Plasma Carnitine Level in Peripheral Arterial Disease

The plasma carnitine fraction, which involves in skeletal muscle metabolism, was measured in 130 patients with peripheral arterial disease (PAD). The ratios of acyl carnitine and free carnitine (carnitine ratio) are 0.42 ± 0.22 in patients with critical limb ischemia (CLI) and 0.26 ± 0.13 in patients with intermittent claudication (IC), respectively, being significantly high in the patients with CLI (p < 0.01). Even in omitted hemodialysis patients, the carnitine ratio is higher in the patients with CLI than in the patients with IC (0.31 ± 0.14 vs. 0.24 ± 0.10, p < 0.05). When the multivariate analysis was performed using gender, diabetes, dyslipidemia, chronic hemodialysis as the explanatory variables, dialysis (p < 0.001) and CLI (p < 0.01) are shown to be the significant determinant factors of carnitine ratio. These results indicate that carnitine metabolism is deeply related to the severity of ischemia in the muscle. The carnitine ratio may become a marker of severity of limb ischemia of PAD and a possible indicator of preclinical CLI. :