اثرات مكمل L- كارنيتين بر غلظت سرم آميلوئيد A و فاكتورهاي التهاب عروقي در بيماران همودياليزي

Effects of L-carnitine supplement on serum amyloid A and vascular inflammatory factors in hemodialysis patients

Background and objectives: Cardiovascular diseases are the most important cause of death in patients with chronic renal failure, including hemodialysis patients. Systemic inflammatory factors, including serum amyloid A and vascular inflammatory factors, are two major risk factors for atherosclerosis in these patients. The present study was designed to investigate the effects of L- carnitine supplement on serum amyloid A and vascular inflammatory factors in hemodialysis patients. Materials and methods: The study was a double-blind randomized clinical trial. Fourty-two hemodialysis patients (25 females and 17 males) were randomly assigned to either carnitine or a placebo group. The patients in the carnitine group received a vial containing 1000 mg oral L- carnitine daily for 12 weeks, while the placebo group received a corresponding placebo vial. At the baseline and the end of the 12th week of the study, 5 ml blood was collected from each patient and each control individual after a 12- to 14-hour fast before dialysis and serum amyloid A, free carnitine, sICAM-1, sICAM-2, sVCAM-l, sE-selectin, sP-selectin and ox-LDL levels were measured. Results: The mean scrum free carnitine concentration increased by 150% in the carnitine group at the end of the 12th week as compared to the baseline value (P<0.001), while the serum amyloid A level decreased by 32% (P<0.001). No significant changes were observed in the serum concentrations of free carnitine or serum amyloid A in the control group. In addition, no significant differences were observed between the two groups in the mean changes of serum slCAM-l, slCʹAM-2, sVCAM-l. sE-selectin, sP-sclectin or ox-LDL concentrations. Conclusion: The results of the present study indicate that L-carnitine supplement can reduce scrum amyloid A concentration, as a systemic inflammatory indicator, in hemodialysis patients and may play an effective role in preventing cardiovascular diseases in these patients, while it has no effect on the serum vascular inflammatory factors.