The impact of carnitine on serum ammonia concentration and lipid metabolism in patients with alcoholic liver cirrhosis.


Lapinski TW, Grzeszczuk A.




Pol Merkuriusz Lek


Treatment of patients with liver cirrhosis with the signs of liver insufficiency is complex and seldom satisfactory. Carnitine, taking part in liver lipid metabolism might be a potentially effective drug. THE AIM: Of the study was to evaluate the influence of L-carnitine on serum ammonia, cholesterol and triglyceride concentrations. PATIENTS AND METHODS: Fifty patients with liver cirrhosis of alcoholic aetiology, 16 females and 34 males, aged 55 +/- 11.3 years (mean +/- SD) were included into the study. Fourteen patients were treated with L-carnitine, 25--with L-ornitine L-aspartate, 11--were not given those medicaments. All patients had proteins reduced down to 0.5 g/kg b.w. per day in their diet. The serum concentrations of ammonia, cholesterol and triglycerides were assessed on inclusion and after 28 days of treatment. RESULTS: All patients improved clinically. A significant improvement was observed in the group of patients treated with L-ornitine L-aspartate (p < 0.003), and among those treated with L-isocarnitine (p = 0.005), while evaluating the Child-Pugh score before and after treatment. The serum ammonia concentration decreased in all patients. However, among the individuals treated with L-carnitine an increase of serum cholesterol and triglyceride concentrations was observed as well (p = 0.02). CONCLUSIONS: L-carnitine lowers the serum ammonia concentration and improves lipid metabolism.