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Efficacy of l-carnitine supplementation for management of blood lipids: A systematic review and dose-response meta-analysis of randomized controlled trials

  • Moein Askarpour
    Affiliations
    Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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  • Amir Hadi
    Affiliations
    Halal Research Center of IRI, FDA, Tehran, Iran

    Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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  • Michael E. Symonds
    Affiliations
    The Early Life Research Unit, Academic Division of Child Health, Obstetrics and Gynaecology, and Nottingham Digestive Disease Centre and Biomedical Research Centre, The School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
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  • Maryam Miraghajani
    Affiliations
    The Early Life Research Unit, Academic Division of Child Health, Obstetrics and Gynaecology, and Nottingham Digestive Disease Centre and Biomedical Research Centre, The School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK

    Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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  • Omid Sadeghi
    Affiliations
    Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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  • Ali Sheikhi
    Affiliations
    Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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  • Ehsan Ghaedi
    Correspondence
    Corresponding author. Department of Cellular and Molecular Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Poorsina Street, Enghelab Avenue, Tehran, 14155-6446, Iran. Fax: +982188974462.
    Affiliations
    Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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      Highlights

      • Dyslipidemia is a major risk factor for cardiovascular disorders. Diet and supplements can improve dyslipidemia.
      • Due to major role of carnitine in fatty acid metabolism, it could act as an adjuvant agent for improvement of dyslipidemia.
      • Carnitine increased high-density lipoprotein (HDL) and lowered triglyceride, total cholesterol and low-density cholesterol.
      • Carnitine supplementation at doses above 2 g/d showed favorable effects on patients’ lipid profiles.

      Abstract

      Background and aim

      l-carnitine has an important role in fatty acid metabolism and could therefore act as an adjuvant agent in the improvement of dyslipidemia. The purpose of present systematic review and meta-analysis was to critically assess the efficacy of l-carnitine supplementation on lipid profiles.

      Methods and results

      We performed a systematic search of all available randomized controlled trials (RCTs) in the following databases: Scopus, PubMed, ISI Web of Science, The Cochrane Library. Mean difference (MD) of any effect was calculated using a random-effects model.
      In total, there were 55 eligible RCTs included with 58 arms, and meta-analysis revealed that l-carnitine supplementation significantly reduced total cholesterol (TC) (56 arms-MD: −8.53 mg/dl, 95% CI: −13.46, −3.6, I2: 93%), low-density lipoprotein-cholesterol (LDL-C) (47 arms-MD: −5.48 mg/dl, 95% CI: −8.49, −2.47, I2: 94.5) and triglyceride (TG) (56 arms-MD: −9.44 mg/dl, 95% CI: −16.02, −2.87, I2: 91.8). It also increased high density lipoprotein-cholesterol (HDL-C) (51 arms-MD:1.64 mg/dl, 95% CI:0.54, 2.75, I2: 92.2). l-carnitine supplementation reduced TC in non-linear fashion based on dosage (r = 21.11). Meta-regression analysis indicated a linear relationship between dose of l-carnitine and absolute change in TC (p = 0.029) and LDL-C (p = 0.013). Subgroup analyses showed that l-carnitine supplementation did not change TC, LDL-C and TG in patients under hemodialysis treatment. Intravenous l-carnitine and lower doses (>2 g/day) had no effect on TC, LDL-C and triglycerides.

      Conclusion

      l-carnitine supplementation at doses above 2 g/d has favorable effects on patients' lipid profiles, but is modulated on participant health and route of administration.

      Keywords

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