Dataset Information

Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome.

ABSTRACT:

Background

L-carnitine (L-C), a ubiquitous nutritional supplement, has been investigated as a potential therapy for cardiovascular disease, but its effects on human atherosclerosis are unknown. Clinical studies suggest improvement of some cardiovascular risk factors, whereas others show increased plasma levels of pro-atherogenic trimethylamine N-oxide. The primary aim was to determine whether L-C therapy led to progression or regression of carotid total plaque volume (TPV) in participants with metabolic syndrome (MetS).

Methods

This was a phase 2, prospective, double blinded, randomized, placebo-controlled, two-center trial. MetS was defined as ≥ 3/5 cardiac risk factors: elevated waist circumference; elevated triglycerides; reduced HDL-cholesterol; elevated blood pressure; elevated glucose or HbA1c; or on treatment. Participants with a baseline TPV ≥ 50 mm³ were randomized to placebo or 2 g L-C daily for 6 months.

Results

The primary outcome was the percent change in TPV over 6 months. In 157 participants (L-C N = 76, placebo N = 81), no difference in TPV change between arms was found. The L-C group had a greater increase in carotid atherosclerotic stenosis of 9.3% (p = 0.02) than the placebo group. There was a greater increase in total cholesterol and LDL-C levels in the L-C arm.

Conclusions

Though total carotid plaque volume did not change in MetS participants taking L-C over 6-months, there was a concerning progression of carotid plaque stenosis. The potential harm of L-C in MetS and its association with pro-atherogenic metabolites raises concerns for its further use as a potential therapy and its widespread availability as a nutritional supplement.

Trial registration

ClinicalTrials.gov, NCT02117661, Registered April 21, 2014, https://clinicaltrials.gov/ct2/show/NCT02117661 .

SUBMITTER: Johri AM

PROVIDER: S-EPMC8976995 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome.

Johri Amer M AM Hétu Marie-France MF Heyland Daren K DK Herr Julia E JE Korol Jennifer J Froese Shawna S Norman Patrick A PA Day Andrew G AG Matangi Murray F MF Michos Erin D ED LaHaye Stephen A SA Saunders Fraser W FW Spence J David JD

Nutrition & metabolism 20220402 1

<h4>Background</h4>L-carnitine (L-C), a ubiquitous nutritional supplement, has been investigated as a potential therapy for cardiovascular disease, but its effects on human atherosclerosis are unknown. Clinical studies suggest improvement of some cardiovascular risk factors, whereas others show increased plasma levels of pro-atherogenic trimethylamine N-oxide. The primary aim was to determine whether L-C therapy led to progression or regression of carotid total plaque volume (TPV) in participant ...[more]

PMID: 35366920

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Dataset Information

Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome.

Background

Methods

Results

Conclusions

Trial registration

Publications

Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome.

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