Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis
Objective: Diminished physical capacity is common and progressive in patients undergoing dialysis, who are also prone to deficiency in carnitine, which plays a pivotal role in maintaining skeletal muscle and cardiac function. The present study aimed to evaluate the association of carnitine profile w...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-03-01
|
| Series: | Frontiers in Physiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2023.1155281/full |
| _version_ | 1811159020160942080 |
|---|---|
| author | Wataru Ito Kiyotaka Uchiyama Ryunosuke Mitsuno Erina Sugita Takashin Nakayama Toshinobu Ryuzaki Rina Takahashi Yoshinori Katsumata Yoshinori Katsumata Kaori Hayashi Takeshi Kanda Naoki Washida Kazuki Sato Hiroshi Itoh |
| author_facet | Wataru Ito Kiyotaka Uchiyama Ryunosuke Mitsuno Erina Sugita Takashin Nakayama Toshinobu Ryuzaki Rina Takahashi Yoshinori Katsumata Yoshinori Katsumata Kaori Hayashi Takeshi Kanda Naoki Washida Kazuki Sato Hiroshi Itoh |
| author_sort | Wataru Ito |
| collection | DOAJ |
| description | Objective: Diminished physical capacity is common and progressive in patients undergoing dialysis, who are also prone to deficiency in carnitine, which plays a pivotal role in maintaining skeletal muscle and cardiac function. The present study aimed to evaluate the association of carnitine profile with exercise parameters in patients with incident dialysis.Design and Methods: This was a single-center cross-sectional study including 87 consecutive patients aged 20–90 years who were initiated on dialysis in Keio University Hospital between December 2019 and December 2022 and fulfilled the eligibility criteria. Exercise parameters were evaluated via cardiopulmonary testing (CPX) using the electronically braked STRENGTH ERGO 8 ergometer, whereas the carnitine profile was assessed by determining serum free carnitine (FC), acylcarnitine (AC) levels and AC/FC ratio.Results: The mean cohort age was 62.1 ± 15.2 years, with male and hemodialysis predominance (70% and 73%, respectively). AC/FC was 0.46 ± 0.15, and CPX revealed peak oxygen consumption (VO2) of 13.9 ± 3.7 (mL/kg/min) with percent-predicted peak VO2 of 53.6% ± 14.7% and minute ventilation (VE)/carbon dioxide output (VCO2) slope of 35.1 ± 8.0. Fully-adjusted multivariate linear regression analysis showed that AC/FC was significantly associated with decreased peak VO2 (β, −5.43 [95% confidence interval (CI), −10.15 to −0.70]) and percent-predicted peak VO2 (β, −19.98 [95% CI, −38.43 to −1.52]) and with increased VE/VCO2 slope (β, 13.76 [95% CI, 3.78–23.75]); FC and AC did not exhibit similar associations with these parameters. Moreover, only AC/FC was associated with a decreased peak work rate (WR), percent-predicted WR, anaerobic threshold, delta VO2/delta WR, and chronotropic index.Conclusion: In patients on incident dialysis, exercise parameters, including those related to both skeletal muscle and cardiac function, were strongly associated with AC/FC, a marker of carnitine deficiency indicating altered fatty acid metabolism. Further studies are warranted to determine whether carnitine supplementation can improve exercise capacity in patients on incident dialysis. |
| first_indexed | 2024-04-10T05:34:04Z |
| format | Article |
| id | doaj.art-f515be77b6b049639445024073f0f102 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-10T05:34:04Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-f515be77b6b049639445024073f0f1022023-03-07T04:48:00ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2023-03-011410.3389/fphys.2023.11552811155281Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysisWataru Ito0Kiyotaka Uchiyama1Ryunosuke Mitsuno2Erina Sugita3Takashin Nakayama4Toshinobu Ryuzaki5Rina Takahashi6Yoshinori Katsumata7Yoshinori Katsumata8Kaori Hayashi9Takeshi Kanda10Naoki Washida11Kazuki Sato12Hiroshi Itoh13Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Cardiology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Cardiology, Keio University School of Medicine, Tokyo, JapanInstitute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanDepartment of Nephrology, International University of Health and Welfare Narita Hospital, Narita, Chiba, JapanInstitute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, JapanDepartment of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, JapanObjective: Diminished physical capacity is common and progressive in patients undergoing dialysis, who