Carnitine status, plasma lipid profiles, and exercise capacity of dialysis patients: Effects of a submaximal exercise program

Lennon, Doris L.F.; Shrago, Earl; Madden, Michael A.; Nagle, F. J.; Hanson, Peter; Zimmerman, S. W.

doi:10.1016/0026-0495(86)90240-4

Cited by 34 publications

(22 citation statements)

References 41 publications

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“…The current studies demonstrate that free carnitine levels can fall dramatically with exercise as acylcarnitines are generated. Exercise has been shown to increase plasma acylcarnitine concentration in patients with peripheral arterial disease ( 19), and the muscle content of acylcarnitines in patients with chronic renal disease (20). These observations suggest that in animals and possibly in humans, carnitine supplementation may replenish muscle free carnitine content as carnitine is utilized for the formation of acylcarnitines (37).…”

Section: Discussionmentioning

confidence: 99%

“…In that changes in carnitine metabolism reflect changes in tissue metabolism, these differences in metabolic state must be incorporated into the design of studies examining carnitine metabolism in exercise and may explain the apparently discrepant results to date. An understanding of the relationship between carnitine metabolism and exercise is critical as studies are extended to the evaluation of carnitine metabolism in disease states (19,20) and as carnitine is used as a therapeutic agent to improve exercise performance (21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Carnitine and acylcarnitine metabolism during exercise in humans. Dependence on skeletal muscle metabolic state.

Hiatt¹,

Regensteiner²,

Wolfel³

et al. 1989

J. Clin. Invest.

126

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Carnitine metabolism has been previously shown to change with exercise in normal subjects, and in patients with ischemic muscle diseases. To characterize carnitine metabolism further during exercise, six normal male subjects performed constantload exercise on a bicycle ergometer on two separate occasions. Low-intensity exercise was performed for 60 min at a work load equal to 50% of the lactate threshold, and high-intensity exercise was performed for 30 min at a work load between the lactate threshold and maximal work capacity for the individual. Low-intensity exercise was not associated with a change in muscle (vastus lateralis) carnitine metabolism. In contrast, from rest to 10 min of high-intensity exercise, muscle shortchain acylcarnitine content increased 5.5-fold while free carnitine content decreased 66%, and muscle total carnitine content decreased by 19% (all P < 0.01). These changes in skeletal muscle carnitine metabolism were present at the completion of 30 min of high-intensity exercise, and persisted through a 60-min recovery period. With 30 min of high-intensity exercise, plasma short-chain and long-chain acylcarnitine concentrations increased by 46% and 23%, respectively. Neither exercise state was associated with a change in the urine excretion rates of free carnitine or acylcarnitines. Thus, alterations in skeletal muscle carnitine metabolism, characterized by an increase in acylcarnitines and a decrease in free and total carnitine, are dependent on the work load and, therefore, the metabolic state associated with the exercise, and are poorly reflected in the plasma and urine carnitine pools.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Carnitine and acylcarnitine metabolism during exercise in humans. Dependence on skeletal muscle metabolic state.

Hiatt¹,

Regensteiner²,

Wolfel³

et al. 1989

J. Clin. Invest.

126

View full text Add to dashboard Cite

show abstract

“…Although the intensity and the duration of exercise in the studies varies, all have included initial moderate aerobic training progressing to vigorous training for 30 min or more three times per week for Ն8 wk up to 12 mo (most studies 3 to 6 mo). On average, aerobic exercise training for 8 wk to 6 mo improves VO 2peak by approximately 17% (Figure 3), but there is considerable variability from study to study, and many studies have been uncontrolled (16,18,30,(32)(33)(34)(35)(36)41,43). Only two of these studies included patients who were on peritoneal dialysis (35,40).…”

Section: Aerobic Exercise Trainingmentioning

confidence: 99%

“…On average, aerobic exercise training for 8 wk to 6 mo improves VO 2peak by approximately 17% (Figure 3), but there is considerable variability from study to study, and many studies have been uncontrolled (16,18,30,(32)(33)(34)(35)(36)41,43). Only two of these studies included patients who were on peritoneal dialysis (35,40). Many studies were conducted before the routine use of erythropoietin to control the anemia that is associated with chronic kidney disease (CKD), but the effects of aerobic training seem to be similar among patients who receive erythropoietin ( Figure 3).…”

