Association of Low Serum l-Carnitine Levels with Peripheral Arterial Stiffness in Patients Who Undergo Kidney Transplantation

Abstract

l-carnitine is an important co-factor in fatty-acid metabolism, and its deficiency is associated with insulin resistance, which is independently associated with arterial stiffness. This study evaluated the relationship between serum l-carnitine level and peripheral arterial stiffness (PAS) in kidney transplantation (KT). Fasting blood samples were collected from 65 patients who underwent KT. We measured the brachial–ankle pulse wave velocity, and 36 patients (55.4%) had PAS. Patients with PAS had a significantly higher percentage of diabetes (p = 0.001), hypertension (p = 0.033), and metabolic syndrome (p = 0.044); higher waist circumference (p = 0.010), systolic blood pressure (p = 0.002), serum triglyceride level (p = 0.040), insulin level (p = 0.002), and homeostasis model assessment of insulin resistance (p = 0.002); lower high-density lipoprotein cholesterol (p = 0.036) and serum l-carnitine levels (p < 0.001); older age (p = 0.041); and a longer KT duration (p = 0.025) than those without PAS. Statistical analysis revealed an independent association between PAS in KT and KT duration (95% confidence interval (CI): 1.003–1.054, p = 0.029) and serum l-carnitine levels (95% CI: 0.842–0.998, p = 0.044). The area under the receiver operating characteristic curve indicated that the diagnostic power of l-carnitine to predict PAS was 0.789 (95% CI: 0.670–0.881, p < 0.001). Serum-free l-carnitine level is negatively associated with PAS in patients who undergo KT.

Determination of Major Endogenous FAHFAs in Healthy Human Circulation: The Correlations with Several Circulating Cardiovascular-Related Biomarkers and Anti-Inflammatory Effects on RAW 264.7 Cells

“…All the samples were stored at −80 °C and the storage time was less than one year. The plasma levels of fasting blood glucose (Glu-AC) and lipid profiles (TG, TCH, HDL-C, and LDL-C) were determined using the COBAS Integra 800 autoanalyzer (Roche Diagnostics, Basel, Switzerland) [ 25 , 26 ].…”

Serum Angiopoietin-like Protein 3 Level Is Associated with Peripheral Arterial Stiffness in Patients with Coronary Artery Disease

“…Previous reports have shown baPWV values are positively correlated with high-sensitivity CRP in the 45-54 years group and in a male Japanese population [31,32]. In our previous reports, PAS was associated with higher SBP, higher percentage of DM, serum insulin levels, and homeostasis model assessment of insulin resistance in patients who underwent kidney transplantation [20,33]. The positive correlation between SBP, DMlog-CRP, and baPWV values, while negative correlation between eGFR and baPWV values was also showed in our patients with CAD.…”

Association of Low Serum l-Carnitine Levels with Aortic Stiffness in Patients with Non-Dialysis Chronic Kidney Disease

“…Likewise, Higuchi et al [ 16 ] reported that administration of LC supplements had a beneficial effect with respect to decreased brachial-ankle PWV; these findings highlighted its anti-atherosclerotic effects in HD patients with carnitine deficiency. Finally, Lai et al [ 12 ] recently reported the negative relationship between brachial-ankle PWV and serum LC levels in renal transplantation recipients. In view of these findings and together with our study, the negative association between serum LC levels and cfPWV may be the result of inflammation, oxidative stress, and/or endothelial dysfunction, although a precise and detailed mechanism would require further evaluation.…”

“…The retention time for free LC was determined at 2.49 min. Quantification of the endogenous compounds was performed by measuring peak areas, followed by comparison to a calibration curve of the standard solutions [ 12 ].…”

“…Quantitative evaluation of PWVs is used to diagnose AS; it is currently understood to be a strong predictor of future CVD and mortality in CKD patients via mechanisms that are independent of those associated with traditional cardiovascular (CV) risk factors [ 9 , 11 ]. Likewise, low serum levels of LC have been associated with AS in renal transplant recipients [ 12 ]. Recent evidence has revealed that administration of LC supplements may serve to limit these co-morbidities in uremic patients; these findings were associated with diminished levels of markers of inflammation and improvements with respect to nutritional markers that were independent of changes of lipid profiles in patients undergoing hemodialysis (HD) [ 13 , 14 , 15 ].…”