Impact of L-carnitine on plasma lipoprotein(a) concentrations: A systematic review and meta-analysis of randomized controlled trials.
Impact of L-carnitine on plasma lipoprotein(a) concentrations: A systematic review and meta-analysis of randomized controlled trials.
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DOI：
10.1038/srep19188
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发表时间：
2016-01-12
影响因子：
4.6
通讯作者：
Banach M
中科院分区：
文献类型：
--
作者：
Serban MC;Sahebkar A;Mikhailidis DP;Toth PP;Jones SR;Muntner P;Blaha MJ;Andrica F;Martin SS;Borza C;Lip GY;Ray KK;Rysz J;Hazen SL;Banach M
我们旨在通过对现有随机对照试验的系统综述和荟萃分析来评估L-卡尼汀对血浆Lp(A)浓度的影响。文献检索包括截至2015年1月31日的选定数据库。根据I2统计量，采用固定效应或随机效应模型进行Meta分析。效应大小用加权平均差(WMD)和95%可信区间(CI)表示。Meta分析显示补充L肉碱后Lp(A)水平显著降低(体重密度：−8.82 mg/dL，95%CI：−10.09，−7.55，p <； 0.001)。当研究按给药途径分类时，口服(wMD：−9.00 mg/dL，95%CI：−10.29，−7.72，p <； 0.001)显著降低血浆Lp(A)浓度，但静脉注射L-卡尼汀(wMD：−2.91 mg/dL，95%CI：−10.22，4.41，p = 0.436)未见明显降低。Meta回归分析结果显示，合并估计值独立于L-卡尼汀剂量(斜率：−0.30；95%CI：−4.19，3.59；p = 0.878)和疗程(斜率：0.18；95%CI：−0.22，0.59；p = 0.374)。综上所述，荟萃分析提示口服L肉碱可显著降低Lp(A)。考虑到针对Lp(A)的药物数量有限，L-卡尼汀可能是有效降低Lp(A)的有效替代药物。需要进行前瞻性结果试验来充分阐明口服L-卡尼汀的临床价值和安全性。
We aimed to assess the impact of L-carnitine on plasma Lp(a) concentrations through systematic review and meta-analysis of available RCTs. The literature search included selected databases up to 31st January 2015. Meta-analysis was performed using fixed-effects or random-effect model according to I2 statistic. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence interval (CI). The meta-analysis showed a significant reduction of Lp(a) levels following L-carnitine supplementation (WMD: −8.82 mg/dL, 95% CI: −10.09, −7.55, p < 0.001). When the studies were categorized according to the route of administration, a significant reduction in plasma Lp(a) concentration was observed with oral (WMD: −9.00 mg/dL, 95% CI: −10.29, −7.72, p < 0.001) but not intravenous L-carnitine (WMD: −2.91 mg/dL, 95% CI: −10.22, 4.41, p = 0.436). The results of the meta-regression analysis showed that the pooled estimate is independent of L-carnitine dose (slope: −0.30; 95% CI: −4.19, 3.59; p = 0.878) and duration of therapy (slope: 0.18; 95% CI: −0.22, 0.59; p = 0.374). In conclusion, the meta-analysis suggests a significant Lp(a) lowering by oral L-carnitine supplementation. Taking into account the limited number of available Lp(a)-targeted drugs, L-carnitine might be an effective alternative to effectively reduce Lp(a). Prospective outcome trials will be required to fully elucidate the clinical value and safety of oral L-carnitine supplementation.