Aplicações clínicas da suplementação de L-carnitina
Palabras clave:
Síndrome de Imunodeficiência Adquirida, diabetes mellitus, doenças cardiovasculares, doenças renais, terapêuticaResumen
A carnitina, uma amina quaternária (3-hidroxi-4-N-trimetilamino-butirato), é sintetizada no organismo (fígado, rins e cérebro) a partir de dois aminoácidos essenciais: lisina e metionina, exigindo para sua síntese a presença de ferro, ácido ascórbico, niacina e vitamina B6. Tem função fundamental na geração de energia pela célula, pois age nas reações transferidoras de ácidos graxos livres do citosol para mitocôndrias, facilitando sua oxidação e geração de adenosina Trifosfato. A concentração orgânica de carnitina é resultado de processos metabólicos - como ingestão, biossíntese, transporte dentro e fora dos tecidos e excreção - que, quando alterados em função de diversas doenças, levam a um estado carencial de carnitina com prejuízos relacionados ao metabolismo de lipídeos. A suplementação de L-carnitina pode aumentar o fluxo sangüíneo aos músculos devido também ao seu efeito vasodilatador e antioxidante, reduzindo algumas complicações de doenças isquêmicas, como a doença arterial coronariana, e as conseqüências da neuropatia diabética. Por esse motivo, o objetivo do presente trabalho foi descrever possíveis benefícios da suplementação de carnitina nos indivíduos com necessidades especiais e susceptíveis a carências de carnitina, como os portadores de doenças renais, neuropatia diabética, síndrome da imunodefeciência adquirida e doenças cardiovasculares.
Citas
CErretelli P, Marconi C. L-carnitine supplementation in humans. The effects on physical performance. Int J Sports Med. 1990; 11(1):1-14
Evans AG, Fornasi G. Pharmacokinetics of L-Carnitine. Clin Pharmacokinet. 2003; 42(11):941-67.
Mitchell ME. Carnitine metabolism in humans subjects. II. Values of carnitine in biological fluids and tissues of “normal” subjects. Am J Clin Nutr. 1978; 31(3):481-91.
Cotter MA, Cameron NE, Keegan A, Dines KC. Effects of acetyl- and proprionyl-L-carnitine on peripheral nerve function and vascular supply in experimental diabetes. Metabolism. 1995; 44(9):1209-14.
Brass EP. Carnitine as ergogenic aid in health and disease. J Am Coll Nutr. 1998; 17(3):203-4.
De Simone C, Famularo G, Tzantzoglou S, Trinchieri V, Moretti S, Sorice F. Carnitine depletion in peripheral blood mononuclear cells from patients with AIDS: effect of oral L-carnitine. AIDS. 1994; 8(5):655-60.
Ahamad S. L-Carnitine in Dialysis Patients. Semin Dial. 2001; 14(3):209-17.
Loignon M, Toma E. L-Carnitine for the treatment of highly active antiretroviral therapy-related hypertriglyceridemia in HIV-infected adults. AIDS. 2001; 15(9):1194-5.
Lagioia R, Scrutinio D, Mangini SG, Ricci A, Mastropasqua F, Valentini G, et al. Propionyl-Lcarnitine: a new compound in the metabolic approach to the treatment of effort angina. Int J Cardiol. 1992; 34(2):167-72
Sethi R, Dhalla KS, Ganguly PK, Ferrari R, Dhalla NS. Beneficial effects of propionyl-L-carnitine on sarcolemmal changes in congestive heart failure due to myocardial infarction. Cardiovasc Res. 1999; 42(3):607-15.
Bartels GL, Scholte HR. Acute myocardial ischaemia induces cardiac carnitine release in man. Eur Heart J. 1997; 18(1):84-90.
Iliceto S, Scrutinio D, Bruzzi P, D’Ambrosio G, Boni L, Di Biase M, et al. Effects of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: the L-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) Trial. J Am Coll Cardiol. 1995; 26(2):380-7.
Regensteiner JG, Hiatt WR. Exercise rehabilitation for patients with peripheral arterial disease. Exerc Sport Sci Rev. 1995; 23:1-24.
Hiatt WR, Regensteiner JG, Wolfel EE, Carry MR, Brass EP. Effect of exercise training on skeletal muscle histology and metabolism in peripheral arterial disease. J Appl Physiol. 1996; 81(2):780-8.
