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Effect of L-carnitine on quality of life in covert hepatic encephalopathy: a randomized, double-blind, placebo-controlled studyopen access

Authors
Yoon, Eileen L.Ahn, Sang BongJun, Dae WonCho, Yong KyunSong, Do SeonJeong, Jae YoonKim, Hee YeonJung, Young KulSong, Myeong JunKim, Sung EunKim, Hyoung SuJeong, Soung WonKim, Sang GyuneLee, Tae Hee
Issue Date
Jul-2022
Publisher
대한내과학회
Keywords
Carnitine; Liver cirrhosis; Hepatic encephalopathy; Randomized controlled trials as topic; Stroop test
Citation
The Korean Journal of Internal Medicine, v.37, no.4, pp.757 - 767
Indexed
SCIE
SCOPUS
KCI
Journal Title
The Korean Journal of Internal Medicine
Volume
37
Number
4
Start Page
757
End Page
767
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61039
DOI
10.3904/kjim.2021.338
ISSN
1226-3303
Abstract
Background/Aims L-carnitine is potentially beneficial in patients with hepatic encephalopathy (HE). We aimed to evaluate the impact of L-carnitine on the quality of life and liver function in patients with liver cirrhosis and covert HE. Methods We conducted an investigator-initiated, prospective, multi-center, double-blind, randomized phase III trial in patients with covert HE. A total of 150 patients were randomized 1:1 to L-carnitine (2 g/day) or placebo for 24 weeks. Changes in quality of life and liver function were assessed at 6 months. The model for end-stage liver disease (MELD), the 36-Item Short Form Survey (SF-36), the psychometric hepatic encephalopathy score (PHES), and the Stroop Test were evaluated in all patients. Results The total SF-36 score significantly improved in the L-carnitine group after 24 weeks (difference: median, 2; interquartile range, 0 to 11; p < 0.001); however, these values were comparable between the two groups. Furthermore, there was a significant ordinal improvement in PHES scores among patients with minimal HE who were in the L-carnitine group (p = 0.007). Changes in the total carnitine level also positively correlated with improvements in the Stroop test in the L-carnitine group (color test, r = 0.3; word test, r = 0.4; inhibition test, r = 0.5; inhibition/switching test, r = 0.3; all p < 0.05). Nevertheless, the MELD scores at week 24 did not differ between the groups. Conclusions Twenty-four weeks of L-carnitine supplementation was safe but ineffective in improving quality of life and liver function.
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Jung, Young Kul
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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