values was a 5% increase in V(O(2)) at 20% and 40% of P(max) 2 months after the cessation of the treatment. The total carnitine content in the skeletal muscle was 4.10 +/- 0.82 micromol/g before, 4.79 +/- 1.19 micromol/g immediately after, and 4.19 +/- 0.61 micromol/g wet weight 2 months after the treatment (no significant difference). Activities of the two mitochondrial enzymes citrate synthase and cytochrome oxidase, as well as the skeletal muscle fiber composition also remained unaffected by the administration of L-carnitine. CONCLUSIONS: Long-term oral treatment of healthy adults with L-carnitine is not associated with a significant increase in the muscle carnitine content, mitochondrial proliferation, or physical performance. Beneficial effects of the long-term treatment with L-carnitine on the physical performance of healthy adults cannot be explained by an increase in the carnitine muscle stores. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 7808246 Carnitine supplementation: effect on muscle carnitine and glycogen content during exercise 무작위 시험 · Med Sci Sports Exerc, 1994 하루 6 g을 7일·14일 - 혈중 카르니틴만 오르고 근육 함량과 운동 중 지방 산화량은 변화 없음.
핵심요약
카르니틴 보충이 최대산소섭취량 70% 강도 자전거 운동 중 근육 카르니틴과 글리코겐에 미치는 영향을 본 시험. 하루 6 g을 7일과 14일 먹인 뒤 근육 생검과 호흡 측정을 했다. 안정 시 혈청 카르니틴은 올랐지만 근육 카르니틴 농도는 그대로였고, 호흡교환율과 탄수화물·지방 산화량, 글리코겐에도 차이가 없었다. 저자들은 혈청 카르니틴이 늘어도 근육 함량이 늘거나 지질 산화가 바뀌지 않으며, 미토콘드리아 안에 지질 산화를 뒷받침할 카르니틴이 이미 충분해 보인다고 해석했다.
원문 초록 보기
This study investigated the effects of L-carnitine supplementation on muscle carnitine and glycogen content during submaximal exercise (EX). Triglycerides were evaluated by a fat feeding (90 g fat) and 3 h later subjects cycled for 60 min at 70% VO2max (CON). Muscle biopsies were obtained preexercise and after 30 and 60 min of EX. Blood samples were taken prior to and every 15 min of exercise. Subjects randomly completed two additional trials following 7 and 14 d of carnitine supplementation (6 g.d-1). During one of the two trials, subjects received 2000 units of heparin 15 min prior to EX to elevate FFA (CNhep); no heparin was administered during the other trial (CN). There were no differences in VO2, respiratory exchange ratio, heart rate, or g.min-1 of CHO and fat oxidized among the three trials. At rest serum total acid soluble (TASC) and free (FC) carnitine increased with supplementation (TASC; CON, 71.3 +/- 2.9; CN, 92.8 +/- 5.4; CNhep, 109.8 +/- 3.5 mumol.l-1) (FC; CON, 44.1 +/- 2.7; CN, 66.1 +/- 5.3; CNhep, 77.1 +/- 4.1 mumol.l-1). During EX, TASC remained stable, while FC decreased and short-chain acylcarnitine (SCAC) increased (P < 0.05). Muscle carnitine concentration at rest was unaffected by supplementation. During EX, muscle TASC did not change, FC decreased, and SCAC increased significantly in all three trials. Pre-EX and post-EX muscle glycogens were not different. Increased availability of serum carnitine does not result in an increase in muscle carnitine content nor does it alter lipid oxidation. It appears that there is an adequate amount of carnitine present within the mitochondria to support lipid oxidation. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 21224234 Chronic oral ingestion of L-carnitine and carbohydrate increases muscle carnitine content and alters muscle fuel metabolism during exercise in humans 무작위 대조시험 · J Physiol, 2011 남성 14명, L-카르니틴 타르트레이트 2 g + 탄수화물 80 g 하루 두 번 24주 - 근육 총카르니틴 21% 상승, 작업량 11% 증가.
핵심요약
인슐린을 올리기 위해 탄수화물을 함께 먹으면 근육 카르니틴이 늘어나는지 본 무작위 이중맹검 시험. 건강한 남성 14명이 탄수화물 80 g 단독 또는 L-카르니틴 타르트레이트 2 g과 탄수화물 80 g을 하루 두 번, 24주 먹었다. 카르니틴 군의 근육 총카르니틴은 21% 올랐고 대조군은 그대로였다. 50% 강도 운동에서 근육 글리코겐을 대조군보다 55% 덜 썼고, 80% 강도에서는 근육 젖산이 44% 낮았다. 수행 시험의 작업량은 기저치보다 11% 늘었고 대조군은 변화가 없었다. 저자들은 식이로 사람 근육의 총카르니틴을 늘릴 수 있음을 처음 보였다고 적었다.
