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Randomised controlled trial of L-carnitine as a nutritional supplement in preterm infants
G J Shortland1, J H Walter, C Stroud
1Department of Child Health, University Hospital of Wales, Heath Park, Cardiff.
Insights
L-carnitine supplementation did not improve growth or reduce hypoglycemia in preterm infants. This study found no significant benefits in weight, length, or blood sugar control for infants receiving L-carnitine.
Area of Science:
- Neonatal nutrition
- Pediatric endocrinology
- Nutritional biochemistry
Background:
- Preterm infants often have altered carnitine metabolism.
- Carnitine plays a vital role in energy metabolism.
- Supplementation is explored to support growth and prevent metabolic disturbances.
Purpose of the Study:
- To assess the impact of L-carnitine supplementation on preterm infant growth.
- To determine if L-carnitine reduces the incidence of hypoglycemia in preterm infants.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 86 preterm infants (28-34 weeks gestational age).
- Infants received either L-carnitine (25 mg/kg/d) or a placebo.
- Growth parameters (weight, length, head circumference) and hypoglycemia episodes were monitored.
Main Results:
- L-carnitine supplementation significantly increased carnitine concentrations in blood and urine.
- No significant differences were observed in growth rates between the L-carnitine and placebo groups.
- The incidence of hypoglycemia episodes did not differ between the supplemented and placebo groups.
Conclusions:
- L-carnitine supplementation at 25 mg/kg/day did not enhance growth in preterm infants.
- This dosage of L-carnitine did not provide protection against hypoglycemia in the study population.
Aims:
To evaluate the effect of L-carnitine supplementation (25 mg/kg/d) on the growth and incidence of hypoglycaemia in preterm infants.
Methods:
A double blind, placebo controlled randomised trial, stratified for gestational age, was conducted of 86 preterm infants between 28 and 34 gestational weeks. The median gestational ages in the carnitine group and placebo groups were 30.7 weeks (range 28.0 to 33.6) and 31.4 weeks (range 28.0 to 33.9), respectively. The median birthweights were 1.557 kg (range 0.944 to 2.275) and 1.645 kg (range 0.885 to 2.545), respectively.
Results:
Mean plasma free carnitine concentrations were below values for normal term infants in both groups on day 1 (carnitine group 44.8 mumol/l, placebo group 25.5 mumol/l) in the placebo group on day 7 (50.7 mumol/l), but in neither group on days 14 and 28. Total, free, and acylcarnitine concentrations were significantly increased in both urine and blood in the L-carnitine group. There was no significant difference between the placebo and carnitine supplemented groups in growth rate, as assessed by weight, length, skinfold thickness and head circumference measurements, or in the incidence of episodes of hypoglycaemia.
Conclusion:
The addition of carnitine as a nutritional supplement at a dose of 25 mg/kg/day did not improve growth in our group of preterm infants nor protect them from episodes of hypoglycaemia.