Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: Effects of acetyl-l-carnitine therapy

Piero Ruggenenti, Dario Cattaneo, Giacomina Loriga, Franca Ledda, Nicola Motterlini, Giulia Gherardi, Silvia Orisio, Giuseppe Remuzzi

Research output: Contribution to journalArticle

Abstract

Insulin resistance, a key component of the metabolic syndrome, is a risk factor for diabetes mellitus and cardiovascular disease. Acetyl-l-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance. In this sequential off-on-off pilot study, we prospectively evaluated the effects of 24-week oral acetyl-l-carnitine (1 g twice daily) therapy on the glucose disposal rate (GDR), assessed by hyperinsulinemic euglycemic clamps, and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori segregated into 2 groups with GDR ≤7.9 (n=16) or >7.9 (n=16) mg/kg per minute, respectively. Baseline GDR and systolic blood pressure were negatively correlated (n=32; P=0.001; r=-0.545), and patients with GDR ≤7.9 mg/kg per minute had higher systolic/diastolic blood pressure than those with higher GDR. Acetyl-l-carnitine increased GDR from 4.89±1.47 to 6.72±3.12 mg/kg per minute (P=0.003, Bonferroni-adjusted) and improved glucose tolerance in patients with GDR ≤7.9 mg/kg per minute, whereas it had no effects in those with higher GDRs. Changes in GDR were significantly different between groups (P=0.017, ANCOVA). Systolic blood pressure decreased from 144.0±13.6 to 135.1±8.4 mm Hg and from 130.8±12.4 to 123.8±10.8 mm Hg in the lower and higher GDR groups, respectively (P

Original languageEnglish
Pages (from-to)567-574
Number of pages8
JournalHypertension
Volume54
Issue number3
DOIs
Publication statusPublished - Sep 1 2009

Keywords

  • Acetyl-L-carnitine
  • Hypertension
  • Insulin resistance
  • Metabolic syndrome

ASJC Scopus subject areas

  • Internal Medicine

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