원문 초록 보기
We have previously shown that insulin increases muscle total carnitine (TC) content during acute i.v. l-carnitine infusion. Here we determined the effects of chronic l-carnitine and carbohydrate (CHO; to elevate serum insulin) ingestion on muscle TC content and exercise metabolism and performance in humans. On three visits, each separated by 12 weeks, 14 healthy male volunteers (age 25.9 ± 2.1 years, BMI 23.0 ± 0.8 kg m−2) performed an exercise test comprising 30 min cycling at 50% , 30 min at 80% , then a 30 min work output performance trial. Muscle biopsies were obtained at rest and after exercise at 50% and 80% on each occasion. Following visit one, volunteers ingested either 80 g of CHO (Control) or 2 g of l-carnitine-l-tartrate and 80 g of CHO (Carnitine) twice daily for 24 weeks in a randomised, double blind manner. All significant effects reported occurred after 24 weeks. Muscle TC increased from basal by 21% in Carnitine (P < 0.05), and was unchanged in Control. At 50% , the Carnitine group utilised 55% less muscle glycogen compared to Control (P < 0.05) and 31% less pyruvate dehydrogenase complex (PDC) activation compared to before supplementation (P < 0.05). Conversely, at 80% , muscle PDC activation was 38% higher (P < 0.05), acetylcarnitine content showed a trend to be 16% greater (P < 0.10), muscle lactate content was 44% lower (P < 0.05) and the muscle PCr/ATP ratio was better maintained (P < 0.05) in Carnitine compared to Control. The Carnitine group increased work output 11% from baseline in the performance trial, while Control showed no change. This is the first demonstration that human muscle TC can be increased by dietary means and results in muscle glycogen sparing during low intensity exercise (consistent with an increase in lipid utilisation) and a better matching of glycolytic, PDC and mitochondrial flux during high intensity exercise, thereby reducing muscle anaerobic ATP production. Furthermore, these changes were associated with an improvement in exercise performance. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 34959912 Effect of Acute and Chronic Oral l-Carnitine Supplementation on Exercise Performance Based on the Exercise Intensity: A Systematic Review 체계적 문헌고찰 · Nutrients, 2021 시험 11건 - 고강도 운동은 향상 보고, 중강도 운동은 유의한 향상 없음. 메타분석여러 개별 연구의 결과를 통계적으로 합쳐 하나의 종합 결론을 내는 분석.은 하지 않음.
핵심요약
경구 L-카르니틴의 급성·만성 복용이 운동 강도별 수행에 미치는 영향을 정리한 체계적 문헌고찰. 220편 중 11편을 포함했고, 만성 복용은 4~24주 하루 1~3 g, 급성 복용은 3~4 g이었다. 고강도 수행은 시험 9건에서, 중강도 수행은 시험 6건에서 평가했다. 저자들은 시험 60~90분 전 3~4 g 또는 하루 2~2.72 g을 9~24주 먹으면 고강도 수행이 향상됐고, 중강도 수행은 나아지지 않았다고 요약했다. 저자들은 연구비를 받지 않았고 이해상충이 없다고 밝혔다.
원문 초록 보기
l-Carnitine (l-C) and any of its forms (glycine-propionyl l-Carnitine (GPL-C) or l-Carnitine l-tartrate (l-CLT)) has been frequently recommended as a supplement to improve sports performance due to, among others, its role in fat metabolism and in maintaining the mitochondrial acetyl-CoA/CoA ratio. The main aim of the present systematic review was to determine the effects of oral l-C supplementation on moderate- (50-79% V˙O2 max) and high-intensity (≥80% V˙O2 max) exercise performance and to show the effective doses and ideal timing of its intake. A structured search was performed according to the PRISMA® statement and the PICOS guidelines in the Web of Science (WOS) and Scopus databases, including selected data obtained up to 24 October 2021. The search included studies where l-C or glycine-propionyl l-Carnitine (GPL-C) supplementation was compared with a placebo in an identical situation and tested its effects on high and/or low-moderate performance. The trials that used the supplementation of l-C together with additional supplements were eliminated. There were no applied filters on physical fitness level, race, or age of the participants. The methodological quality of studies was evaluated by the McMaster Critical Review Form. Of the 220 articles obtained, 11 were finally included in this systematic review. Six studies used l-C, while three studies used l-CLT, and two others combined the molecule propionyl l-Carnitine (PL-C) with GPL-C. Five studies analyzed chronic supplementation (4-24 weeks) and six studies used an acute administration (<7 days). The administration doses in this chronic supplementation varied from 1 to 3 g/day; in acute supplementation, oral l-C supplementation doses ranged from 3 to 4 g. On the one hand, the effects of oral l-C supplementation on high-intensity exercise performance variables were analyzed in nine studies. Four of them measured the effects of chronic supplementation (lower rating of perceived exertion (RPE) after 30 min at 80% V˙O2 max on cycle ergometer and higher work capacity in "all-out" tests, peak power in a Wingate test, and the number of repetitions and volume lifted in leg press exercises), and five studies analyzed the effects of acute supplementation (lower RPE after graded exercise test on the treadmill until exhaustion and higher peak and average power in the Wingate cycle ergometer test). On the other hand, the effects of l-C supplementation on moderate exercise performance variables were observed in six studies. Out of those, three measured the effect of an acute supplementation, and three described the effect of a chronic supplementation, but no significant improvements on performance were found. In summary, l-C supplementation with 3 to 4 g ingested between 60 and 90 min before testing or 2 to 2.72 g/day for 9 to 24 weeks improved high-intensity exercise performance. However, chronic or acute l-C or GPL-C supplementation did not present improvements on moderate exercise performance. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 32958033 The bright and the dark sides of L-carnitine supplementation: a systematic review 체계적 문헌고찰 · J Int Soc Sports Nutr, 2020 건강인 12주 이상 연구 11건 - 탄수화물 병용 시 근육 카르니틴 상승, 수행 효과는 조건부, 공복 TMAO 상승.
