左卡尼汀干预癌性恶液质能量代谢

L-carnitine intervention in energy metabolism of cancer cachexia patients

目的癌性恶液质患者左旋肉碱水平低下,能量代谢异常,本文探讨左卡尼汀对癌性恶液质能量代谢的影响。方法回顾近年来国内外发表的有关左卡尼汀和癌性恶液质、能量代谢的中英文文献,并进行综合评述。结果左卡尼汀能够纠正恶液质患者脂质代谢紊乱,通过调节下丘脑脂肪酸代谢而改善恶液质者厌食;显著降低蛋白质代谢相关蛋白酶体活性,抑制蛋白质水解,改善患者一般情况,改善乏力;改善胰岛素抵抗,提高胰岛素敏感性。结论左卡尼汀干预癌性恶液质能量代谢值得关注,但尚需大样本研究证据证实,潜在机制也需要进一步深入研究。

Objective As cancer cachexia patients present low level of L-carnitine and abnormal energy metabolism, this study is to evaluate the impact of L-carnitine on energy metabolism of cancer cachexia patients. Methods We collected and analysed the results from the domestic and foreign published literature related to L-carnitine, cancer cachexia and energy metabolism in recent years. Results L-carnitine can ameliorate lipid metabolism disorders in cachexia patients, ameliorate anorexia by adjusting fatty acid metabolism in the hypothalamus;signiifcantly decrease activities of proteasome related with protein metabolism, inhibit proteolysis, improve performance status and fatigue of patients;improve insulin resistance and increase insulin sensitivity. Conclusions The intervention of L-carnitine in cancer cachexia is worth paying attention to, but still need large sample research evidence to conifrm, its underlying mechanisms also need further research.