Relative Carnitine Insufficiency in Children With Type I Diabetes Mellitus

Winter, Susan; Simon, M. Celeste; Zorn, E; Szabo-Aczel, S.; Vance, W H; Ohara, Takahiro; Higashi, Leonardo

doi:10.1001/archpedi.1989.02150230095030

Cited by 35 publications

(32 citation statements)

References 22 publications

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“…Accumulation of long-chain fatty acids and other fatty acid metabolites impair insulin signaling and contribute to the development of insulin resistance in skeletal muscle and heart (18). Some studies reported that subjects with diabetes have reduced plasma free carnitine concentrations compared with healthy subjects, indicating an association between impaired carnitine status and glucose intolerance (18,28,29). All participants in our study had diabetes and experienced significant decreases in HbA 1c after 12 weeks of carnitine-orotate complex treatment compared with no significant change in the placebo group.…”

Section: Discussionmentioning

confidence: 99%

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

et al. 2015

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OBJECTIVEWe aimed to evaluate the effects of carnitine-orotate complex in patients with nonalcoholic fatty liver disease (NAFLD) and diabetes. RESEARCH DESIGN AND METHODSEight hospitals in Korea participated in this randomized, controlled, double-blind trial of patients with diabetes and NAFLD. Seventy-eight patients were randomly assigned in a 1:1 ratio to receive carnitine-orotate complex (824 mg, three times daily) or matching placebo. The primary study outcome was decline in alanine aminotransferase (ALT) to the normal range. Secondary study outcomes were change in ALT, radiological hepatic steatosis, parameters for anthropometry, liver function, lipid profiles, and glycemic control. Hepatic steatosis was assessed using Hounsfield units on noncontrast computed tomography (CT) imaging with hepatic attenuation. RESULTSAfter 12 weeks of treatment, compared with placebo group, carnitine-orotate complex-treated participants had a significantly higher rate of normalization of serum ALT level (17.9% vs. 89.7%, P < 0.001). On hepatic CT analysis, participants treated with carnitine-orotate complex showed an increased liver attenuation index (0.74 6 8.05 vs. 6.21 6 8.96, P < 0.008). A significant decrease in HbA 1c was observed in the carnitine-orotate complex group (20.33 6 0.82% [23.6 6 9.0 mmol/mol], P = 0.007), but no significant change was seen in the placebo group. CONCLUSIONSTreatment with carnitine-orotate complex improves serum ALT and may improve hepatic steatosis as assessed by CT in patients with diabetes and NAFLD. Further studies using more advanced magnetic resonance imaging and liver histology as an end point are needed to assess its efficacy in NAFLD.Ectopic fat accumulation in a visceral organ is associated with insulin resistance (1). As an example of such ectopic fat accumulation, nonalcoholic fatty liver disease (NAFLD) is now recognized as the hepatic component of metabolic syndrome and is even reportedly associated with insulin resistance independent of obesity and other metabolic components. Therefore, NAFLD can be a major determinant of insulin

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Section: Discussionmentioning

confidence: 99%

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

et al. 2015

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“…Susa C found a relation between the levels of urine glucose and ketones and the level of acylcarnitine. They also showed that carnitine deficiency and relative insufficiency may be an overlooked component in the management of diabetes (Winter et al, 1987). Keller et al (1998) suggested that acute L-carnitine supplementation significantly improves the recovery of the ischemic myocardium in diabetic and euglycemic rats.…”

Section: Discussionmentioning

confidence: 99%

“…Plasma carnitine levels have been found to be normal or decreased in studies on carnitine metabolism in diabetes mellitus patients (Okuda et al, 1987;Winter et al, 1987;Pregnant et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

Determination of free L-carnitine levels in type II diabetic women with and without complications

Poorabbas¹,

Fallah²,

Bagdadchi

et al. 2007

Eur J Clin Nutr

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Background: Studies on the determination of carnitine levels and nutritional status in patients of type II diabetes. Objective: We designed this study to determine changes of serum-free L-carnitine in type II diabetic women. Design: A cross-sectional study (case-control study). Setting: Clinical of Endocrinology and Metabolism, Sina Hospital, Pharmacological Research Center, Tabriz Medical university, Iran. Patients and methods: Taking into account the importance of the control of diabetes, in the present case-control study, the levels of serum-free L-carnitine, blood glucose and lipids, systolic and diastolic blood pressure, body mass index (BMI) and nutritional status assessed in the case and control groups which were selected by the simple sampling method. The control group (n ¼ 18) included patients with no complications and the case group (n ¼ 33) was grouped into three subgroups including patients with retinopathy, hyperlipidemia and neuropathy. Results: Study results indicated that the mean serum-free L-carnitine concentration in the case group was significantly lower than its mean concentration level in the control group, 39.6378.99 vs 53.4270.93 mmol/l, respectively (Po0.001). Serum-free L-carnitine in retinopathy, hyperlipidemia and neuropathy case subgroups were 39.0379.89, 39.6378.99 and 40.44712.50 mmol/l, respectively (P40.05). No significant difference was found between the serum-free carnitine levels of the case subgroups. The mean blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, very lowdensity lipoprotein cholesterol levels and systolic and diastolic blood pressure were significantly higher in the case group than in the control group. Conclusion: In this study, the mean serum-free L-carnitine levels in diabetic patients with complications was almost 25% lower than in diabetic patients with no complications. On the basis of the study results, carnitine supplementation in diabetic patients, especially in patients with diabetes complications, might be useful.

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“…supplementation because diabetic subjects were reported to have diminished plasma free carnitine concentrations, even though the levels were still within or only slightly below the physiological range (25-50 μmol/l) reported for healthy subjects [33][34][35]. Given the observed increase in type I muscle fiber proportion in obese rats and the relationship between type I muscle fiber proportion and insulin sensitivity it is not unlikely that the improvement of glucose tolerance and insulin sensitivity by carnitine supplementation in obese and diabetic subjects is due to the effect of carnitine on muscle fiber distribution.…”

Section: Discussionmentioning

confidence: 86%

Carnitine supplementation

Vukovich

Costill

Fink

1994

Medicine & Science in Sports & Exercise

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Background: In the present study, we tested the hypothesis that carnitine supplementation counteracts obesityinduced muscle fiber transition from type I to type II. Methods: 24 obese Zucker rats were randomly divided into two groups of 12 rats each (obese control, obese carnitine) and 12 lean Zucker rats were selected for lean control group. A control diet was given to both control groups and a carnitine supplemented diet (3 g/kg diet) was given to obese carnitine group for 4 wk. Components of the muscle fiber transformation in skeletal muscle were examined.

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Relative Carnitine Insufficiency in Children With Type I Diabetes Mellitus

Cited by 35 publications

References 22 publications

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

Determination of free L-carnitine levels in type II diabetic women with and without complications

Carnitine supplementation

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