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Effect of L‐carnitine on liver enzymes and biochemical factors in hepatic encephalopathy: A systematic review and meta‐analysis
Author(s) -
Abbasnezhad Amir,
Choghakhori Razieh,
Kashkooli Sara,
Alipour Meysam,
Asbaghi Omid,
Mohammadi Rasool
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14765
Subject(s) - medicine , carnitine , meta analysis , blood urea nitrogen , albumin , creatinine , cochrane library , gastroenterology , bilirubin , hepatic encephalopathy , randomized controlled trial , endocrinology , cirrhosis
Background and Aims We aimed to investigate the effect of L‐carnitine on biochemical factors including ammonia, bilirubin, albumin, alanine aminotransferase, aspartate aminotransferase (AST), blood urea nitrogen (BUN), and creatinine (Cr) in patients with hepatic encephalopathy (HE). Methods A systematic search was carried out in Web of Science, PubMed, Scopus, and Cochrane Library databases to find articles related to the effect of L‐carnitine supplementation in patients with HE, up to 7 February 2019. There was no language and time limitation. Meta‐analyses were carried out using both the random and fixed effects models where appropriate, and I 2 index was used to evaluate the heterogeneity. Results Search yielded 3462 publications. Nine randomized clinical trials with 779 patients were eligible. L‐carnitine supplementation significantly reduced blood levels of ammonia. Furthermore, our results indicated that L‐carnitine supplementation significantly reduced blood levels of bilirubin, AST, BUN, and Cr in patients with HE. Subgroup analysis demonstrated that L‐carnitine significantly reduced ammonia in patients with all the ages, long and short duration of the supplementation, doses less or higher than 4000 mg/day, any route of treatment (intravenous or oral), and in patients with any grade of the symptoms of HE. Moreover, we found that L‐carnitine significantly increased circulating levels of albumin in HE patients. Conclusions Present systematic review and meta‐analysis revealed that L‐carnitine supplementation significantly reduced blood levels of ammonia, bilirubin, AST, BUN, and Cr in HE patients. Moreover, we found that L‐carnitine significantly increased circulating levels of albumin. However, further large‐scale randomized clinical trials are needed.