Can L-carnitine supplementation and exercise improve muscle complications in patients with liver cirrhosis who receive branched-chain amino acid supplementation?

Abstract

BACKGROUND:

The aim of this study was to elucidate the efficacy of the combination of L-carnitine and exercise, reported to prevent muscle wasting, for muscle complications (function, volume, and cramping) in patients with liver cirrhosis (LC) who received branched-chain amino acid supplementation.

MATERIALS AND METHODS:

From December 2017 to April 2018, 18 patients with LC who had been given branched-chain amino acid granule supplementation (12.45 g/day) were enrolled (mean age 68.4±10.8 years; 10 males and eight females; Child-Pugh A : B=9 : 9). After evaluating the average number of daily steps, oral L-carnitine supplementation (1000 mg/day) and additional exercise (plus 2000 steps/day) were added for 6 months. Every 4 weeks, a pedometer, a hand dynamometer, ergometer, and bioelectrical impedance analysis were used to evaluate daily steps, muscle function and muscle volume, and muscle cramps were recorded using a numerical rating scale.

RESULTS:

Average steps and serum levels of total and free carnitine were increased from before treatment to the final measurement (1883.5±1211.6 vs. 3165.1±1800.0/day, 62.6±16.5 vs. 110.9±28.6 μmol/l, and 47.7±15.2 vs. 83.2±21.5 μmol/l, respectively; P<0.01), whereas there were no significant changes in the ratios of handgrip strength, leg strength, and muscle volume after 6 months [1.00±0.13 (P=0.991), 1.07±0.13 (P=0.073), and 0.992±0.036 (P=0.390), respectively]. However, the frequency of complaints of muscle cramping was reduced as compared with the start of therapy (baseline, 3 months, and 6 months: 6.3±4.8, 3.1±3.3, and 2.1±2.0, respectively) (P=0.025, Holm's method), whereas numerical rating scale did not show any significant improvement.

CONCLUSION:

L-Carnitine may have an important role for prevention of muscle wasting and reducing the frequency of muscle cramping.

• Authors: Atsushi Hiraoka, Daisuke Kiguchi, Tomoyuki Ninomiya, Masashi Hirooka, Masanori Abe, Bunzo Matsuura, Yoichi Hiasa, Kojiro Michitaka
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 31 Issue 7 Pg. 878-884 (Jul 2019) ISSN: 1473-5687 [Electronic] England
• PMID: 31150367 (Publication Type: Journal Article)

Chemical References

• Amino Acids, Branched-Chain
• Carnitine

Topics

• Aged
• Amino Acids, Branched-Chain (therapeutic use)
• Carnitine (therapeutic use)
• Dietary Supplements
• Electric Impedance
• Exercise Therapy (methods)
• Female
• Hand Strength
• Humans
• Liver Cirrhosis (complications, therapy)
• Male
• Middle Aged
• Muscle Cramp (etiology, physiopathology, prevention & control)
• Muscle Strength (physiology)
• Muscle Strength Dynamometer
• Muscle Weakness (etiology, physiopathology, therapy)
• Muscle, Skeletal (pathology, physiopathology)
• Muscular Atrophy (etiology, physiopathology, prevention & control)
• Organ Size
• Sarcopenia (etiology, physiopathology, therapy)