Encouraging results for L-carnitine in metabolic dysfunction-associated steatotic liver disease

L-carnitine supplementation was associated with improvements in markers of metabolic dysfunction-associated steatotic liver disease (MASLD; previously NAFLD) compared with lifestyle advice in a randomised clinical trial.

“MASLD, the hepatic manifestation of the metabolic syndrome, is the leading cause of liver failure and transplantation worldwide,” claimed Dr Pezhman Alavinejad (Ahvaz Jundishapur University of Medical Sciences, Iran) [1]. “The first-line treatment is lifestyle modification and weight loss.”

Dr Alavinejad and his team compared the use of L-carnitine, which plays an important role in lipid metabolism and beta-oxidation of long-chain fatty acids, versus lifestyle modification advice in participants with MASLD. The participants (n=393) were randomly assigned 1:1 to receive either L-carnitine supplementation, 1,000 mg, twice daily, or lifestyle modification advice. Dr Alavinejad discussed the results after 12 weeks of therapy.

The average serum level of alanine transaminase (ALT) had dropped from 65.6 IU/L to 40.9 IU/L in the L-carnitine arm and from 62.8 IU/L to 50.7 IU/L in the control arm, a significant difference in favour of the intervention arm (P=0.0029). Similarly, the average serum level of aspartate aminotransferase (AST) was reduced from 50.9 IU/L to 35.7 IU/L in the L-carnitine group and from 54.7 IU/L to 44.9 IU/L in the control group (P=0.046). “Other metabolic biomarkers such as blood sugar, lipid levels, and BMI did not show differences between the 2 groups after 12 weeks of therapy,” added Dr Alavinejad. Finally, ultrasonic assessments at 12 weeks showed that the rate of participants with grade 4 MASLD was reduced from 37.9% to 12% in the intervention arm, while the control group showed a reduction from 41% to 30% (P<0.05).

“L-carnitine may be effective in the management of MASLD and can improve the biophysical profile of these patients, including liver transaminases and the grade of fatty liver disease,” concluded Dr Alavinejad.

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   1. Alavinejad P, et al. L-carnitine efficacy for management of non-alcoholic fatty liver disease: a multi centric randomized clinical trial. LB20, UEG Week 2024, 12–15 October, Vienna, Austria.

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Posted on 28 November 2024