핵심요약
건강인에게 12주 이상 경구 L-카르니틴만 투여한 연구를 모은 체계적 문헌고찰. 1,024편 중 11편을 포함했고 용량은 하루 1~4 g, 기간은 12주 또는 24주였다. 탄수화물과 함께 먹으면 골격근 총카르니틴이 효과적으로 올랐다. 24주 복용은 건강한 고령 여성의 근력에 영향이 없었지만 100세 이상 노인의 근육량, 신체 활동 내성, 인지 기능은 유의하게 나아졌다. 공복 혈장 TMAO도 올랐으나 측정한 염증·산화 스트레스 표지자 변화와는 관련이 없었다. 저자들은 심혈관계에 대한 장기 추적 연구가 필요하다고 결론지었고 이해상충이 없다고 밝혔다.
원문 초록 보기
BACKGROUND: L-carnitine (LC) is used as a supplement by recreationally-active, competitive and highly trained athletes. This systematic review aims to evaluate the effect of prolonged LC supplementation on metabolism and metabolic modifications. METHODS: A literature search was conducted in the MEDLINE (via PubMed) and Web of Science databases from the inception up February 2020. Eligibility criteria included studies on healthy human subjects, treated for at least 12 weeks with LC administered orally, with no drugs or any other multi-ingredient supplements co-ingestion. RESULTS: The initial search retrieved 1024 articles, and a total of 11 studies were finally included after applying inclusion and exclusion criteria. All the selected studies were conducted with healthy human subjects, with supplemented dose ranging from 1 g to 4 g per day for either 12 or 24 weeks. LC supplementation, in combination with carbohydrates (CHO) effectively elevated total carnitine content in skeletal muscle. Twenty-four-weeks of LC supplementation did not affect muscle strength in healthy aged women, but significantly increased muscle mass, improved physical effort tolerance and cognitive function in centenarians. LC supplementation was also noted to induce an increase of fasting plasma trimethylamine-N-oxide (TMAO) levels, which was not associated with modification of determined inflammatory nor oxidative stress markers. CONCLUSION: Prolonged LC supplementation in specific conditions may affect physical performance. On the other hand, LC supplementation elevates fasting plasma TMAO, compound supposed to be pro-atherogenic. Therefore, additional studies focusing on long-term supplementation and its longitudinal effect on the cardiovascular system are needed. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트와 아래 전문 인용을 근거로 작성합니다.
전문에서 확인한 내용 보기
연구비는 폴란드 국립과학센터가 냈습니다(업계 자금 아님).
"Funding This work was supported by National Science Centre in Poland, grant number 2014/15/B/NZ7/00893."
저자들은 이해상충이 없다고 선언했습니다.
"Competing interests The authors declare that they have no competing interests."
※ PMC 공개 전문과 기계로 대조한 인용문 (CC BY 4.0, 2026-11-07) 원문 보기 ↗ PMID 22989098 Systemic primary carnitine deficiency: an overview of clinical manifestations, diagnosis, and management 전문가 리뷰 · Orphanet J Rare Dis, 2012 일차성 결핍 개요 - 경구 50~400 mg/kg/일 세 번 분할, 복용을 유지하는 한 장기 예후 양호.
핵심요약
전신성 일차성 카르니틴 결핍의 임상 양상, 진단, 관리를 정리한 리뷰. 영아기에는 저케톤성 저혈당과 간비대, 소아기에는 근병증과 심근병증, 성인기에는 심근병증, 부정맥, 피로로 나타난다. 진단은 혈장 유리 카르니틴 저하(<5 μM, 정상 25~50 μM), 섬유아세포 운반 저하, SLC22A5 유전자 검사로 확정한다. 미국 빈도는 신생아 선별 자료로 약 5만 명 중 1명이다. 기본 처방은 경구 레보카르니틴 50~400 mg/kg/일을 세 번에 나눠 먹는 것이고, 복용을 유지하는 한 장기 예후가 좋다. 저자들은 이해상충이 없다고 밝혔다.
