Serum L-Carnitine Levels Are Associated With First Stroke in Chinese Adults With Hypertension.

Abstract

BACKGROUND:

This study aimed to evaluate the association of serum L-carnitine with first stroke and explore potential effect modifiers.

METHODS:

This is a nested, case-control study drawn from the China Stroke Primary Prevention Trial among rural Chinese adults with hypertension, including 557 first stroke cases and 557 age-matched, sex-matched, treatment group-matched, and residence-matched controls. Serum L-carnitine was measured by liquid chromatography with tandem quadrupole mass spectrometry. Multiple conditional logistic regression models were used to evaluate the association between L-carnitine and first stroke.

RESULTS:

The mean level of serum L-carnitine in the stroke population was 4.7 μg/mL, which was significantly lower than that of the control group (5.7 μg/mL). When L-carnitine was assessed as quintiles, compared with the reference group (quintile 1, <3.3 μg/mL), the odds of stroke were 0.62 (95% CI, 0.39-1.00) in quintile 2, 0.66 (95% CI, 0.40-1.10) in quintile 3, 0.47 (95% CI, 0.28-0.81) in quintile 4, and 0.50 (95% CI, 0.30-0.84) in quintile 5. The trend test was significant (P=0.01). When quintiles 2 to 5 were combined, the adjusted odds ratio of first stroke was 0.58 (95% CI, 0.38-0.87) compared with quintile 1. Similar associations were found for ischemic stroke and hemorrhagic stroke. In subgroup analysis, a significant L-carnitine-stroke association was only observed in the normal folate group (P interaction, 0.039) and in the MTHFR CC genotype group (P interaction, 0.047).

CONCLUSIONS:

In this study of rural Chinese adults with hypertension, serum L-carnitine had an inverse but nonlinear association with first stroke. Folate status and the MTHFR C677T variant were significant effect modifiers of the association.

• Authors: Ziyi Zhou, Nan Zhang, Yun Song, Lishun Liu, Jianping Li, Yan Zhang, Yong Huo, Xiangyi Liu, Yong Duan, Binyan Wang, Hao Zhang, Huiyuan Guo, Xianhui Qin, Xiaobin Wang, Xiping Xu
• Journal: Stroke (Stroke) Vol. 53 Issue 10 Pg. 3091-3098 (10 2022) ISSN: 1524-4628 [Electronic] United States
• PMID: 35770671 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Folic Acid
• Methylenetetrahydrofolate Reductase (NADPH2)
• Carnitine

Topics

• Adult
• Carnitine
• Case-Control Studies
• China (epidemiology)
• Folic Acid
• Genotype
• Humans
• Hypertension (complications)
• Methylenetetrahydrofolate Reductase (NADPH2) (genetics)
• Stroke (prevention & control)