The Plasma and Urinary Carnitine System in Korean Diabetic Patients

  • Lee Yeoul (Department of Food Science and Nutrition and Research Institute of Human Ecology, Chonbuk National University) ;
  • Heo Young Ran (Department of Food and Nutrition, Collage of Human Ecology Chonnam National University) ;
  • Cha Youn Soo (Department of Food Science and Nutrition and Research Institute of Human Ecology, Chonbuk National University)
  • Published : 2005.05.01

Abstract

The goal of this study was to investigate abnotmalities in camitine metabolism present by determining blood camitine and lipid concentrations in Korean diabetic patients. The study subjects included 108 Korean diabetic patients (64 males and 44 females) who were hospitalized in Chonbuk National University Hospital and 27 subjects were also hospitalized as non-diabetic controls (10 males and 17 females). Glucose, total cholesterol, triglyceride (TG) and HDL-cholesterol in plasma were enzymatically assayed and insulin was measured by immunoradiometric assay. Nonesterified camitine (NEC), acid-soluble acylcarnitine (ASAC), and acid-insoluble acylcarnitine (AIAC) were determined by a modified radioisotopic method Glucose and insulin levels were significantly elevated in diabetic patients compared with controls. Total cholesterol was elevated in female but not male diabetic patients and triglycerides were elevated both in male and female diabetics. Plasma and urinary total carnitine (TCNE) were significantly elevated in diabetics as compared with normal controls. In male diabetics, NEC concentrations were significantly elevated above controls, but not in female subjects. Plasma NEC and TCNE concentrations were significantly increased in male diabetics, but significantly decreased in female diabetics. All urinary carnitine concentrations were significantly increased in diabetics as compared with controls. Urinary NEC concentrations were four times higher in male diabetics and three times higher in female diabetics than in controls. The ratios of serum and urinary acylcarnitine/NEC were also significantly higher in diabetics than in controls. This study suggested that there was a remarkable abnormality in lipid and carnitine metabolism in Korean diabetic patients, and the further study on carnitine metabolism and the effects of carnitine supplementation for Korean diabetic patients are needed.

Keywords

References

  1. DeFronzo R, Bonadonna R, Ferrannini E. Pathogenesis of NIDDM: a balanced overview. Diabetes Care 15:318-368, 1992 https://doi.org/10.2337/diacare.15.3.318
  2. DeFronzo R. Pathogenesis of type 2 diabetes; metabolic and molecular implications for identifying diabetes genes. Diabetes Reviews 5:177-269, 1997
  3. Weyer C, Bogardus C, Mott D, Pratley R. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest 104:787-794, 1999 https://doi.org/10.1172/JCI7231
  4. American Diabetes association. Postprandial blood glucose. Diabetes Care 24:775-778, 2001 https://doi.org/10.2337/diacare.24.4.775
  5. Matthai S, Stmvoll M, Kellerer M, Haring H. Pathophysiology and pharmacological treatment of insulin resistance. Endocr Rev 21:585-618, 2000 https://doi.org/10.1210/er.21.6.585
  6. Gulli G, Ferrannini E, Stern M, Haffner S, DeFronzo R. The metabolic profile of NIDDM is fully established in glucosetolerant offsprings of two Mexican-American NIDDM parents. Diabetes 41:1575-1586, 1992 https://doi.org/10.2337/diabetes.41.12.1575
  7. Lillioja S, Mott D, Howard B, Bennett P, Yki-Jarvinen H, Freymond D, Nyomba B, Zurlo F, Swinburn B, Bogardus C. Impaired glucose tolerance as a disorder of insulin action: longitudinal and cross-sectional studies in Pima Indians. N Engl J Med 318:1217-1225, 1988 https://doi.org/10.1056/NEJM198805123181901
  8. Martin B, Warram J, Krolewski A, Bergman R, Soeldner J, Kahn C. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet 340:925-929, 1992 https://doi.org/10.1016/0140-6736(92)92814-V
  9. Kendler B. Carnitine. An overview if its role in preventive medicine. Preventive Medicine 15:373-390, 1986 https://doi.org/10.1016/0091-7435(86)90005-8
  10. Rebouche C, Seim H. Carnitine metabolism and its regulation in microorganisms and mammals. Annu Rev Nutr 8:39-61, 1998
  11. Derosa G, Cicero A, Gaddi A, Mugellini A, Ciccarelli L, Fogari R. The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus. Clin Ther 25:1429-1439, 2003 https://doi.org/10.1016/S0149-2918(03)80130-3
  12. Brooks S, Bahl J, Bressler R. Carnitine in the streptozotocin-diabetic rat. J Nutr 115:1267-1273, 1985 https://doi.org/10.1093/jn/115.10.1267
  13. Giancaaterini A, De Gaetano A, Mingrone G, Capristo E, Greco A. Acetyl-L-carnitine infusion increases glucose disposal in type 2 diabetic patients. Metabolism 49:704-708, 2000 https://doi.org/10.1053/meta.2000.6250
  14. Lowitt S, Malone J, Salem A, Korthals J, Benford S. Acetyl L-carnitine corrects the altered peripheral nerve function of experimental diabetes. Metabolism 44:677-680, 1995 https://doi.org/10.1016/0026-0495(95)90128-0
  15. Heo Y, Lee Y, Cha Y. L-carnitine Administration Improves Lipid Metabolism in Streptozotocin-induced diabetic rat. Nutritional Science 5:3-8, 2002
  16. Yoshikawa Y, Ueda E, Sahurai H, Kojima Y. Anti-diabetices effect of Zn(II)/carnitine complex by oral administration. Chem Pharm Bull 51:230-231, 2003 https://doi.org/10.1248/cpb.51.230
  17. Reaven G. Role of insulin resistance in human disease. Diabetes 37:1595-1607, 1988 https://doi.org/10.2337/diabetes.37.12.1595
  18. Laakso M. Hyperglycemia and cardiovascular disease in Type 2 diabetes. Diabetes 48:937-942, 1999 https://doi.org/10.2337/diabetes.48.5.937
  19. Howard B. Lipoprotein metabolism in diabetes mellitus. J Lipid Res 28:613-628, 1987
  20. Cavallero E, Dachet C, Neufcou D, Wirquin E, Mathe D, Jacotot B. Postprandial amplication of lipopotein abnormalities in controlled type II diabetic subjects: relationship to postprandial lipemia and C-peptide/glucagons levels. Metabolism 43:270-278, 1994 https://doi.org/10.1016/0026-0495(94)90092-2
  21. Niina M, Mikko S, Marja-riitta T. Postprandial lipid metabolism in diabetes. Atherosclerosis 141suppl:S53-S55, 1998 https://doi.org/10.1016/S0021-9150(98)00148-8
  22. Bieber L. Carnitine. AnnRev Biochem 57:261-283, 1988 https://doi.org/10.1146/annurev.bi.57.070188.001401
  23. Bell F, Vidmar R, Raymond T. L-carnitine administration and withdrawal affect plasma and hepatic carnitine concentrations, plasma lipid and lipoprotein composition, and in vitro hepatic lipogenesis from labeled mevalonate and olate in normal rabits. J Nutr 122:959-966, 1992 https://doi.org/10.1093/jn/122.4.959
  24. Monola P, Belfiore A, Santangelo F, Senicchio M. L-Carnitine on the apolipoprotein pattern of rats fed a cholesterol-rich diet. Comp Biochem Physiol 89:69-73, 1988 https://doi.org/10.1016/0305-0491(88)90263-5
  25. Sachan D, Dodsan W. The serum carnitine status of cancer patients. J Am Nutr 6(2):14-15, 1987