OJGas  Vol.4 No.5 , May 2014
Carnitine Deficiency and Improvement of Muscle Cramp by Administration of Carnitine in Patients with Liver Cirrhosis
Author(s) Naoki Hotta*
ABSTRACT

Aim: We measured carnitine levels in patients with carnitine including dialysis patients, and examined whether administration of L-carnitine improved muscle symptoms. Methods: We measured carnitine levels in 27 patients with liver cirrhosis who were receiving treatment in our hospital, and administered L-carnitine (600 mg - 1800 mg) to patients having muscle cramps for approximately one month and examined the presence/absence of the symptom. We measured carnitine concentration before and after dialysis, before dialysis after the administration to eight dialysis patients, before and after the administration to 19 nondialytic patients. Results: The total carnitine levels before the dialysis of dialysis patients were an average of 42.2 μmol/L and fell to 17.7 μmol/L after more dialysis, but it was increased to 155 μmol/L after the administration of L-carnitine. In the nondialytic patients, the total carnitine levels were significantly increased from 71.7 μmol/L to 101.7 μmol/L after the administration of L-carnitine (P = 0.038). For symptomatic patients, significant improvement of muscle clamps was observed in the L-carnitine administrated group when compared with the non-administrated group (P = 0.0002). Conclusions: Total carnitine levels were low even before dialysis in the dialysis patients with liver cirrhosis in particular and they further decreased after the dialysis. Administration of L-carnitine increased the total carnitine levels and improved the symptom. Based on these results, we conclude that L-carnitine is useful for carnitine deficiency in patients with liver cirrhosis.

 


Cite this paper
Hotta, N. (2014) Carnitine Deficiency and Improvement of Muscle Cramp by Administration of Carnitine in Patients with Liver Cirrhosis. Open Journal of Gastroenterology, 4, 242-248. doi: 10.4236/ojgas.2014.45036.
References
[1]   Malguarnera, M., Vacante, M., Motta, M., et al. (2001) Acetly-L-Carnitine Improves Cognitive Functions in Severe Hepatic Encephalopathy: A Randomized and Controlled Clinical Trial. Metabolic Brain Disease, 26, 281-289,
http://dx.doi.org/10.1007/s11011-011-9260-z

[2]   Malguarnera, M., Gargante, M.P., Cristaldi, E., et al. (2008) Ace-tyl-L-Carnitine Treatment in Minimal Hepatic Encephalopathy. Digestive Diseases and Sciences, 53, 3018-3025.
http://dx.doi.org/10.1007/s10620-008-0238-6

[3]   Malguarnera, M., Bella, R., Vacante, M., et al. (2011) Acet-ly-L-Carnitine Reduces Depression and Improves Quality of Life in Patients with Minimal Hepatic Encephalopathy. Scan-dinavian Journal of Gastroenterology, 46, 750-759.
http://dx.doi.org/10.3109/00365521.2011.565067

[4]   Moorthy, A.V., Rosenblum, M., Rajaram, R., et al. (1983) A Comparison of Plasma and Muscle Carnitine Levels in Patients on Peri-toneal or Hemodialysis for Chronic Renal Falure. American Journal of Nephrology, 3, 205-208.
http://dx.doi.org/10.1159/000166711

[5]   Hiatt, W.R., Koziol, B.J., Shapiro, J.L., et al. (1992) Carnitine Metabolism during Exercise in Patients on Chronic Hemodialysis. Kidney International, 41, 1613 -1619.
http://dx.doi.org/10.1038/ki.1992.233

[6]   Ahmad, S., Robartson, H.T., Golper, T.A., et al. (1990) Multicenter Trial of L-Carnitine in Maintenance Hemodialysis Patients 2. Clinical and Biochemical Effects. Kidney International, 38, 912-918.
http://dx.doi.org/10.1038/ki.1990.290

[7]   Takayanagi, M. (2009) Abnormality. Carnitine Metabolism Child Internal Medicine, 41, The Special Number 387-389.

[8]   Pons, R. and De Vivo, D.C. (1995) Primary and Secondary Carnitine Deficiency Syndrome. Journal of Child Neurology, 10, S8-S24.

[9]   Kaneko, Y. and Tsuchiyama, H. (2012) Examination of the Usefulness of the Oral Nutrition Agent for Hepatic Insufficiency to Liver Cirrhosis. Frontiers in Gastroenterology, 17, 94-101.

[10]   Goto, N., Iida, K. and Hagisawa, Y. (2001) Usefulness of the Branched-Chain-Amino-Acid Tablet to the Leg Cramps Accompanying Liver Cirrhosis. Liver, 42, 590-599.

[11]   Casciani, C.U. and Caruso, U. (1982) Beneficial Effects of L-Carnirine in Post-Dialysis Sundrome. Current Therapeutic Research, l32, 116-127.

[12]   Sakurauchi, Y., Matsumoto, Y., Shinzato, T., et al. (1998) Effects of L-Carnitine Supplementation on Muscular Symotpms in Hemodaialyzed Patients. American Journal of Kidney Diseases, 32, 258-264.
http://dx.doi.org/10.1053/ajkd.1998.v32.pm9708610

[13]   Borum, P.R. and Taggart, E.M. (1986) Carnitine Nutriture of Dialysis Parients. Journal of the American Dietetic Association, 86, 644-647.

[14]   Lynch, K.E., Feldman, H.I., Berlin, J.A., et al. (2008) Effects of L-Carnitine on Dialysis-Related Hypotension and Muscle Cramps: A Meta-Analysis. American Journal of Kidney Diseases, 52, 962-971.
http://dx.doi.org/10.1053/j.ajkd.2008.05.031

[15]   Siami, G., Clinton, M.E., Mrak, R., et al. (1991) Evaluation of the Effect of Intravenous L-Carnitine Therapy on Function, Structure and Fatty Acid Metabolism of Skeletal Muscle in Patients Receiving Chronic Hemodialysis. Nephron, 57, 306-313.
http://dx.doi.org/10.1159/000186280

[16]   Ginvenali, P., Fenocchio, D., Montanari, G., et al. (1994) Selective Trophic Effect of L-Carnitine Type 1 and 2 Skeletal Muscle Fibers. Kidney International, 46, 1616-1619.
http://dx.doi.org/10.1038/ki.1994.460

[17]   Takahashi, T., Hashimoto, Y. and Doi, T. (2000) No 2 20 Carnitine and Muscles. Clinical Dialysis, 16, 201-206.

 
 
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