The effect of L-carnitine supplementation on lipid profile in adults: an umbrella meta-analysis on interventional meta-analyses

Introduction Previous meta-analyses investigating the therapeutic effects of L-carnitine on lipid profiles have demonstrated inconsistent results. The present umbrella meta-analysis aimed to investigate the impact of efficacy of L-carnitine on lipid profiles in adults. Methods Databases including PubMed, Scopus, and Embase, Web of Science, and Google Scholar were searched up to June 2023. Meta-analysis was performed using a random-effects model. Results Our results from thirteen meta-analyses indicated that L-carnitine supplementation significantly total cholesterol (TC) (ES = −1.05 mg/dL, 95% CI: −1.71, −0.39; p = 0.002), triglycerides (TG) (ES = −2.51 mg/dL; 95% CI: −3.62, −1.39, p < 0.001), and low-density lipoprotein-cholesterol (LDL-C) (ES = −4.81 mg/dL; 95% CI: −6.04, −3.59; p < 0.001). It also increased high-density lipoprotein-cholesterol (HDL-C) (ES: 0.66 mg/dL, 95% CI: 0.20, 1.12, p = 0.005) levels. Conclusion The present umbrella meta-analysis suggests supplementation with L-carnitine in a dosage of more than 2 g/day can improve lipid profile. Thus, L-carnitine supplementation can be recommended as an adjuvant anti-hyperlipidemic agent.

[1]  A. K. Kareem,et al.  The effects of Chlorella vulgaris on cardiovascular risk factors: A comprehensive review on putative molecular mechanisms. , 2023, Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie.

[2]  P. Dehghan,et al.  Efficacy of omega-3-rich Camelina sativa on the metabolic and clinical markers in nonalcoholic fatty liver disease: a randomized, controlled trial , 2022, European journal of gastroenterology & hepatology.

[3]  Ammar Salehi-Sahlabadi,et al.  Does propolis have any effect on rheumatoid arthritis? A review study , 2022, Food science & nutrition.

[4]  D. Liao,et al.  Clinical evidence of the effects of carnitine supplementation on body weight, glycemic control and serum lipids in women with polycystic ovary syndrome: a systematic review and meta-analysis , 2021, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology.

[5]  Hui Zhao,et al.  Role of Carnitine in Non-alcoholic Fatty Liver Disease and Other Related Diseases: An Update , 2021, Frontiers in Medicine.

[6]  G. Spagnuolo,et al.  L-Carnitine in Drosophila: A Review , 2020, Antioxidants.

[7]  K. Djafarian,et al.  The effects of L-carnitine supplementation on lipid concentrations inpatients with type 2 diabetes: A systematic review and meta-analysis of randomized clinical trials , 2020, Journal of cardiovascular and thoracic research.

[8]  Myoungsook Lee,et al.  L-Carnitine’s Effect on the Biomarkers of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials , 2020, Nutrients.

[9]  Amir Abbasnezhad,et al.  Effect of L-Carnitine Supplementation on Lipid Profiles of Patients with Liver Disease: A Systematic Review and Meta-Analysis , 2020, Preventive nutrition and food science.

[10]  Jing Liu,et al.  The influence of l‐carnitine on the expression of miRNAs in asthenospermia spermatozoa and the network regulation of the associated molecules , 2019, Andrologia.

[11]  A. Alirezaei,et al.  The impact of dyslipidemia and oxidative stress on vasoactive mediators in patients with renal dysfunction , 2019, International Urology and Nephrology.

[12]  F. Haghighatdoost,et al.  The effect of L-carnitine on inflammatory mediators: a systematic review and meta-analysis of randomized clinical trials , 2019, European Journal of Clinical Pharmacology.

[13]  T. Broderick,et al.  Biosynthesis of the Essential Fatty Acid Oxidation Cofactor Carnitine Is Stimulated in Heart and Liver after a Single Bout of Exercise in Mice , 2018, Journal of nutrition and metabolism.

[14]  J. Rahmani,et al.  The effect of l-carnitine supplementation on serum leptin concentrations: a systematic review and meta-analysis of randomized controlled trials , 2018, Endocrine.

[15]  Cuiying Mao,et al.  l‐Carnitine and heart disease , 2018, Life sciences.

[16]  P. Tugwell,et al.  AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both , 2017, British Medical Journal.

[17]  F. Reis Therapeutic strategies targeting oxidative stress to improve dyslipidemia and left ventricular hypertrophy. , 2017, Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology.

[18]  D. Pella,et al.  Addition of omega-3 fatty acid and coenzyme Q10 to statin therapy in patients with combined dyslipidemia , 2017, Journal of basic and clinical physiology and pharmacology.

[19]  M. Elisaf,et al.  Statin Therapy and Risk of Intracranial Hemorrhage in Patients with Ischemic Stroke , 2017, Drug Safety.

[20]  Yi-Chin Lin,et al.  Effects of L-carnitine supplementation on lipid profiles in patients with coronary artery disease , 2016, Lipids in Health and Disease.

