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Plasma and urine carnitine in children with diabetes mellitus
Insights
Children and adolescents with insulin-dependent diabetes have lower plasma L-carnitine levels. Acylcarnitine is elevated in younger diabetics, correlating with glycosylated hemoglobin, indicating altered fatty acid metabolism in juvenile diabetes.
Area of Science:
- Biochemistry
- Endocrinology
- Pediatrics
Background:
- L-Carnitine plays a crucial role in long-chain fatty acid transport into mitochondria, essential for energy production and ketoacid formation.
- Insulin-dependent diabetes mellitus (juvenile diabetes) is characterized by metabolic dysregulation, potentially affecting carnitine metabolism.
Purpose of the Study:
- To investigate plasma and urinary levels of total, free, and acylcarnitine in children and adolescents with insulin-dependent diabetes.
- To compare carnitine profiles between diabetic subjects and age-matched healthy controls.
- To explore correlations between carnitine derivatives and glycemic control (glycosylated hemoglobin).
Main Methods:
- Quantification of total, free, and acylcarnitine in plasma and urine samples from 52 diabetic and 72 control subjects.
- Subjects were stratified into three age groups: 8-10, 11-15, and 16-20 years.
- Statistical analysis was performed to compare groups and assess correlations.
Main Results:
- Diabetic patients exhibited significantly lower plasma total and free carnitine levels across all age groups compared to controls.
- Acylcarnitine levels were significantly higher in diabetic patients within the two younger age groups (8-15 years).
- A significant positive correlation was observed between glycosylated hemoglobin and the plasma acyl/free carnitine ratio (p < 0.05).
Conclusions:
- Insulin-dependent diabetes in children and adolescents is associated with altered L-carnitine metabolism, characterized by reduced total and free carnitine and increased acylcarnitine, particularly in younger individuals.
- The elevated acyl/free carnitine ratio in diabetics suggests impaired fatty acid oxidation and may serve as a marker related to glycemic control.
Abstract:
L-Carnitine is essential for the transport of long chain fatty acids into mitochondria and, hence, in ketoacid production. Total, free and acylcarnitine in plasma and urine have been determined in 52 children and adolescents with insulin-dependent juvenile diabetes and compared with 72 controls. The subjects were divided into three age groups 8-10, 11-15 and 16-20 years. The plasma, total and free carnitine were significantly lower in diabetic patients than in controls in all age groups. Acylcarnitine was significantly higher in the diabetic patients than in the controls in the two younger age groups. No sex-related differences in plasma carnitine and its derivatives were found in the two younger groups. A statistically significant correlation coefficient was noted between glycosylated hemoglobin and the plasma acyl/free carnitine ratio, 2 p less than 0.05. The daily urinary excretion and renal clearance of carnitine and its derivatives showed few significant differences between the diabetic and the control subjects.