Serum Carnitine Level and Its Associated Factors in Patients With Chronic Viral Hepatitis

Azin Nassiri; Simin Dashti-Khavidaki; Hossein Khalili*; Mohsen Nassiri-Toosi; Alireza Abdollahi


Future Virology. 2014;9(4):373-383. 

In This Article


Baseline demographic characteristics were statistically similar between the healthy (control) and patients with hepatitis (case) groups. Compared with the control group, serum levels of AST, ALT and ALP were significantly higher and serum level of albumin was lower in the case group. Also, dietary intake of carnitine was significantly lower in patients with hepatitis than the control group (p < 0.001). Demographic characteristics of the case and control groups are summarized in Table 1 .

Mean ± standard deviation of serum carnitine level in the case and control groups were 34.3 ± 15.3 and 55.7 ± 28.4 μmol/l, respectively, which is significantly lower in the case compared with control group (p < 0.001). Regarding carnitine deficiency definition (serum carnitine concentration <40 μmol/l), 64 out of 86 patients (74.4%) and 21 out of 86 (24.5%) healthy individuals, suffered from carnitine deficiency (p < 0.001).

There was no significant difference in age, BMI, serum total cholesterol, LDL, HDL, albumin, hemoglobin, ALT, AST, ALP, bilirubin, creatinine and BUN levels between patients with and without carnitine deficiency. However, carnitine dietary intake (p < 0.001) and prothrombin time (PT; p = 0.04) were significantly lower and serum TG (p = 0.002) was significantly higher in carnitine-deficient compared with nondeficient patients ( Table 2 ).

A total of 43 out of 86 patients, had chronic hepatitis C infection (50%) and 42 patients suffered from chronic hepatitis B infection (48.8%). Serum carnitine level was significantly lower (p = 0.03) in patients with chronic hepatitis B infection than patients with chronic hepatitis C infection (18.39 ± 15.68 vs 42.30 ± 32.92 μmol/l).

Twenty two out of 86 patients had cirrhosis based on the liver biopsy findings. Serum carnitine level (41.1 ± 14.8 μmol/l) was significantly higher in the cirrhotic than noncirrhotic patients (31.6 ± 13.2; p = 0.04).

Reverse but nonsignificant correlations were found between patients' serum carnitine level and BMI, serum total cholesterol, LDL, HDL, TG, albumin, hemoglobin, ALT and AST, and duration of therapy ( Table 3 ).

On the other hand, positive but nonsignificant correlations were detected between patients' serum carnitine concentration and age (p = 0.13), PT (p = 0.16), ALP (p = 0.55), total bilirubin (p = 0.11), BUN (p = 0.52) and serum creatinine (p = 0.42). Only carnitine dietary intake showed positive significant correlation with serum carnitine level (r = 0.79; p <0.001) ( Table 4 ).

No correlation between patients' serum carnitine level and BMI category (p = 0.87), route of infection transmission (p = 0.38) and type of treatment regimen (p = 0.92) was detected.