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The effects of L-carnitine supplementation on inflammatory and anti-inflammatory markers in adults: a systematic review and dose–response meta-analysis

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Abstract

L-carnitine supplementation may be beneficial in improving inflammatory conditions and reducing the level of inflammatory cytokines. Therefore, according to the finding of randomized controlled trials (RCTs), the systematic review and meta-analysis aimed to investigate the effect of L-carnitine supplementation on inflammation in adults. To obtain acceptable articles up to October 2022, a thorough search was conducted in databases including PubMed, ISI Web of Science, the Cochrane Library, and Scopus. A random-effects model was used to estimate the weighted mean difference (WMD). We included the 48 RCTs (n = 3255) with 51 effect sizes in this study. L-carnitine supplementation had a significant effect on C-reactive protein (CRP) (p < 0.001), interleukin-6 (IL-6) (p = 0.001), tumor necrosis factor-α (TNF-α) (p = 0.002), malondialdehyde (MDA) (p = 0.001), total antioxidant capacity (TAC) (p = 0.029), alanine transaminase (ALT) (p < 0.001), and aspartate transaminase (AST) (p < 0.001) in intervention, compared to the placebo group. Subgroup analyses showed that L-carnitine supplementation had a lowering effect on CRP and TNF-α in trial duration ≥ 12 weeks in type 2 diabetes and BMI ≥ 25 kg/m2. L-carnitine supplementation reduced ALT levels in overweight and normal BMI subjects at any trial dose and trial duration ≥ 12 weeks and reduced AST levels in overweight subjects and trial dose ≥ 2 g/day. This meta-analysis revealed that L-carnitine supplementation effectively reduces the inflammatory state by increasing the level of TAC and decreasing the levels of CRP, IL-6, TNF-α and MDA in the serum.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

RCTs:

Randomized clinical trials

WMD:

Weighted mean differences

CI:

Confidence intervals

BMI:

Body mass index

GRADE:

Grading of recommendations assessment, development, and evaluation

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

PICO:

Participant, intervention, comparison/control, and outcome

ALT:

Alanine transaminase

ALP:

Alkaline phosphatase

AST:

Aspartate transaminase

CI:

Confidence interval

CRP:

C-reactive protein

GSH:

Glutathione

MDA:

Malondialdehyde

NO:

Nitric oxide

TAC:

Total antioxidant capacity

TNF-α:

Tumor necrosis factor-α

WMD:

Weighted mean differences

IL-6:

Interleukin-6

MCP-:

Monocyte chemoattractant protein-1

LCFAs:

Long-chain fatty acids

ROS:

Reactive oxygen species

PPARγ:

Peroxisome-activated receptors γ

NF-κB:

Peroxisome-activated receptors γ

NAFLD:

Non-alcoholic fatty liver disease

SD:

Standard deviation

SEs:

Standard errors

IQRs:

Interquartile ranges

hs-CRP:

High-sensitivity CRP

IG:

Intervention group

CG:

Control group

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Authors and Affiliations

  1. Department of Cellular and Molecular Nutrition, Faculty of Nutrition Science and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Samira Rastgoo

  2. Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Samira Rastgoo & Omid Asbaghi

  3. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Sahand Tehrani Fateh

  4. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran

    Mahlagha Nikbaf-Shandiz

  5. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Niloufar Rasaei, Yasaman Aali & Farideh Shiraseb

  6. Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Zamani

  7. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Omid Asbaghi

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  1. Samira Rastgoo
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  2. Sahand Tehrani Fateh
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  3. Mahlagha Nikbaf-Shandiz
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  4. Niloufar Rasaei
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  5. Yasaman Aali
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  6. Mohammad Zamani
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  7. Farideh Shiraseb
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  8. Omid Asbaghi
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Contributions

The authors’ responsibilities were as follows: SR designed the study; SR and OA developed the search strategy; MZ, MNS, and OA extracted the data and conducted the analyses; STF, NR, YA, and SR drafted the manuscript; SR and OA assessed the risk of bias of the meta-analyses; FSH, OA, SR, and MNS interpreted the results; SR and FSH revised manuscript, and all authors read and approved the final manuscript.

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Correspondence to Farideh Shiraseb or Omid Asbaghi.

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Rastgoo, S., Fateh, S.T., Nikbaf-Shandiz, M. et al. The effects of L-carnitine supplementation on inflammatory and anti-inflammatory markers in adults: a systematic review and dose–response meta-analysis. Inflammopharmacol 31, 2173–2199 (2023). https://doi.org/10.1007/s10787-023-01323-9

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  • DOI: https://doi.org/10.1007/s10787-023-01323-9

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