Carnitine Helps Reduce Diabetes During Pregnancy

Taking L-Carnitine tartrate (Carnipure) supplements during pregnancy significantly reduce the increased level of plasma free fatty acids that is considered the main cause of insulin resistance in pregnant women, shows a new study.

Insulin resistance during pregnancy can lead to gestational diabetes, which affects about 5-10 percent of pregnancies. According to the American Diabetes Association, about a third of women who suffered from gestational diabetes during pregnancy develop type 2 diabetes in the following years.

Blood levels of the vitamin-like substance L-carnitine are already significantly reduced by the 12th week of pregnancy, and are reduced further before birth. Researchers at the University of Vienna found that lower L-Carnitine plasma levels lead to a down-regulation of the expression of certain enzymes involved in fatty acid metabolism, namely CPT1, CPT2 and CRAT. When the relative mRNA abundances of these enzymes are low, however, the plasma levels of free fatty acids increase.

In the study, published in the August 2005 issue of Chemical Monthly, taking a daily supplement of 2g of L-Carnitine was found to increase the relative mRNA levels of these enzymes in pregnant women.

In three separate trials, more than 80 women in the 20th week of pregnancy took a L-carnitine supplement in different doses until giving birth. Only the 2g dose of L-Carnipure tartrate, which consists of 68 percent L-Carnitine and 32 percent L-tartaric acid, had an impact on the fatty acid enzymes.

Lonza says there is increasing evidence that L-Carnitine may play an important role during pregnancy, particularly in women following a meat-reduced or vegetarian diet. These women may have a daily L-Carnitine intake that is too low to meet the increased needs during pregnancy.

Summary. By the 12th week of gestation, mean whole blood and plasma carnitine levels are already significantly (p<0.01) lower than those of controls, with a further significant (p<0.01) decrease up to parturition. Diminished carnitine levels may cause a downregulation of carnitine palmitoyltransferase1 (CPT1), both the liver isoform (CPT1A) and muscle isoform (CPT1B), carnitine palmitoyltransferase2 (CPT2), and carnitine acetyltransferase (CRAT) in white blood cells of pregnant women, as determined by real time PCR using the LightCyclerSYBR Green technology.

L-Carnitine-L-tartrate supplementation of 2 g/d resulted in an up to 10-fold increase of the relative mRNA abundances of CPT1B, CPT2, and OCTN2 and a 5-fold increase of CPT1A, and CRAT. There is a relationship between the relative mRNA levels of CPT1A and CPT1B and the FFA plasma levels. The substitution of 2 g L-carnitine-L-tartrate/d resulted in significant (p<0.001) lower FFA levels compared to untreated controls and the groups substituted with 0.5 and 1 g L-carnitine/d although plasma carnitine levels were not significantly increased. The most substantial effect was the reduced portion of acylcarnitines on total carnitine in those women receiving 2 g L-carnitine-L-tartrate.
Carnitine substitution resulted in an enhanced excretion of both, free carnitine and acylcarnitines, whereas acetylcarnitine accounts for 50–65% of total acylcarnitines.
The results of the present study provide evidence that L-carnitine supplementation in pregnancy in sufficient doses avoids a striking increase of plasma FFAs, which are thought to be the main cause of insulin resistance and consequently gestational diabetes mellitus (GDM).

Source

Alfred Lohninger, H. Karlic, S. Lohninger, A. Tammaa, S. Jinniate, Hermann Mascher, Daniel Mascher and H. Salzer. Carnitine in Pregnancy; Chemical Monthly; 2005 Aug; vol 136, pp1523-1533.

Key concepts: carnitine, gestational diabetes, pregnancy