Effects of levocarnitine on brachial-ankle pulse wave velocity in hemodialysis patients: a randomized controlled trial.
Effects of levocarnitine on brachial-ankle pulse wave velocity in hemodialysis patients: a randomized controlled trial.
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DOI：
10.3390/nu6125992
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发表时间：
2014-12-22
期刊：
影响因子：
5.9
通讯作者：
Soma M
中科院分区：
文献类型：
--
作者：
Higuchi T;Abe M;Yamazaki T;Mizuno M;Okawa E;Ando H;Oikawa O;Okada K;Kikuchi F;Soma M
背景和目的：动脉粥样硬化性心血管疾病是终末期肾病患者最常见的死亡原因。慢性肾脏疾病患者经常表现出左旋肉碱缺乏，由于血液透析（HD）期间损失。我们研究了补充左旋肉碱对HD患者动脉粥样硬化标志物臂踝脉搏波速度（baPWV）的影响。方法：这是一项前瞻性、开放标签、随机、平行对照、多中心的试验，测试口服左旋肉碱（20mg /kg/天）的抗动脉粥样硬化效果。将血浆游离左旋肉碱缺乏（<40 μmol/L）的HD患者176例，平均年龄67.2±10.3岁，平均病程54±51个月，随机分为口服左旋肉碱组（n = 88）和对照组（n = 88），治疗12个月。结果：左旋肉碱组与对照组在基线临床指标上无显著差异。补充12个月的左旋肉碱显著提高了总、游离和酰基左旋肉碱水平，降低了酰基/游离左旋肉碱比值。l-肉碱治疗6个月后，baPWV值从基线时的2085±478 cm/s下降到1972±440 cm/s (p < 0.05)， 12个月后下降到1933±363 cm/s (p < 0.001)，而对照组baPWV无明显变化。基线baPWV是唯一与baPWV降低显著相关的因素。结论：补充左旋肉碱可显著降低HD患者的baPWV。左旋肉碱可能是预防动脉粥样硬化性心血管疾病进展的一种新的治疗策略。
Background and Aims: Atherosclerotic cardiovascular disease is the most common cause of mortality in patients with end-stage kidney disease. Chronic kidney disease patients often exhibit a deficiency in l-carnitine due to loss during hemodialysis (HD). We studied the effects of l-carnitine supplementation on brachial-ankle pulse wave velocity (baPWV), a marker of atherosclerosis, in HD patients. Methods: This was a prospective, open-label, randomized, parallel controlled, multi-center trial testing the anti-atherosclerotic efficacy of oral l-carnitine administration (20 mg/kg/day). HD patients (n = 176, mean age, 67.2 ± 10.3 years old; mean duration of HD, 54 ± 51 months) with plasma free l-carnitine deficiency (<40 μmol/L) were randomly assigned to the oral l-carnitine group (n = 88) or control group (n = 88) and monitored during 12 months of treatment. Results: There were no significant differences in baseline clinical variables between the l-carnitine and control groups. l-carnitine supplementation for 12 months significantly increased total, free, and acyl carnitine levels, and reduced the acyl/free carnitine ratio. The baPWV value decreased from 2085 ± 478 cm/s at baseline to 1972 ± 440 cm/s after six months (p < 0.05) to 1933 ± 363 cm/s after 12 months (p < 0.001) of l-carnitine administration, while no significant changes in baPWV were observed in the control group. Baseline baPWV was the only factor significantly correlated with the decrease in baPWV. Conclusions: l-carnitine supplementation significantly reduced baPWV in HD patients. l-carnitine may be a novel therapeutic strategy for preventing the progression of atherosclerotic cardiovascular disease.
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影响因子：
1.7
作者：
Abe, Masanori;Okada, Kazuyoshi;Soma, Masayoshi
通讯作者：
Soma, Masayoshi
影响因子：
13.2
作者：
Kitahara, T;Ono, K;Nojima, Y
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Nojima, Y
影响因子：
13.2
作者：
Barrett, BJ;Parfrey, PS;Richardson, RMA
通讯作者：
Richardson, RMA
影响因子：
6.1
作者：
Bueno, R;de Sotomayor, MA;Herrera, MD
通讯作者：
Herrera, MD
影响因子：
--
作者：
Aulivola, B;Hile, CN;Pomposelli, FB
通讯作者：
Pomposelli, FB