Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
The Influence of L-Carnitine in the Complex Treatment of Patients with Renal Dysfunction Who Have Synchronous Chronic Coronary Artery Disease and Prostate Adenocarcinoma
Eş Zamanlı Kronik Koroner Arter Hastalığı ve Prostat Adenokarsinoması Olan Renal Disfonksiyonlu Hastaların Kompleks Tedavisinde L-Karnitinin Etkisi
Oksana SIRENKOa, Olexandr KURYATAa
aDepartment of Internal Medicine, Dnipropetrovsk Medical Academy of Health Ministry of Ukraine, Dnipro, UKRAINE
Turkiye Klinikleri J Med Sci. 2019;39(4):381-8
doi: 10.5336/medsci.2019-65452
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of the study is to evaluate the effect of L-Carnitine on the dynamics of inflammation, insulin resistance (IR), functional status of kidneys in the complex therapy of patients with coronary heart disease (CHD) in combination with prostate adenocarcinoma and renal dysfunction. Material and Methods: Forty two men with prostate adenocarcinoma and coronary heart disease were enrolled. The patients were randomly and blindly divided into 2 groups: Group I patients were treated with L-Carnitine in addition to standard treatment; Group II patients received only conventional treatment. Standard laboratory blood tests, lipid profile, glucose, renal and liver function tests, serum C-reactive protein (CRP), insulin, testosterone levels, echocardiographic examination were performed for all patients at baseline and after 10 days of treatment. Results:Median level of HOMA index was 3.1 [1.9; 4.8] mg/ml. Insulin resistance was established in 54.8% patients of Group I and 40% patients of control group (p<0.05). In Group I, the mean insulin index and HOMA index decreased by 15.4% (p=0.001) and 19.2% (p=0.003), respectively. The supplementation of L-Carnitine in standard therapy contributed to a significant decrease in serum creatinine level and an increase in the level of glomerular filtration rate (GFR) in Group I patients (p<0.05). Conclusion: The supplementation of L-Carnitine in the complex therapy of patients with coronary artery disease in combination with prostate adenocarcinoma contributes to a significant decrease in insulin resistance, improves the functional state of kidneys.

Keywords: Insulin resistance; carnitine; coronary disease; prostatic neoplasms
ÖZET
 Amaç: Bu çalışmanın amacı koroner kalp hastalığı (KKH) olan hastalarda prostat adeno karsinomu ve böbrek fonksiyon bozukluğu bulunması durumunda tedavide böbreklerin fonksiyonel durumu, inflamasyon dinamikleri ve insülin direnci (IR) üzerinde L-Karnitinin etkisini değerlendirmektir. Gereç ve Yöntemler: Prostat adenokarsinomu ve koroner kalp hastalığı olan 42 erkek alındı. Hastalar randomize ve kör olarak 2 gruba ayrıldı: Grup I hastaları standart tedaviye ek olarak L-Karnitin ile tedavi edildi; Grup II hastalar sadece geleneksel tedavi aldı. Bütün hastalar için standart laboratuvar kan testleri, lipid profili, glukoz, böbrek ve karaciğer fonksiyon testleri, serum C-reaktif protein (CRP), insülin, testosteron düzeyleri, ekokardiyografik inceleme bazal olarak ve 10 günlük tedavi sonrasında yapıldı. Bulgular: Ortanca HOMA indeksi seviyesi 3,1 [1,9; 4,8] mg/ml. İnsülin rezistansı açılımı Grup I'de %54,8, kontrol grubunda% 40 hastada saptandı (p<0,05). Grup I'de ortanca insülin indeksi ve HOMA indeksi sırasıyla% 15,4 (p=0,001) ve %19,2 (p=0,003) azaldı. L-Karnitinin standart tedaviye eklenmesi, Grup I hastalarında serum kreatinin seviyesinde anlamlı bir düşüşe ve glomerül filtrasyon hızında bir artışa neden oldu (p<0,05). Sonuç: Koroner arter hastalığı olan hastaların prostat adenokarsinomu ile kombinasyon halinde kompleks tedavisinde L-Karnitin takviyesi, insülin direncinde önemli bir düşüşe neden olur, böbreklerin fonksiyonel durumunu iyileştirir.

Anahtar Kelimeler: İnsülin direnci; karnitin; koroner hastalığı; prostatik neoplazmalar
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