원문 초록 보기
Systemic primary carnitine deficiency (CDSP) is an autosomal recessive disorder of carnitine transportation. The clinical manifestations of CDSP can vary widely with respect to age of onset, organ involvement, and severity of symptoms, but are typically characterized by episodes of hypoketotic hypoglycemia, hepatomegaly, elevated transaminases, and hyperammonemia in infants; skeletal myopathy, elevated creatine kinase (CK), and cardiomyopathy in childhood; or cardiomyopathy, arrhythmias, or fatigability in adulthood. The diagnosis can be suspected on newborn screening, but is established by demonstration of low plasma free carnitine concentration (<5 μM, normal 25-50 μM), reduced fibroblast carnitine transport (<10% of controls), and molecular testing of the SLC22A5 gene. The incidence of CDSP varies depending on ethnicity; however the frequency in the United States is estimated to be approximately 1 in 50,000 individuals based on newborn screening data. CDSP is caused by recessive mutations in the SLC22A5 gene. This gene encodes organic cation transporter type 2 (OCTN2) which transport carnitine across cell membranes. Over 100 mutations have been reported in this gene with the c.136C > T (p.P46S) mutation being the most frequent mutation identified. CDSP should be differentiated from secondary causes of carnitine deficiency such as various organic acidemias and fatty acid oxidation defects. CDSP is an autosomal recessive condition; therefore the recurrence risk in each pregnancy is 25%. Carrier screening for at-risk individuals and family members should be obtained by performing targeted mutation analysis of the SLC22A5 gene since plasma carnitine analysis is not a sufficient methodology for determining carrier status. Antenatal diagnosis for pregnancies at increased risk of CDSP is possible by molecular genetic testing of extracted DNA from chorionic villus sampling or amniocentesis if both mutations in SLC22A5 gene are known. Once the diagnosis of CDSP is established in an individual, an echocardiogram, electrocardiogram, CK concentration, liver transaminanses measurement, and pre-prandial blood sugar levels, should be performed for baseline assessment. Primary treatment involves supplementation of oral levocarnitine (L-carnitine) at a dose of 50-400 mg/kg/day divided into three doses. No formal surveillance guidelines for individuals with CDSP have been established to date, however the following screening recommendations are suggested: annual echocardiogram and electrocardiogram, frequent plasma carnitine levels, and CK and liver transaminases measurement can be considered during acute illness. Adult women with CDSP who are planning to or are pregnant should meet with a metabolic or genetic specialist ideally before conception to discuss management of carnitine levels during pregnancy since carnitine levels are typically lower during pregnancy. The prognosis for individuals with CDSP depends on the age, presentation, and severity of symptoms at the time of diagnosis; however the long-term prognosis is favorable as long as individuals remain on carnitine supplementation. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 31373028 Increased risk of sudden death in untreated primary carnitine deficiency 관찰연구 · J Inherit Metab Dis, 2020 페로 제도 45세 미만 돌연사 53건 중 6건이 미복용 일차성 결핍 - 오즈비 54.3.
핵심요약
일차성 카르니틴 결핍 유병률이 1:300으로 높은 페로 제도에서, 1979~2012년 45세 미만 법의학적 돌연사 전례를 조사했다. 65건 중 53건의 보관 검체를 유전자 분석한 결과 6건이 c.95A>G 변이 동형접합이었다(11.3%, 95% CI 5~23%). 배경 인구 유병률 0.23%와 비교한 오즈비는 54.3(95% CI 21~138)이었고, 여성 11건 중에서는 5건이 동형접합으로 오즈비 348.8이었다. 배경 인구와 비교한 연관성이며, 복용 효과를 무작위로 비교한 연구는 아니다.
