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Impact and related mechanisms of L-carnitine on lipid metabolism, inflammation and oxidative stress status in hemodialysis patients with chronic kidney disease

Published on May. 07, 2024Total Views: 162 times Total Downloads: 87 times Download Mobile

Author: WANG Mingming DONG Linyan LIU Jing

Affiliation: Department of Nephrology, Xingtai People's Hospital, Xingtai 054000, Hebei Province, China

Keywords: L-carnitine Chronic kidney failure Lipid metabolism Microinflammation status Oxidative stress status

DOI: 10.12173/j.issn.1008-049X.202402027

Reference: WANG Mingming, DONG Linyan, LIU Jing.Impact and related mechanisms of L-carnitine on lipid metabolism,inflammation and oxidative stress status in hemodialysis patients with chronic kidney disease[J].Zhongguo Yaoshi Zazhi,2024, 24(4):631-639.DOI: 10.12173/j.issn.1008-049X.202402027.[Article in Chinese]

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Abstract

Objective  To investigate the impact and related mechanisms of L-carnitine on lipid metabolism, microinflammation, and oxidative stress status in hemodialysis patients with chronic kidney disease, and explore the potential mechanisms.

Methods  The data of patients with chronic kidney disease receiving dialysis admitted to Xingtai People's Hospital from January 2022 to January 2023 were collected, and they were divided into levocanidin group (levocanidin+conventional treatment) and conventional treatment group. The two groups were compared in terms of treatment safety and renal function indexes [blood creatinine (Scr) and urea nitrogen (BUN)], lipid metabolism status [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and serum free carnitine (FC)], microinflammatory markers [interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP)] and oxidative stress markers [malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px)].

Results  A total of 120 patients were included in the study, with 60 in each group. After 6 months of treatment, there was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05), but the Scr and BUN of the patients in the levocanidin group were lower than those in the conventional treatment group (P<0.05), and the therapeutic efficacy rate was higher than that in the conventional treatment group (P<0.05). Regarding lipid metabolic status, serum TC, TG, LDL-C and ApoB levels of patients in the levocanitine group decreased compared with those before treatment (P<0.05), while serum ApoA1 and FC were elevated (P<0.05); and serum ApoB levels of patients in the conventional treatment group decreased compared with those before treatment (P<0.05). The levels of TC, TG, LDL-C and ApoB were significantly lower and the levels of ApoA1 and FC were significantly higher in the leucovorin group than in the conventional treatment group (P<0.05), whereas there was no significant difference in the levels of serum HDL-C (P>0.05). In terms of microinflammatory status, IL-6, IL-8, TNF-α, and CRP levels decreased in both groups compared with those before treatment (P<0.05), but IL-6, IL-8, TNF-α, and CRP levels of patients in the leucovorin group were significantly lower than those in the conventional treatment group (P<0.05). As for the oxidative stress indexes, the SOD and MDA levels of patients in both groups decreased (P<0.05), while the GSH-Px levels increased (P<0.05) compared with the pretreatment; and compared with the conventional treatment group, patients in the levocanitine group had higher levels of GSH-Px, and lower levels of SOD and MDA (P<0.05).

Conclusion  The use of L-carnitine may further ameliorate microinflammation and oxidative stress by improving lipid metabolism in dialysis patients with chronic kidney disease.

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References

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