Effective dosing of L-carnitine in the secondary prevention of cardiovascular disease: a systematic review and meta-analysis

Shang, R.-P.; Sun, Zhiqi; Li, Hui

doi:10.1186/1471-2261-14-88

Cited by 59 publications

(45 citation statements)

References 31 publications

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“…Moreover, combinations of intravenous loading and oral ingestion of L-carnitine seems to have the potential to reduce short-term mortality following acute myocardial infarction (Tarantini et al, 2006). However, recent meta-analysis studies revealed conflicting effects for the secondary prevention of cardiovascular disease (CVD) by L-carnitine administration (DiNicolantonio et al, 2013; Shang et al, 2014). …”

Section: Existing Theories To Explain Increased Disease Risks Of Rmentioning

confidence: 99%

Human risk of diseases associated with red meat intake: Analysis of current theories and proposed role for metabolic incorporation of a non-human sialic acid

Alisson-Silva

Kawanishi

Varki

2016

Molecular Aspects of Medicine

132

103

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One of the most consistent epidemiological associations between diet and human disease risk is the impact of red meat consumption (beef, pork, and lamb, particularly in processed forms). While risk estimates vary, associations are reported with all-cause mortality, colorectal and other carcinomas, atherosclerotic cardiovascular disease, type II diabetes, and possibly other inflammatory processes. There are many proposed explanations for these associations, some long discussed in the literature. Attempts to explain the effects of red meat consumption have invoked various red meat-associated agents, including saturated fat, high salt intake, Trimethylamine–N-oxide (TMAO) generation by microbiota, and environmental pollutants contaminating red meat, none of which are specific for red meat. Even the frequently mentioned polycyclic aromatic carcinogens arising from high temperature cooking methods are not red meat specific, as these are also generated by grilling poultry or fish, as well as by other forms of cooking. The traditional explanations that appear to be more red meat specific invoke the impact of N-nitroso compounds, heme iron, and the potential of heme to catalyze endogenous nitrosation. However, heme can be denatured by cooking, high levels of plasma hemopexin will block its tissue delivery, and much higher amounts of heme likely originate from red blood cell breakdown in vivo. Therefore, red meat-derived heme could only contribute to colorectal carcinoma risk, via direct local effects. Also, none of these mechanisms explain the apparent human propensity i.e., other carnivores have not been reported at high risk for all these diseases. A more recently proposed hypothesis involves infectious agents in beef from specific dairy cattle as agents of colorectal cancer. We have also described another mechanistic explanation for the human propensity for risk of red-meat associated diseases that is consistent with most observations: metabolic incorporation of a non-human sialic acid N-glycolylneuraminic acid (Neu5Gc) into the tissues of red meat consumers and the subsequent interaction with inflammation-provoking antibodies against this “xenoautoantigen”. Overall, we conclude that while multiple mechanisms are likely operative, many proposed theories to date are not specific for red meat, and that the viral and xenoautoantigen theories deserve further consideration. Importantly, there are potential non-toxic dietary antidotes, if the xenoautoantigen is indeed correct.

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Section: Existing Theories To Explain Increased Disease Risks Of Rmentioning

confidence: 99%

Human risk of diseases associated with red meat intake: Analysis of current theories and proposed role for metabolic incorporation of a non-human sialic acid

Alisson-Silva

Kawanishi

Varki

2016

Molecular Aspects of Medicine

132

103

View full text Add to dashboard Cite

show abstract

“…However, 11 of 13 studies in these meta-analyses, including two large studies with over 1000 subjects, failed to demonstrate any clinical benefit with short-term carnitine supplementation [71]. In addition, another recent meta-analysis on the effects of oral carnitine for the prevention of secondary acute MI concluded that there appeared to be no significant benefit [72]. …”

Section: Microbiota Produced Metabolites and The Evolving Relationshimentioning

confidence: 99%

Listening to Our Gut: Contribution of Gut Microbiota and Cardiovascular Risk in Diabetes Pathogenesis

Kirsop

Tang

2015

Curr Diab Rep

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What we understand about diabetes from decades of genetics research is now being supplemented with exciting new evidence based on a better understanding of how one of the biggest “environmental” factors the body is exposed to is influencing the pathogenesis of disease. The recent discovery that certain dietary nutrients possessing a trimethylamine (TMA) moiety (namely choline/phosphatidylcholine and L-carnitine) participate in the development of atherosclerotic heart disease has renewed attention towards the contributions of gut microbiota in the development of cardiovascular diseases. Collectively, animal and human studies reveal that conversion of these nutrient precursors to trimethylamine N-oxide (TMAO) depends on both microbial composition and host factors, and can be induced by dietary exposures. In addition, circulating TMAO levels are strongly linked to cardiovascular disease risks and various adverse cardio-renal consequences. Our group and others have further demonstrated that circulating TMAO levels are elevated in patients with type 2 diabetes mellitus compared to healthy controls and gut microbiota-dependent phosphatidylcholine metabolism has been implicated in metabolic dysregulation and insulin resistance in animal models. Therefore, preventive strategies to minimize adverse consequences associated with TMAO generation in the diabetic population are warranted.

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“…Possible side effects of L-carnitine have been reported, including agitation, headache, diarrhoea, nausea, vomiting, anorexia and abdominal discomfort, mostly of mild or moderate severity (Hudson 2003;Montgomery 2003;. L-carnitine and its derivatives have been proposed as a treatment, or as an adjunct to conventional medicine, for many conditions, including stable angina, intermittent claudication, diabetic neuropathy, kidney disease and dialysis, hyperthyroidism, male infertility, erectile dysfunction, chronic fatigue syndrome, Alzheimer's disease and memory impairment (Hudson 2003;Montgomery 2003;Ribas 2014;Shang 2014;. ALC is thought to traverse the blood-brain barrier more readily and may have a preferential effect on the central nervous system, whereas PLC may have better bioavailability and be specific for skeletal and cardiac muscle (Malaguarnera 2012;Mingorance 2011).…”

Section: Description Of the Interventionmentioning

confidence: 98%

L-carnitine for cognitive enhancement in people without cognitive impairment

Chen¹,

Yang²,

Zhou³

et al. 2015

Cochrane Database of Systematic Reviews

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Effective dosing of L-carnitine in the secondary prevention of cardiovascular disease: a systematic review and meta-analysis

Cited by 59 publications

References 31 publications

Human risk of diseases associated with red meat intake: Analysis of current theories and proposed role for metabolic incorporation of a non-human sialic acid

Human risk of diseases associated with red meat intake: Analysis of current theories and proposed role for metabolic incorporation of a non-human sialic acid

Listening to Our Gut: Contribution of Gut Microbiota and Cardiovascular Risk in Diabetes Pathogenesis

L-carnitine for cognitive enhancement in people without cognitive impairment

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