원문 초록 보기
Primary carnitine deficiency (PCD) affects fatty acid oxidation and is associated with cardiomyopathy and cardiac arrhythmia, but the risk of sudden death in PCD is unknown. The Faroe Islands have a high prevalence of PCD, 1:300. This study systematically investigated a possible association between untreated PCD and sudden death in young Faroese subjects. We investigated all medico-legal cases of sudden death between 1979 and 2012 among subjects below the age of 45. Stored biomaterial was examined with molecular genetic analysis to reveal PCD. We compared the prevalence of PCD among sudden death cases with that of the background population (0.23%) to calculate the odds ratio (OR) for sudden death with PCD. Biomaterial was available and genetically analyzed from 53 of 65 sudden death cases (82%) in the Faroe Islands. Six (one male and five females) of the 53 cases were homozygous for the PCD related c.95A>G mutation-a prevalence of 11.3% (95% CI 5%-23%) and an OR of 54.3 (95% CI 21-138, P < .0001) for the association between sudden death and untreated PCD. Only 11 of the 53 sudden death cases were women-of whom five were homozygous for the c.95A>G mutation (45.5%) yielding an OR of 348.8 (95% CI 94-1287, P < .0001) for the association between sudden death and untreated PCD in females. This study showed a strong association between sudden death and untreated PCD, especially in females. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 30219858 L-Carnitine Improves Skeletal Muscle Fat Oxidation in Primary Carnitine Deficiency 임상시험 · J Clin Endocrinol Metab, 2018 일차성 결핍 성인 8명, 나흘 복용 중단 - 운동 중 지방산 산화율 12.3에서 8.5 µmol/kg/min으로 감소(P=0.008).
핵심요약
c.95A>G 동형접합 일차성 결핍 성인 8명과 건강 대조군 10명을 비교하고, 환자는 나흘 복용 중단 전후로 1시간 자전거 운동 중 에너지 대사를 동위원소로 측정했다. 지방산 산화율은 복용 중 12.3, 중단 시 8.5 µmol/kg/min이었고(P=0.008), 건강 대조군 29.5보다 복용 중에도 낮았다(P<0.001). 저자들은 복용이 심장 합병증을 막을 뿐 아니라 운동 중 골격근 지방 대사도 끌어올릴 수 있다고 봤다. 결핍 환자의 결과이므로 건강인의 지방 산화 근거로 쓸 수 없다.
원문 초록 보기
CONTEXT: Primary carnitine deficiency (PCD) is an inborn error of fatty acid metabolism. Patients with PCD are risk for sudden heart failure upon fasting or illness if they are not treated with daily l-carnitine. OBJECTIVE: To investigate energy metabolism during exercise in patients with PCD with and without l-carnitine treatment. DESIGN: Interventional study. SETTING: Hospital exercise laboratories and department of cardiology. PARTICIPANTS: Eight adults with PCD who were homozygous for the c.95A>G (p.N32S) mutation and 10 healthy age- and sex-matched controls. INTERVENTION: Four-day pause in l-carnitine treatment. MAIN OUTCOME MEASURES: Total fatty acid and palmitate oxidation rates during 1-hour submaximal cycle ergometer exercise assessed with stable isotope method (U13C-palmitate and 2H2-d-glucose) and indirect calorimetry with and without l-carnitine. RESULTS: Total fatty acid oxidation rate was higher in patients with l-carnitine treatment during exercise than without treatment [12.3 (SD, 3.7) vs 8.5 (SD, 4.6) µmol × kg-1 × min-1; P = 0.008]. However, the fatty acid oxidation rate was still lower in patients treated with l-carnitine than in the healthy controls [29.5 (SD, 10.1) µmol × kg-1 × min-1; P < 0.001] and in the l-carnitine group without treatment it was less than one third of that in the healthy controls (P < 0.001). In line with this, the palmitate oxidation rates during exercise were lower in the no-treatment period [144 (SD, 66) µmol × kg-1 × min-1] than during treatment [204 (SD, 84) µmol × kg-1 × min-1; P = 0.004) . CONCLUSIONS: The results indicate that patients with PCD have limited fat oxidation during exercise. l-Carnitine treatment in asymptomatic patients with PCD may not only prevent cardiac complications but also boost skeletal muscle fat metabolism during exercise. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 33713287 Effect of L-carnitine supplementation on renal anemia in patients on hemodialysis: a meta-analysis 메타분석 · Int Urol Nephrol, 2021 투석 환자 시험 18건 1,090명 - ESA 필요량 감소, 헤모글로빈·적혈구용적률은 차이 없음, 장기 결과는 불분명.
핵심요약
혈액투석 환자의 신성 빈혈에 대한 L-카르니틴 무작위 시험의 메타분석여러 개별 연구의 결과를 통계적으로 합쳐 하나의 종합 결론을 내는 분석.. 시험 18건(1,090명)을 포함했다. 혈장 유리 카르니틴(평균차 140.53, 95% CI 102.22~178.85)이 오르고, 적혈구조혈자극제 반응 지수(-2.72, 95% CI -3.20~-2.24)와 필요 용량(-1.70, 95% CI -2.04~-1.36)이 줄었다. 헤모글로빈(0.18, 95% CI -0.20~0.55)과 적혈구용적률(1.07, 95% CI -0.73~2.87)은 유의한 차이가 없었다. 저자들은 보충을 지지하면서도 장기 결과와의 관계는 아직 불분명하고 질 높은 시험이 더 필요하다고 적었다.