Hou XY, Green S, Askew CD, Barker G, Green A, Walker PJ. Skeletal muscle mitochondrial ATP production rate and walking performance in peripheral arterial disease. Clin Physiol Funct Imaging. 2002; 22(3):226-32
Barker GA, Green S, Askew CD, Green AA, Walker PJ. Effect of propionyl-L-carnitine on exercise performance in pheripheral arterial disease. Med Sci Sports Exerc. 2001; 33(9):1415-22.
Brevetti G, Fanin M, De Amicis V, Carrozzo R, Di Lello F, Martone VD, et al. Changes in skeletal muscle histology and metabolism in patients undergoing exercise deconditioning: effect of propionyl-L-carnitine. Muscle Nerve. 1997; 20(9):1115-20.
Hiatt WR, Wolfel EE, Regensteiner JG, Brass EP. Skeletal muscle carnitine metabolism in patients with unilateral peripheral arterial disease. J Appl Physiol. 1992; 73(1):346-53.
Brevetti G, Chiariello M, Ferulano G, Policicchio A, Nevola E, Rossini A, et al. Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: a double blind, cross-over study. Circulation. 1988; 77(4):767-73.
Brevetti G, Perna S, Sabba C, Martone VD, Condorelli, M. Propionyl-L-carnitine in intermittent claudication: double-blind, placebo-controlled, dose titration, multicenter study. J Am Coll Cardiol. 1995; 26(6):1411-6.
Brevetti G, Diehm C, Lambert D. European multicenter study on propyonil-L-carnitine in intermittent claudication. J Am Coll Cardiol. 1999; 34(5):1618-24.
Strano A. Propionyl-L-Carnitine versus Pentoxifylline. Clin Drug. 2002; 22(1):1-6.
Vacha GM, Giorcelli G, Siliprandi N, Corsi M. Favorable effects of L-carnitine treatment on hypertriglyceridemia in hemodialysis patients: decisive role of low levels of high-density lipoprotein-cholesterol. Am J Clin Nutr. 1983; 38(4):532-40.
Guarnieri G, Situlin R, Biolo G. Carnitine metabolism in uremia. Am J Kidney Dis. 2001; 38(4 Suppl 1): S63-7.
Locatelli F, Fouque D, Heimburger O, Drueke TB, Cannata-Andia JB, Horl WH, et al. Nutritional status in dialysis patients: a European consensus. Nephrol Dial Transplant. 2002; 17(4):563-72.
Brass EP, Adler S, Sietsema KE, Hiatt WR, Orlando AM, Amato A. Intravenous L-carnitine increases plasma carnitine, reduces fatigue and may preserve exercise capacity in hemodialysis patients. Am J Kidney Dis. 2001; 37(5):1018-28.
Spagnoli LG, Palmieri G, Mauriello A, Vacha GM, D’Iddio S, Giorcelli G, et al. Morphometric evidence of the trophic effect of L-carnitine on human skeletal muscle. Nephron. 1990; 55(1):16-23.
Bellinghieri G, Savica V, Mallamace A, Di Stefano C, Consolo F, Spagnoli LG, et al. Correlation between increased serum and tissue L-carnitine levels and improved muscle symptoms in hemodialyzed patients. Am J Clin Nutr. 1983; 38(4):523-31
Schambelan M, Benson CA, Carr A, Currier JS, Dube MP, Gerber JG, et al. Management of metabolic complications associated with antiretroviral therapy for HIV-1 infection: recommendations of an International AIDS Society-USA panel. J Acquir Immune Defic Syndr. 2002; 31(3):257-75.
Lyn Patrick ND. Nutrients and HIV: part tree – nacetylcysteine, alpha – lipoic acid, L-glutamine and L-carnitine. Altern Med Rev. 2000; 5(4):290-305.
Moretti S, Alesse E, Di Marzio L, Zazzeroni F, Ruggeri B, Marcellini S, et al. Effect of L-carnitine on human immunodeficiency virus-1 infection associated apoptosis: a pilot study. Blood. 1998; 91(10):3817-24.
Feldman EL. Oxidative stress and diabetic neuropathy: a new understanding of an old problem. J Clin Invest. 2003; 111(4):431-3.
De Grandis D, Minardi C. Acetyl-L-carnitine (levacecarnine) in treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo- -controlled study. Drugs R D. 2002; 3(4):223-31.
Rubin MR, Volek JS, Gómez AL, Ratamess NA, French DN, Sharman MJ, et al. Safety measures of L-carnitine L-tartrate supplementation in healthy men. J Strength Cond Res. 2001; 15(4):486-90
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2023 Christianne de Faria COELHO, João Felipe MOTA, Euclésio BRAGANÇA, Roberto Carlos BURINI
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.