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KMID : 0338420220370040757
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The Korean Journal of Internal Medicine
2022 Volume.37 No. 4 p.757 ~ p.767
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Effect of L-carnitine on quality of life in covert hepatic encephalopathy: a randomized, double-blind, placebo-controlled study
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Yoon Eileen L.
Ahn Sang-Bong
Jun Dae-Won
Cho Yong-Kyun
Song Do-Seon
Jeong Jae-Yoon
Kim Hee-Yeon
Jung Young-Kul
Song Myeong-Jun
Kim Sung-Eun
Kim Hyoung-Su
Jeong Soung-Won
Kim Sang-Gyune
Lee Tae-Hee
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Abstract
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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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KEYWORD
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Carnitine, Liver cirrhosis, Hepatic encephalopathy, Randomized controlled trials as topic, Stroop test
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