원문 초록 보기
BACKGROUND: L-carnitine is an amino acid derivative that is thought to be helpful for treating renal anemia in hemodialysis patients. However, the mechanism remains to be fully elucidated. METHODS: A literature search was performed on PubMed, Embase, and Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) and conduct a meta-analysis for investigating the effect of L-carnitine in the treatment of renal anemia in participants receiving hemodialysis. RESULTS: A total of 18 eligible trials with 1090 participants were included in this study. L-carnitine can significantly increase plasma free L-carnitine levels (mean difference [MD]: 140.53, 95% confidence interval [CI] 102.22-178.85; P < 0.00001), decrease the erythropoietin responsiveness index (ERI; MD: -2.72, 95% CI -3.20 to -2.24; P < 0.00001) and the required erythropoiesis-stimulating agent (ESA) doses (MD: -1.70, 95% CI -2.04 to -1.36; P < 0.00001). However, the use of L-carnitine was not associated with a higher hemoglobin level (MD: 0.18, 95% CI -0.20 to 0.55; P = 0.35) and hematocrit level (MD: 1.07, 95% CI -0.73 to 2.87; P = 0.24). In subgroup analyses, the effects of L-carnitine supplementation on renal anemia in patients on hemodialysis were independent of the treatment duration and intervention routes. CONCLUSION: The present meta-analysis indicated that L-carnitine therapy significantly increased plasma L-carnitine concentrations, improved the response to ESA, decreased the required ESA doses in patients receiving hemodialysis, and maintained hemoglobin and hematocrit levels. L-carnitine supplementation should be supported in hemodialysis patients. However, the relationship between L-carnitine treatment and long-term outcomes is still unclear. Further high-quality RCTs are needed to verify our findings. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 12908852 Pharmacokinetics of L-carnitine 약동학 리뷰 · Clin Pharmacokinet, 2003 경구 1~6 g의 절대 생체이용률먹은 성분이 실제로 혈액·조직에 도달해 작용할 수 있는 비율. 낮으면 많이 먹어도 흡수가 잘 안 된다.은 5~18%, 식품 속 카르니틴은 최대 75% - 많이 먹을수록 덜 흡수된다.
핵심요약
L-카르니틴의 약동학을 정리한 리뷰. 체내 카르니틴은 식이 흡수, 생합성, 콩팥의 재흡수(98~99%)로 유지된다. 경구 1~6 g의 절대 생체이용률먹은 성분이 실제로 혈액·조직에 도달해 작용할 수 있는 비율. 낮으면 많이 먹어도 흡수가 잘 안 된다.은 5~18%인 반면 식품 속 카르니틴은 최대 75%에 이를 수 있어, 보충제나 의약품 용량은 일반 식단의 적은 양보다 덜 효율적으로 흡수된다. 재흡수 역치가 평소 혈장 농도와 비슷해 외부에서 넣으면 소변 배설이 늘어난다. 투석 환자는 투석기로 빠져나가 이차성 결핍이 생길 수 있다.
원문 초록 보기
L-Carnitine is a naturally occurring compound that facilitates the transport of fatty acids into mitochondria for beta-oxidation. Exogenous L-carnitine is used clinically for the treatment of carnitine deficiency disorders and a range of other conditions. In humans, the endogenous carnitine pool, which comprises free L-carnitine and a range of short-, medium- and long-chain esters, is maintained by absorption of L-carnitine from dietary sources, biosynthesis within the body and extensive renal tubular reabsorption from glomerular filtrate. In addition, carrier-mediated transport ensures high tissue-to-plasma concentration ratios in tissues that depend critically on fatty acid oxidation. The absorption of L-carnitine after oral administration occurs partly via carrier-mediated transport and partly by passive diffusion. After oral doses of 1-6g, the absolute bioavailability is 5-18%. In contrast, the bioavailability of dietary L-carnitine may be as high as 75%. Therefore, pharmacological or supplemental doses of L-carnitine are absorbed less efficiently than the relatively smaller amounts present within a normal diet.L-Carnitine and its short-chain esters do not bind to plasma proteins and, although blood cells contain L-carnitine, the rate of distribution between erythrocytes and plasma is extremely slow in whole blood. After intravenous administration, the initial distribution volume of L-carnitine is typically about 0.2-0.3 L/kg, which corresponds to extracellular fluid volume. There are at least three distinct pharmacokinetic compartments for L-carnitine, with the slowest equilibrating pool comprising skeletal and cardiac muscle.L-Carnitine is eliminated from the body mainly via urinary excretion. Under baseline conditions, the renal clearance of L-carnitine (1-3 mL/min) is substantially less than glomerular filtration rate (GFR), indicating extensive (98-99%) tubular reabsorption. The threshold concentration for tubular reabsorption (above which the fractional reabsorption begins to decline) is about 40-60 micromol/L, which is similar to the endogenous plasma L-carnitine level. Therefore, the renal clearance of L-carnitine increases after exogenous administration, approaching GFR after high intravenous doses. Patients with primary carnitine deficiency display alterations in the renal handling of L-carnitine and/or the transport of the compound into muscle tissue. Similarly, many forms of secondary carnitine deficiency, including some drug-induced disorders, arise from impaired renal tubular reabsorption. Patients with end-stage renal disease undergoing dialysis can develop a secondary carnitine deficiency due to the unrestricted loss of L-carnitine through the dialyser, and L-carnitine has been used for treatment of some patients during long-term haemodialysis. Recent studies have started to shed light on the pharmacokinetics of L-carnitine when used in haemodialysis patients. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 23563705 Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis 동물·관찰 연구 · Nat Med, 2013 생쥐에서 카르니틴이 TMAO를 거쳐 죽상경화 가속, 2,595명에서 혈장 카르니틴은 TMAO가 높을 때만 위험 예측.
