Effects of L-Carnitine Supplementation on MicroRNA-217 Expression Level in Non-alcoholic Steatohepatitis Suffering Patients with Obesity: A Randomized Controlled Trial

Abstract

BackgroundNonalcoholic steatohepatitis (NASH) is a severe subtype of Nonalcoholic fatty liver disease (NAFLD) and a progressive chronic liver disease which is associated with oxidative stress, inflammation, fibrosis, lipotoxicity, and altered mitochondrial metabolism. Silent Information Regulator 1 (SIRT1) gene is considered as a potential therapeutic target in NAFLD, microRNA-217 (MiRNA-217) inhibits expression of SIRT1 and this inhibition may play role in the pathogenesis of NASH. On the other hand, L-carnitine may have beneficial effects on NASH. Therefore, we investigated the effect of L-carnitine on the MiRNA-217 expression levels in obese NASH suffering patients.MethodsThis double-blind randomized controlled trial (RCT) was carried out in the nutrition clinic of Mashhad University of Medical Sciences (March 2013-June 2014). Seventy-one obese NASH suffering patients were enrolled and randomly assigned to receive L-carnitine (2000 mg/day) /placebo for 12 weeks. Micro RNA (MiR)-217 expression levels were assessed at the study baseline and at the end of study. The MiRNA-217 expression level were assessed in compare with 36 age, sex, and BMI matched NAFLD/NASH negative obese subjects, as control population.ResultsMiRNA-217 expression level was higher in NASH suffering group compared to NASH negative obese patients (P < 0.001). There was a significant difference in the expression level of MiRNA-217 between L-carnitine and placebo receiving groups after the study intervention (P = 0.001); while the expression levels had no significant difference between the two groups at the initiation of the study. L-carnitine supplementation reduced MiRNA-217 expression levels in participants who were assigned to the supplementation group; while MiRNA-217 expression levels in the placebo received NASH, positive obese patients didn’t change during the study.ConclusionMiRNA-217 expression level can be considered as a noninvasive practical biomarker for diagnosis, and treatment follow-up of NASH suffering patients. However, further studies are required to find out the exact relationships between MiRNA-217 expression and different stages of NAFLD.Trial registrationThis trial was registered on Iranian Clinical Trials Registry Platform IRCT201212052602N8 (https://en.irct.ir/trial/2379) on February 4, 2013.