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l-Carnitine and Long-Chain Acylcarnitines are Positively Correlated with Ambulatory Blood Pressure in Humans: The SABPA Study

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Lipids

Abstract

The prevalence of hypertension in sub-Saharan Africa is increasing rapidly, and treatment remains challenging. Although the use of l-carnitine in treatment has received much attention, studies reporting on physiological l-carnitine levels in hypertensives are limited. Our aim was to determine physiological levels of l-carnitine and acylcarnitines in African and Caucasian men, and to investigate associations between ambulatory blood pressure (BP) and carnitine levels. Participants included 101 African and 101 Caucasian teachers. Ambulatory BP measurements were conducted, and l-carnitine and acylcarnitine levels determined. African men showed significantly higher systolic BP (p < 0.001), diastolic BP (p < 0.001) and l-carnitine levels (p = 0.01). In both ethnic groups, partial regression analyses revealed a positive association between BP and l-carnitine, although in Caucasians it was with systolic (r = 0.20, p = 0.045), and in Africans with diastolic BP (r = 0.23, p = 0.023). After adjusting for confounders, an independent positive association between systolic (R 2 = 0.37, β = 0.12, p = 0.041) and diastolic BP (R 2 = 0.39, β = 0.14, p = 0.018) and l-carnitine and long-chain acylcarnitines (R 2 = 0.38, β = 0.17, p = 0.005 and R 2 = 0.39, β = 0.15, p = 0.011) were found, independent of ethnicity. Physiological l-carnitine levels were not only higher in Africans than in Caucasians but also above the expected reference range. Despite promising results on l-carnitine (and its short-chain derivatives) in hypertension treatment regimens, our findings paradoxically show that elevated BP is significantly associated with higher physiological l-carnitine and long-chain acylcarnitine levels.

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Abbreviations

ABPM:

Ambulatory blood pressure monitoring

ATP:

Adenosine-5′-triphosphate

BP:

Blood pressure

cIMT:

Carotid intima-media thickness

CRP:

C-reactive protein

CSWA:

Cross-sectional wall area

ESI–MS/MS:

Electrospray ionisation tandem mass spectrometry

FRAP:

Ferric reducing antioxidant power

GGT:

γ-Glutamyl transferase

HDL:

High-density lipoprotein

LCFA:

Long-chain fatty acids

L-NAME:

Nω-nitro-l-arginine methyl ester

MAP:

Mean arterial pressure

OCTN2:

Organic cation transporter 2

PPARα:

Peroxisome proliferator-activated receptor α

ROS:

Reactive oxygen species

SABPA study:

Sympathetic activity and ambulatory blood pressure in Africans study

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Acknowledgments

The Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) Study would not have been possible without the voluntary collaboration of the participants and the Department of Education, North-West Province, South Africa. We gratefully acknowledge the technical assistance of Mrs. Tina Scholtz, Dr Szabolcs Péter and Sr Chrissie Lessing. This study was supported by the National Research Foundation, South Africa; the North-West University, Potchefstroom, South Africa, and the Metabolic Syndrome Institute, France.

Conflict of interest

The authors declare no conflict of interest. This study was supported by the National Research Foundation, South Africa; the North-West University, Potchefstroom, South Africa; and the Metabolic Syndrome Institute, France.

Author information

Authors and Affiliations

  1. Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, Private Bag X6001, Potchefstroom, 2520, South Africa

    Catharina M. C. Mels, Aletta E. Schutte, Hugo W. Huisman, Rudolph Schutte, Carla M. T. Fourie, Ruan Kruger, Johannes M. Van Rooyen, Wayne Smith, Nicolaas T. Malan & Leoné Malan

  2. Centre for Human Metabonomics, North-West University, Potchefstroom, South Africa

    Elardus Erasmus

Authors
  1. Catharina M. C. Mels
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  2. Aletta E. Schutte
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  3. Elardus Erasmus
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  4. Hugo W. Huisman
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  5. Rudolph Schutte
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  10. Nicolaas T. Malan
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  11. Leoné Malan
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Correspondence to Catharina M. C. Mels.

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Mels, C.M.C., Schutte, A.E., Erasmus, E. et al. l-Carnitine and Long-Chain Acylcarnitines are Positively Correlated with Ambulatory Blood Pressure in Humans: The SABPA Study. Lipids 48, 63–73 (2013). https://doi.org/10.1007/s11745-012-3732-8

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  • DOI: https://doi.org/10.1007/s11745-012-3732-8

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