are also prone to deficiency in carnitine, which plays a pivotal role in maintaining skeletal muscle and cardiac function. The present study aimed to evaluate the association of carnitine profile with exercise parameters in patients with incident dialysis.Design and Methods: This was a single-center cross-sectional study including 87 consecutive patients aged 20–90 years who were initiated on dialysis in Keio University Hospital between December 2019 and December 2022 and fulfilled the eligibility criteria. Exercise parameters were evaluated via cardiopulmonary testing (CPX) using the electronically braked STRENGTH ERGO 8 ergometer, whereas the carnitine profile was assessed by determining serum free carnitine (FC), acylcarnitine (AC) levels and AC/FC ratio.Results: The mean cohort age was 62.1 ± 15.2 years, with male and hemodialysis predominance (70% and 73%, respectively). AC/FC was 0.46 ± 0.15, and CPX revealed peak oxygen consumption (VO2) of 13.9 ± 3.7 (mL/kg/min) with percent-predicted peak VO2 of 53.6% ± 14.7% and minute ventilation (VE)/carbon dioxide output (VCO2) slope of 35.1 ± 8.0. Fully-adjusted multivariate linear regression analysis showed that AC/FC was significantly associated with decreased peak VO2 (β, −5.43 [95% confidence interval (CI), −10.15 to −0.70]) and percent-predicted peak VO2 (β, −19.98 [95% CI, −38.43 to −1.52]) and with increased VE/VCO2 slope (β, 13.76 [95% CI, 3.78–23.75]); FC and AC did not exhibit similar associations with these parameters. Moreover, only AC/FC was associated with a decreased peak work rate (WR), percent-predicted WR, anaerobic threshold, delta VO2/delta WR, and chronotropic index.Conclusion: In patients on incident dialysis, exercise parameters, including those related to both skeletal muscle and cardiac function, were strongly associated with AC/FC, a marker of carnitine deficiency indicating altered fatty acid metabolism. Further studies are warranted to determine whether carnitine supplementation can improve exercise capacity in patients on incident dialysis.https://www.frontiersin.org/articles/10.3389/fphys.2023.1155281/fullcarnitinecardiopulmonary exercise testdialysispeak oxygen consumptionVE/VCO2 slopework rate |
| spellingShingle | Wataru Ito Kiyotaka Uchiyama Ryunosuke Mitsuno Erina Sugita Takashin Nakayama Toshinobu Ryuzaki Rina Takahashi Yoshinori Katsumata Yoshinori Katsumata Kaori Hayashi Takeshi Kanda Naoki Washida Kazuki Sato Hiroshi Itoh Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis Frontiers in Physiology carnitine cardiopulmonary exercise test dialysis peak oxygen consumption VE/VCO2 slope work rate |
| title | Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis |
| title_full | Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis |
| title_fullStr | Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis |
| title_full_unstemmed | Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis |
| title_short | Correlation between acylcarnitine/free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis |
| title_sort | correlation between acylcarnitine free carnitine ratio and cardiopulmonary exercise test parameters in patients with incident dialysis |
| topic | carnitine cardiopulmonary exercise test dialysis peak oxygen consumption VE/VCO2 slope work rate |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2023.1155281/full |
| work_keys_str_mv | AT wataruito correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT kiyotakauchiyama correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT ryunosukemitsuno correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT erinasugita correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT takashinnakayama correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT toshinoburyuzaki correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT rinatakahashi correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT yoshinorikatsumata correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT yoshinorikatsumata correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT kaorihayashi correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT takeshikanda correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT naokiwashida correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT kazukisato correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis AT hiroshiitoh correlationbetweenacylcarnitinefreecarnitineratioandcardiopulmonaryexercisetestparametersinpatientswithincidentdialysis |