The Plasma and Urinary Carnitine System in Korean Diabetic Patients

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.