Effect of L‑carnitine on health‑related quality of life in patients with liver cirrhosis

• Published in: Biomedical reports 2020-12, Vol.13 (6), p.1-1
• Main Authors: Sato, Shinya, Namisaki, Tadashi, Furukawa, Masanori, Saikawa, Soichiro, Kawaratani, Hideto, Kaji, Kosuke, Takaya, Hiroaki, Shimozato, Naotaka, Sawada, Yasuhiko, Kitagawa, Koh, Moriya, Kei, Akahane, Takemi, Mitoro, Akira, Hoki, Noriyuki, Ann, Tatsuichi, Yoshiji, Hitoshi
• Format: Article
• Language: English
• Subjects: Albumin; Ammonia; Antioxidants; Antioxidants (Nutrients); Care and treatment; Carnitine; Chronic fatigue syndrome; Cirrhosis; Cramps; Fatigue; Health surveys; Hepatic encephalopathy; Hepatitis; Hyperammonemia; Infections; Levocarnitine; Liver cirrhosis; Liver diseases; Mental health; Muscles; Nutritional status; Oral administration; Oxidative stress; Patients; Quality of life; Questionnaires; Serum albumin; Supplements; Viral infections
• ISSN: 2049-9434; 2049-9442
• DOI: 10.3892/br.2020.1372

L-carnitine (4-N-trimethylammonium-3-hydroxybutyric acid) is the physiologically active form of carnitine and is a natural compound that has been shown to exhibit antioxidant activity. L-carnitine is used as a supplementary treatment in patients with cirrhosis with hepatic encephalopathy, hyperammonemia or muscle cramps. In the present study, the effect of L-carnitine supplementation on health-related quality of life in 30 patients with cirrhosis was prospectively examined. L-carnitine (1,800 mg/day) was administered orally for 6 months. To assess the effects of L-carnitine on chronic fatigue, patients filled out a self-report questionnaire regarding their physical and mental health. The levels of total and free carnitine, and acylcarnitine were found to be significantly higher 1, 3 and 6 months after therapy initiation compared with before treatment. Serum albumin levels were significantly increased 3 and 6 months after initiation of therapy. L-carnitine supplementation significantly increased the BAP/d-ROM ratio, a marker of antioxidant status in patients with cirrhosis. Changes in serum carnitine concentrations were positively correlated with changes in serum albumin levels ([R.sup.2]=0.369; P=0.012), but not with changes in serum ammonia levels ([R.sup.2]= 0.005; P=0.78). Total and mental health scores improved significantly, and physical scores improved marginally 3 and 6 months after initiation of L-carnitine. These findings may be attributed to the enhanced serum albumin levels and oxidative stress rather than the reduced serum ammonia levels. Based on these results, it is suggested that L-carnitine can potentially alleviate chronic fatigue, along with the increased BAP/d-ROM ratio, which were involved in increased oxidative stress in patients with cirrhosis. The specific mechanisms by which L-carnitine ameliorates chronic fatigue is not fully understood and requires further investigation. Key words: L-carnitine, carnitine profile, albumin, cirrhosis, chronic fatigue, antioxidant activity