Role of carnitine in disease

Abstract

Carnitine is a conditionally essential nutrient that plays a vital role in energy production and fatty acid metabolism. Vegetarians possess a greater bioavailability than meat eaters. Distinct deficiencies arise either from genetic mutation of carnitine transporters or in association with other disorders such as liver or kidney disease. Carnitine deficiency occurs in aberrations of carnitine regulation in disorders such as diabetes, sepsis, cardiomyopathy, malnutrition, cirrhosis, endocrine disorders and with aging. Nutritional supplementation of L-carnitine, the biologically active form of carnitine, is ameliorative for uremic patients, and can improve nerve conduction, neuropathic pain and immune function in diabetes patients while it is life-saving for patients suffering primary carnitine deficiency. Clinical application of carnitine holds much promise in a range of neural disorders such as Alzheimer's disease, hepatic encephalopathy and other painful neuropathies. Topical application in dry eye offers osmoprotection and modulates immune and inflammatory responses. Carnitine has been recognized as a nutritional supplement in cardiovascular disease and there is increasing evidence that carnitine supplementation may be beneficial in treating obesity, improving glucose intolerance and total energy expenditure.

Serum Metabolomic Profiling and Incident CKD among African Americans

“…Carnitine is synthesized from lysine and methionine, and kidney plays an important role in its biosynthesis (35). The participants in this study all have normal kidney function; thus, the level of carnitine is dominated by its biosynthesis.…”

Anaplerotic Accumulation of Tricarboxylic Acid Cycle Intermediates as Well as Changes in Other Key Metabolites During Heterotopic Ossification

“…Once in the target cell, for the fatty acid to undergo metabolism it has to reach the mitochondria as all the enzymes required for fatty acid oxidation are present there. The fatty acids undergo activation in the cytosol through conversion to fatty acyl CoA in order to pass though the mitochondrial membrane with the help of carnitine (present as L‐carnitine, the active stereoisomer) after which they undergo β‐oxidation in the mitochondria [Flanagan et al, 2010]. Fatty acyl‐CoA formed in the cytosol can also be used for synthesis of phospholipids and triacylglycerols.…”

Multi Supplementation in Vegetarian Male Patient Submitted to Resistance Training Improves Body Composition in 14 Days

“…By the results presented in this case report, the patient seemed to lose weight by the ability to augment fatty acid transportation to the mitochondria. The carnitine normally shows positive effects in subjects that are in secondary deficiencies, for instance those submitted to hemodialysis where the carnitine loss is significant [8]. Additionally, vegetarians shows lower concentration of carnitine in plasma, when compared to omnivores [9].…”