핵심요약
장내세균이 식이 L-카르니틴을 TMAO로 바꾸는 경로를 보고한 연구. 생쥐에서 만성 카르니틴 보충은 TMA·TMAO 합성을 높이고 죽상경화를 늘렸으며, 장내세균을 억눌렀을 때는 그렇지 않았다. 잡식인은 채식인보다 카르니틴 섭취 뒤 TMAO를 더 많이 만들었다. 심장 검사를 받은 2,595명에서 혈장 카르니틴은 TMAO가 함께 높은 사람에게서만 심혈관 질환과 주요 심장 사건 위험을 예측했다. NIH 등의 연구비를 받았고, PMC 전문의 공개에 따르면 저자 일부가 심혈관 진단·약물 관련 특허의 공동 발명자다. 전문의 이해상충 선언에 따르면 주요 저자들이 심혈관 진단·치료 관련 특허의 공동 발명자다.
원문 초록 보기
Intestinal microbiota metabolism of choline and phosphatidylcholine produces trimethylamine (TMA), which is further metabolized to a proatherogenic species, trimethylamine-N-oxide (TMAO). We demonstrate here that metabolism by intestinal microbiota of dietary L-carnitine, a trimethylamine abundant in red meat, also produces TMAO and accelerates atherosclerosis in mice. Omnivorous human subjects produced more TMAO than did vegans or vegetarians following ingestion of L-carnitine through a microbiota-dependent mechanism. The presence of specific bacterial taxa in human feces was associated with both plasma TMAO concentration and dietary status. Plasma L-carnitine levels in subjects undergoing cardiac evaluation (n = 2,595) predicted increased risks for both prevalent cardiovascular disease (CVD) and incident major adverse cardiac events (myocardial infarction, stroke or death), but only among subjects with concurrently high TMAO levels. Chronic dietary L-carnitine supplementation in mice altered cecal microbial composition, markedly enhanced synthesis of TMA and TMAO, and increased atherosclerosis, but this did not occur if intestinal microbiota was concurrently suppressed. In mice with an intact intestinal microbiota, dietary supplementation with TMAO or either carnitine or choline reduced in vivo reverse cholesterol transport. Intestinal microbiota may thus contribute to the well-established link between high levels of red meat consumption and CVD risk. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트와 아래 전문 인용을 근거로 작성합니다.
전문에서 확인한 내용 보기
교신저자 Hazen 등은 소속 기관이 보유한 심혈관 진단·치료 특허의 공동 발명자로 선언했습니다. TMAO 위험을 주장하는 쪽의 이해관계로 읽어야 합니다.
"Drs. Hazen and Smith are named as co-inventors on pending and issued patents held by the Cleveland Clinic relating to cardiovascular diagnostics and therapeutics."
※ PMC 공개 전문과 기계로 대조한 인용문 (PMC 학술 연구용 텍스트 마이닝 허용, 2026-11-07) 원문 보기 ↗ PMID 30485835 L-Carnitine Supplementation Increases Trimethylamine-N-Oxide but not Markers of Atherosclerosis in Healthy Aged Women 임상 연구 · Ann Nutr Metab, 2019 건강한 고령 여성 24주 복용 - 혈장 TMAO 10배 상승, 지질·염증·혈관 표지자는 변화 없음.
핵심요약
L-카르니틴 보충이 죽상경화 혈청 표지자를 바꾸는지 건강한 고령 여성에게 24주 동안 본 연구. 혈장 유리 카르니틴과 TMAO가 올랐고, TMAO는 10배 상승했다. 그러나 CRP, IL-6, TNF-α, 셀렉틴, 접착 분자, 지질 표지자에는 영향이 없었다. 24주의 혈액 표지자 결과이며 심혈관 사건을 본 연구는 아니다.