[21]  Antonio Pérez,et al.  Statin-related myotoxicity. , 2016, Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion.

[22]  R. Hajar Framingham Contribution to Cardiovascular Disease , 2016, Heart views : the official journal of the Gulf Heart Association.

[23]  Jianping Wu,et al.  L-carnitine ameliorates the liver inflammatory response by regulating carnitine palmitoyltransferase I-dependent PPARγ signaling. , 2016, Molecular medicine reports.

[24]  A. Sahebkar,et al.  Impact of L-carnitine on plasma lipoprotein(a) concentrations: A systematic review and meta-analysis of randomized controlled trials , 2016, Scientific Reports.

[25]  M. Djalali,et al.  Effect of Genistein and L-Carnitine and Their Combination on Gene Expression of Hepatocyte HMG-COA Reductase and LDL Receptor in Experimental Nephrotic Syndrome , 2015, Iranian journal of public health.

[26]  X. Wang,et al.  Dietary intake of heme iron and risk of cardiovascular disease: a dose-response meta-analysis of prospective cohort studies. , 2015, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[27]  Yi-Chin Lin,et al.  Effects of L-carnitine supplementation on oxidative stress and antioxidant enzymes activities in patients with coronary artery disease: a randomized, placebo-controlled trial , 2014, Nutrition Journal.

[28]  Lin Sun,et al.  Effect of l-carnitine therapy on patients in maintenance hemodialysis: a systematic review and meta-analysis , 2014, Journal of Nephrology.

[29]  Á. Chamorro,et al.  Atherogenic Dyslipidemia and Residual Cardiovascular Risk in Statin-Treated Patients , 2014, Stroke.

[30]  N. Wong Faculty Opinions recommendation of 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. , 2014 .

[31]  Haohai Huang,et al.  Influence of L-Carnitine Supplementation on Serum Lipid Profile in Hemodialysis Patients: A Systematic Review and Meta-Analysis , 2014, Kidney and Blood Pressure Research.

[32]  Li Tang,et al.  L-Carnitine supplementation for adults with end-stage kidney disease requiring maintenance hemodialysis: a systematic review and meta-analysis. , 2014, The American journal of clinical nutrition.

[33]  J. DiNicolantonio,et al.  L-carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis. , 2013, Mayo Clinic proceedings.

[34]  C. Martínez-Faedo,et al.  Metabolic effects of L-carnitine on type 2 diabetes mellitus: systematic review and meta-analysis. , 2013, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[35]  V. Pesce,et al.  Acetyl-L-carnitine activates the peroxisome proliferator-activated receptor-γ coactivators PGC-1α/PGC-1β-dependent signaling cascade of mitochondrial biogenesis and decreases the oxidized peroxiredoxins content in old rat liver. , 2012, Rejuvenation research.

[36]  R. Ringseis,et al.  Role of carnitine in the regulation of glucose homeostasis and insulin sensitivity: evidence from in vivo and in vitro studies with carnitine supplementation and carnitine deficiency , 2012, European Journal of Nutrition.

[37]  T. Librowski,et al.  L-carnitine--metabolic functions and meaning in humans life. , 2011, Current drug metabolism.

[38]  M. Herrera,et al.  Pharmacological effects and clinical applications of propionyl-L-carnitine. , 2011, Nutrition reviews.

[39]  J. Odle,et al.  Carnitine palmitoyltransferase I control of acetogenesis, the major pathway of fatty acid {beta}-oxidation in liver of neonatal swine. , 2010, American journal of physiology. Regulatory, integrative and comparative physiology.

[40]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement , 2009, BMJ : British Medical Journal.

[41]  G. Guyatt,et al.  GRADE: an emerging consensus on rating quality of evidence and strength of recommendations , 2008, BMJ : British Medical Journal.

[42]  E. Skrzydlewska,et al.  The Influence of L-Carnitine on Oxidative Modification of LDL In Vitro , 2008, Toxicology mechanisms and methods.

[43]  I. Gülçin Antioxidant and antiradical activities of L-carnitine. , 2006, Life sciences.

[44]  C. Stanley Carnitine Deficiency Disorders in Children , 2004, Annals of the New York Academy of Sciences.

[45]  G. Eknoyan,et al.  Practice recommendations for the use of L-carnitine in dialysis-related carnitine disorder. National Kidney Foundation Carnitine Consensus Conference. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[46]  F. Latteri,et al.  Effect of acetyl-l-carnitine on lipid peroxidation and xanthine oxidase activity in rat skeletal muscle , 1993, Neurochemical Research.

[47]  E. Skrzydlewska,et al.  The comparison of effect of catechins and green tea extract on oxidative modification of LDL in vitro. , 2006, Advances in medical sciences.

[48]  A. Bach [Carnitine biosynthesis in mammals]. , 1982, Reproduction, nutrition, developpement.

[49]  G. Burch [Cardiovascular diseases]. , 1956, Revista medica cubana.