L-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial

Background and purpose: Insulin resistance (IR) can negatively affect clinical outcomes in acute ischemic stroke (IS) patients. Safe and cost-saving interventions are still needed to improve glycemic indices in this population. The primary objective was to evaluate L-carnitine (LC) effects in acute...

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Autores principales:	Malihe Nejati, Saeed Abbasi, Shadi Farsaei, Fatemeh Shafiee
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2022
Materias:	critical care; insulin resistance ischemic stroke; l-carnitine homa-ir hyperglycemia. Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/18120391c2ad404d92bbdf1ea063540c
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spelling	oai:doaj.org-article:18120391c2ad404d92bbdf1ea063540c2021-11-19T12:17:03ZL-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial1735-53621735-941410.4103/1735-5362.329927https://doaj.org/article/18120391c2ad404d92bbdf1ea063540c2022-01-01T00:00:00Zhttp://www.rpsjournal.net/article.asp?issn=1735-5362;year=2022;volume=17;issue=1;spage=66;epage=77;aulast=Nejatihttps://doaj.org/toc/1735-5362https://doaj.org/toc/1735-9414Background and purpose: Insulin resistance (IR) can negatively affect clinical outcomes in acute ischemic stroke (IS) patients. Safe and cost-saving interventions are still needed to improve glycemic indices in this population. The primary objective was to evaluate L-carnitine (LC) effects in acute IS patients’ homeostatic model assessment of IR (HOMA-IR). Experimental approach: In this randomized, double-blind placebo-controlled clinical trial, critically ill IS patients were allocated to receive daily oral L-carnitine (1.5 g) or a placebo for six days. Fasting serum levels of glucose, insulin, C-reactive protein, LC, and HOMA-IR were measured on days 1 and 7. Mechanical ventilation duration, ICU/hospital duration, illness severity score, sepsis, and death events were assessed. Findings/Results: Forty-eight patients were allocated to the research groups, 24 patients in each group, and all were included in the final analysis. LC administration showed a decrease in mean difference of HOMA-IR and insulin levels at day 7 compared to placebo, -0.94 ± 1.92 vs 0.87 ± 2.24 (P = 0.01) and -2.26 ± 6.81 vs 0.88 ± 4.95 (P = 0.03), respectively. However, LC administration did not result in significant improvement in clinical outcomes compared to placebo. The short duration of intervention and low sample size limited our results. Conclusion and implication: Supplementation of L-carnitine improved HOMA-IR index in acute IS patients admitted to the critical care unit. Supplementation of LC would be a potential option to help to control IR in critically ill acute IS patients.Malihe NejatiSaeed AbbasiShadi FarsaeiFatemeh ShafieeWolters Kluwer Medknow Publicationsarticlecritical care; insulin resistanceischemic stroke; l-carnitinehoma-irhyperglycemia.Pharmacy and materia medicaRS1-441ENResearch in Pharmaceutical Sciences, Vol 17, Iss 1, Pp 66-77 (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	critical care; insulin resistance ischemic stroke; l-carnitine homa-ir hyperglycemia. Pharmacy and materia medica RS1-441
spellingShingle	critical care; insulin resistance ischemic stroke; l-carnitine homa-ir hyperglycemia. Pharmacy and materia medica RS1-441 Malihe Nejati Saeed Abbasi Shadi Farsaei Fatemeh Shafiee L-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial
description	Background and purpose: Insulin resistance (IR) can negatively affect clinical outcomes in acute ischemic stroke (IS) patients. Safe and cost-saving interventions are still needed to improve glycemic indices in this population. The primary objective was to evaluate L-carnitine (LC) effects in acute IS patients’ homeostatic model assessment of IR (HOMA-IR). Experimental approach: In this randomized, double-blind placebo-controlled clinical trial, critically ill IS patients were allocated to receive daily oral L-carnitine (1.5 g) or a placebo for six days. Fasting serum levels of glucose, insulin, C-reactive protein, LC, and HOMA-IR were measured on days 1 and 7. Mechanical ventilation duration, ICU/hospital duration, illness severity score, sepsis, and death events were assessed. Findings/Results: Forty-eight patients were allocated to the research groups, 24 patients in each group, and all were included in the final analysis. LC administration showed a decrease in mean difference of HOMA-IR and insulin levels at day 7 compared to placebo, -0.94 ± 1.92 vs 0.87 ± 2.24 (P = 0.01) and -2.26 ± 6.81 vs 0.88 ± 4.95 (P = 0.03), respectively. However, LC administration did not result in significant improvement in clinical outcomes compared to placebo. The short duration of intervention and low sample size limited our results. Conclusion and implication: Supplementation of L-carnitine improved HOMA-IR index in acute IS patients admitted to the critical care unit. Supplementation of LC would be a potential option to help to control IR in critically ill acute IS patients.
format	article
author	Malihe Nejati Saeed Abbasi Shadi Farsaei Fatemeh Shafiee
author_facet	Malihe Nejati Saeed Abbasi Shadi Farsaei Fatemeh Shafiee
author_sort	Malihe Nejati
title	L-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial
title_short	L-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial
title_full	L-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial
title_fullStr	L-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial
title_full_unstemmed	L-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial
title_sort	l-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial
publisher	Wolters Kluwer Medknow Publications
publishDate	2022
url	https://doaj.org/article/18120391c2ad404d92bbdf1ea063540c
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L-carnitine supplementation ameliorates insulin resistance in critically ill acute stroke patients: a randomized, double-blinded, placebo-controlled clinical trial

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