원문 초록 보기
BACKGROUND: L-carnitine can be metabolized to trimethylamine N-oxide (TMAO), a molecule that promotes atherogenesis through its interaction with macrophages and lipid metabolism. OBJECTIVE: The aim of the present study was to assess whether L-carnitine supplementation may promote changes in selected serum biomarkers of atherosclerosis. METHODS: Before the start, in the mid-point and after completing the 24-weeks supplementation protocol, fasting blood samples were taken from the antecubital vein. Plasma free L-carnitine and TMAO were determined by the UPLC/MS/MS method. Serum proteins were determined by the enzyme immunoassay method using commercially available kits. Total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and triglycerides have been determined using standard automatic analyzer. RESULTS: L-carnitine supplementation elevated fasting plasma carnitine in the mid-point of our study and it remained increased until the end of supplementation period. Moreover, it induced tenfold increase in plasma TMAO concentration but did not affect serum C-reactive protein, interleukin-6, tumour necrosis factor-α, L-selectin, P-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1 or lipid profile markers. CONCLUSION: We demonstrated that -although oral L-carnitine supplementation significantly -increased plasma TMAO concentration, no lipid profile changes or other markers of adverse cardiovascular events were detected in healthy aged women over the period of 24 weeks. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ PMID 31167879 Assessment of Causal Direction Between Gut Microbiota-Dependent Metabolites and Cardiometabolic Health: A Bidirectional Mendelian Randomization Analysis 멘델 무작위 분석 · Diabetes, 2019 유전적으로 높은 TMAO·카르니틴은 관상동맥심장 근육에 피를 공급하는 혈관. 좁아지면 협심증·심근경색이 생긴다.질환·심근경색·뇌졸중과 연관 없음 - 당뇨·신장병이 TMAO를 올리는 방향 지지.
핵심요약
유전 변이를 도구로 TMAO와 그 전구체가 심혈관·대사 질환의 원인인지 양방향으로 검증한 멘델 무작위 분석. 유전적으로 예측된 높은 TMAO와 카르니틴은 본페로니 보정 뒤 제2형 당뇨, 심방세동심장의 심방이 불규칙하고 빠르게 뛰는 부정맥. 뇌졸중 위험을 높일 수 있다., 관상동맥심장 근육에 피를 공급하는 혈관. 좁아지면 협심증·심근경색이 생긴다.질환, 심근경색, 뇌졸중, 만성 신장병과 연관되지 않았다. 반대로 제2형 당뇨와 만성 신장병은 TMAO를 높이는 방향으로 인과 관계가 지지됐다. 저자들은 심혈관 질환에 대한 관찰 근거가 교란이나 역인과 때문일 수 있다고 해석했다. 카르니틴 보충제를 직접 시험한 연구는 아니다.
원문 초록 보기
We examined the causal direction between gut microbiota-dependent metabolite trimethylamine N-oxide (TMAO) or its predecessors and cardiometabolic diseases, such as risk of type 2 diabetes mellitus (T2DM), coronary artery disease (CAD), myocardial infarction (MI), stroke, atrial fibrillation (AF), and chronic kidney disease (CKD). We used genetic variants as instruments to test the causal associations. Genetically predicted higher TMAO and carnitine were not associated with higher odds of T2DM, AF, CAD, MI, stroke, and CKD after Bonferroni correction (P ≤ 0.0005). However, we observed that genetically increased choline showed a suggestive association with higher risk of T2DM (odds ratio 1.84 [95% CI 1.00-3.42] per 10 units, P = 0.05). In contrast, genetically predicted higher betaine (0.68 [0.48-0.95] per 10 units, P = 0.023) was suggestively associated with a lower risk of T2DM. We observed a suggestive association of genetically increased choline with a lower level of body fat percentage (β ± SE -0.28 ± 0.11, P = 0.013) but a higher estimated glomerular filtration rate (0.10 ± 0.05, P = 0.034). We further found that T2DM (0.130 ± 0.036, P < 0.0001) and CKD (0.483 ± 0.168, P = 0.004) were causally associated with higher TMAO levels. Our Mendelian randomization findings support that T2DM and kidney disease increase TMAO levels and that observational evidence for cardiovascular diseases may be due to confounding or reverse causality. ※ 파이프라인이 API로 수집·저장한 초록 원문 그대로. 한국어 핵심요약은 이 텍스트만을 근거로 작성됩니다.
원문 보기 ↗ FDA (openFDA) CARNITOR (레보카르니틴 경구제) - 의약품 라벨(일차성 결핍 적응증·생체이용률·신기능 저하 주의·와파린 상호작용·이상반응)
기관 정보 출처입니다. 아래 원문에서 직접 확인하세요.
원문 보기 ↗ FDA (openFDA) CARNITOR (레보카르니틴 주사제) - 의약품 라벨(투석 환자 결핍 적응증·용량·임상 결과 미확인)
기관 정보 출처입니다. 아래 원문에서 직접 확인하세요.
원문 보기 ↗ 