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 inc...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | Nutrition & Metabolism |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12986-022-00661-9 |
| _version_ | 1819052108821823488 |
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| author | Amer M. Johri Marie-France Hétu Daren K. Heyland Julia E. Herr Jennifer Korol Shawna Froese Patrick A. Norman Andrew G. Day Murray F. Matangi Erin D. Michos Stephen A. LaHaye Fraser W. Saunders J. David Spence |
| author_facet | Amer M. Johri Marie-France Hétu Daren K. Heyland Julia E. Herr Jennifer Korol Shawna Froese Patrick A. Norman Andrew G. Day Murray F. Matangi Erin D. Michos Stephen A. LaHaye Fraser W. Saunders J. David Spence |
| author_sort | Amer M. Johri |
| collection | DOAJ |
| description | 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 . |
| first_indexed | 2024-12-21T12:14:36Z |
| format | Article |
| id | doaj.art-bbce847432504b3b9c01f253b0595c2e |
| institution | Directory Open Access Journal |
| issn | 1743-7075 |
| language | English |
| last_indexed | 2024-12-21T12:14:36Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Nutrition & Metabolism |
| spelling | doaj.art-bbce847432504b3b9c01f253b0595c2e2022-12-21T19:04:29ZengBMCNutrition & Metabolism1743-70752022-04-0119111110.1186/s12986-022-00661-9Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndromeAmer M. Johri0Marie-France Hétu1Daren K. Heyland2Julia E. Herr3Jennifer Korol4Shawna Froese5Patrick A. Norman6Andrew G. Day7Murray F. Matangi8Erin D. Michos9Stephen A. LaHaye10Fraser W. Saunders11J. David Spence12Department of Medicine, Cardiovascular Imaging Network at Queen’s UniversityDepartment of Medicine, Cardiovascular Imaging Network at Queen’s UniversityDepartment of Critical Care Medicine, Clinical Evaluation Research UnitDepartment of Medicine, Cardiovascular Imaging Network at Queen’s UniversityDepartment of Critical Care Medicine, Clinical Evaluation Research UnitDepartment of Critical Care Medicine, Clinical Evaluation Research UnitKingston Health Sciences CentreKingston Health Sciences CentreThe Kingston Heart ClinicDivision of Cardiology, Johns Hopkins University School of MedicineDepartment of Medicine, Queen’s UniversitySoutheastern Ontario Vascular Laboratory, Kingston Health Sciences CentreStroke Prevention and Atherosclerosis Research Centre, University of Western OntarioAbstract 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 .https://doi.org/10.1186/s12986-022-00661-9L-carnitineCardiovascularCarotidPlaqueUltrasound |
| spellingShingle | Amer M. Johri Marie-France Hétu Daren K. Heyland Julia E. Herr Jennifer Korol Shawna Froese Patrick A. Norman Andrew G. Day Murray F. Matangi Erin D. Michos Stephen A. LaHaye Fraser W. Saunders J. David Spence Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome Nutrition & Metabolism L-carnitine Cardiovascular Carotid Plaque Ultrasound |
| title | Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome |
| title_full | Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome |
| title_fullStr | Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome |
| title_full_unstemmed | Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome |
| title_short | Progression of atherosclerosis with carnitine supplementation: a randomized controlled trial in the metabolic syndrome |
| title_sort | progression of atherosclerosis with carnitine supplementation a randomized controlled trial in the metabolic syndrome |
| topic | L-carnitine Cardiovascular Carotid Plaque Ultrasound |
| url | https://doi.org/10.1186/s12986-022-00661-9 |
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