Effects of carnitine supplementation on liver aminotransferase enzymes: A systematic review and meta-analysis of randomized controlled clinical trials

Yousefi Rad, Esmaeil and Eslampour, Elham and Falahi, Ebrahim and Mardani, Mahnaz and Hekmatdoost, Azita and Asbaghi, Omid and Saboori, Somayeh (2019) Effects of carnitine supplementation on liver aminotransferase enzymes: A systematic review and meta-analysis of randomized controlled clinical trials. Indian Journal of Gastroenterology.

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Abstract

Background and Aims This meta-analysis of the randomized controlled trials was performed to assess effects of carnitine supplementation on serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Methods A comprehensive literature search of PubMed, Cochrane’s library, Web of Science, Scopus, and Embase was performeduptoMay2018.Fromatotalof2012articlesidentifiedinitially,only17articleswereincludedinthefinalmeta-analysis to evaluate the effects of carnitine supplementation on serum levels of ALTand ASTenzymes. Results Random effects model meta-analysis showed that carnitine supplementation led to reduction in serum ALT (weighted mean difference [WMD] −10.25 IU/L; 95% CI=−15.73, −4.77; p<0.001) and AST levels (WMD −7.85 IU/L; 95% CI=− 11.85,−3.86;p<0.001).TheresultsofsubgroupanalysisshowedthatcarnitinecouldreduceserumASTlevelsatdosagesequal to2000mg/day(p=0.014)ormorethan2000mg/day(p<0.001).However,carnitinesupplementationatdosagesof≤1000mg/ day (p=0.035) or equal to 2000 mg/day (p=0.013) resulted in significant reduction in ALT level, while doses more than 2000 mg/day did not change ALT significantly. Carnitine exerts its reducing effect on serum ALT and AST levels only when these aminotransferases are raised or when the duration of supplementation lasts at least 3 months. Conclusion Results of the current meta-analysis showed that carnitine supplementation can decrease serum AST and ALT levels significantly, especially when supplementation lasts 3 months or more in patients with elevated serum aminotransferase levels. Keywords Alanineaminotransferase .Aspartateaminotransferase .Carnitine .Liverenzymes .Meta-analysis

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