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The effect of l-carnitine supplementation on insulin resistance, sex hormone-binding globulin and lipid profile in overweight/obese women with polycystic ovary syndrome: a randomized clinical trial

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Abstract

Purpose

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women. Insulin resistance and dyslipidemia are linked to PCOS. l-Carnitine supplementation as a management strategy for women with PCOS has been proposed. The effect of l-carnitine supplementation on insulin resistance, sex hormone-binding globulin (SHBG) and lipid profile in overweight/obese women with PCOS was investigated.

Methods

This randomized, double-blind, controlled clinical trial, was conducted on 62overweight/obese women with PCOS. Participants were randomly assigned into two groups to receive 1000 mg/day l-carnitine or placebo (1000 mg starch) for 12 weeks.

Results

l-Carnitine supplementation compared to the placebo showed a significant improvement in insulin [− 0.7 (− 7.3 to 4.0) vs. 0.7 (− 3.0 to 5.2); P = 0.001], homeostatic model assessment for insulin resistance [− 0.4 (− 1.7 to 1.1) vs. 0.0 (− 0.7 to 1.3); P = 0.002], quantitative insulin sensitivity check index (+ 0.01 ± 0.02 vs. − 0.01 ± 0.01; P = 0.02) and a non-significant change toward improvement in SHBG (+ 11.5 ± 40.2 vs. − 3.2 ± 40.2; P = 0.2). However, there was no significant differences between the two groups in serum levels of fasting plasma glucose, total cholesterol, triglyceride, low density lipoprotein-cholesterol and high density lipoprotein cholesterol (P > 0.05).

Conclusion

12-week l-carnitine supplementation in overweight or obese women with PCOS ameliorate insulin resistance, but has no effect on SHBG and lipid profile. Studies with higher dosages and duration of l-carnitine intake are required. The trial was registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1.

Trial registration

Registered on 30th December 2019 at Iranian Registry of Clinical Trials (IRCT20191016045131N1).

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Abbreviations

Acyl-CoA:

Acyl-coenzyme A

AES:

Androgen Excess Society

ASRM:

American Society for Reproductive Medicine

BMI:

Body mass index

CVD:

Cardiovascular disease

DHEA:

Dehydroepiandrosterone

ESHRE:

European Society of Human Reproduction and Embryology

FAI:

Free androgen index

FPG:

Fasting plasma glucose

HC:

Hip circumference

HDL-c:

High density lipoprotein-cholesterol

HOMA-IR:

Homeostatic model assessment for insulin resistance

IPAQ:

International physical activity questionnaire

LDL-c:

Low-density lipoprotein-cholesterol

LH:

Luteinizing hormone

MET-h:

Metabolic equivalent task hours

NAFLD:

Nonalcoholic fatty liver disease

NIH:

National Institutes of Health

PCOS:

Polycystic ovary syndrome

QUICKI:

Quantitative insulin sensitivity check index

SHBG:

Sex hormone-binding globulin

T2DM:

Type 2 diabetes mellitus

TC:

Total cholesterol

TG:

Triglyceride

VLDL:

Very low-density lipoprotein

WC:

Waist circumference

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Acknowledgements

We acknowledge the contribution of the co-researchers. We also thank the participants for their cooperation throughout recruitment and data collection processes.

Funding

Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran supported this study. This was a financial support for student thesis process including laboratory works, and provide kits as well as supplements.

Author information

Authors and Affiliations

  1. Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Abbas Ali Sangouni, Fatemeh Pakravanfar, Azadeh Nadjarzadeh & Mahdieh Hosseinzadeh

  2. Nutrition and Food Security Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Abbas Ali Sangouni, Fatemeh Pakravanfar, Azadeh Nadjarzadeh & Mahdieh Hosseinzadeh

  3. Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Akram Ghadiri-Anari

  4. Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Hossein Fallahzadeh

Authors
  1. Abbas Ali Sangouni
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  2. Fatemeh Pakravanfar
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  3. Akram Ghadiri-Anari
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  4. Azadeh Nadjarzadeh
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  5. Hossein Fallahzadeh
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  6. Mahdieh Hosseinzadeh
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Contributions

FP and MH: conducted the study; AG: provided material and technical support, AS: interpreted the finding and drafted the manuscript; MH and AN: critically revised the manuscript; HF: carried out the statistical analysis; and MH: supervised the study. The final version of the manuscript was approved by all authors.

Corresponding author

Correspondence to Mahdieh Hosseinzadeh.

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Conflict of interests

The authors have declared no competing interests.

Ethical approval

The research council of Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences and Health Services approved the study protocol. The ethical committee of Shahid Sadoughi University of Medical Sciences and Health Services in Yazd approved the written informed consent (code number: IR.SSU.SPH.REC.1397.014).

Informed consent

Written informed consent was obtained from all participants before the data collection.

Consent for publication

Not applicable.

Data availability

The data and materials of the current study is available from the corresponding author on reasonable request.

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Sangouni, A.A., Pakravanfar, F., Ghadiri-Anari, A. et al. The effect of l-carnitine supplementation on insulin resistance, sex hormone-binding globulin and lipid profile in overweight/obese women with polycystic ovary syndrome: a randomized clinical trial. Eur J Nutr 61, 1199–1207 (2022). https://doi.org/10.1007/s00394-021-02659-0

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  • DOI: https://doi.org/10.1007/s00394-021-02659-0

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