Section: Aerobic Exercise Trainingmentioning

confidence: 99%

Exercise in the End-Stage Renal Disease Population

Johansen¹

2007

Journal of the American Society of Nephrology

282

228

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Many of the known benefits of exercise in the general population are of particular relevance to the ESRD population. In addition, the poor physical functioning that is experienced by patients who are on dialysis is potentially addressable through exercise interventions. The study of exercise in the ESRD population dates back almost 30 yr, and numerous interventions, including aerobic training, resistance exercise training, and combined training programs, have reported beneficial effects. Recently, interventions during hemodialysis sessions have become more popular and have been shown to be safe. The risks of exercise in this population have not been rigorously studied, but there have been no reports of serious injury as a result of participation in an exercise training program. It is time that we incorporate exercise into the routine care of patients who are on dialysis, but identification of an optimal training regimen or regimens, according to patient characteristics or needs, is still needed to facilitate implementation of exercise programs.

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“…Alguns estudos (2,35) também observaram que não houve alterações da SaO 2 , quando realizados somente exercícios de alta intensidade em pacientes com DPOC. Quanto aos valores obtidos para a dispnéia, avaliada pela escala de Borg, Berry et al (36) também não detectaram melhora deste sintoma após um programa de 12 semanas, embora outros investigadores tenham observado resultados positivos de melhora da dispnéia após um programa de TF.…”

Section: Discussionunclassified

Efeitos da suplementação oral de L-carnitina associada ao treinamento físico na tolerância ao exercício de pacientes com doença pulmonar obstrutiva crônica

Silva

Lorenzo²,

Jamami

et al. 2003

J. Pneumologia

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INTRODUÇÃO: Pacientes portadores de doença pulmonar obstrutiva crônica apresentam redução da tolerância ao exercício físico, principalmente devido à limitação ventilatória. A L-carnitina tem sido utilizada com o objetivo de melhorar a capacidade aeróbia de pacientes com doenças crônicas, porém não existem estudos em pacientes portadores de doença pulmonar obstrutiva crônica. OBJETIVO: Avaliar a influência da suplementação de L-carnitina, associada ao treinamento físico por seis semanas, três vezes por semana em pacientes portadores de doença pulmonar obstrutiva crônica. MÉTODO: A amostra foi constituída de 30 pacientes portadores de doença pulmonar obstrutiva crônica (69 ± 7 anos) com volume expiratório forçado no primeiro segundo < 65% do previsto, dividida em três grupos de 10 pacientes: grupo 1 com treinamento físico e suplementação com 2g/dia de L-carnitina, grupo 2 que recebeu treinamento físico e placebo e grupo 3 que não foi submetido a treinamento físico e recebeu 2g/dia de L-carnitina. Os pacientes foram submetidos a avaliação espirométrica, a teste de caminhada de seis minutos e à mensuração dos níveis plasmáticos de carnitina livre no inicio e no final do estudo. RESULTADOS: Foi constatado aumento significativo (p < 0,05) da distância percorrida no teste de caminhada de seis minutos somente nos pacientes dos dois primeiros grupos (de 421 ± 100 para 508 ± 80,7 e de 496 ± 78,7 para 526 ± 64,3 respectivamente). Além disso, com intensidade de exercício semelhante, a subida da freqüência cardíaca foi menor no grupo 1 quando comparado com o grupo 2. As variáveis espirométricas, a saturação da oxihemoglobina e a dispnéia não se alteraram em nenhum dos grupos estudados. Os valores de L-carnitina livre no plasma aumentaram somente nos pacientes do terceiro grupo (59,2 ± 13,8 para 102,3 ± 15,32mmol/L). CONCLUSÃO: A L-carnitina associada ao treinamento físico pode proporcionar maior tolerância ao exercício em pacientes com doença pulmonar obstrutiva crônica.

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Carnitine status, plasma lipid profiles, and exercise capacity of dialysis patients: Effects of a submaximal exercise program

Cited by 34 publications

References 41 publications

Carnitine and acylcarnitine metabolism during exercise in humans. Dependence on skeletal muscle metabolic state.

Carnitine and acylcarnitine metabolism during exercise in humans. Dependence on skeletal muscle metabolic state.

Exercise in the End-Stage Renal Disease Population

Efeitos da suplementação oral de L-carnitina associada ao treinamento físico na tolerância ao exercício de pacientes com doença pulmonar obstrutiva crônica

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