Modulatory Effects of Multi-species/Multi-strain Synbiotic and L-carnitine Concomitant Supplementation on Atherogenic-Indices, Body Composition, Visceral Obesity, and Appetite in Metabolically Healthy Women with Obesity: A Double-Blind Randomized...

Overview

Journal Probiotics Antimicrob Proteins

Publisher Springer

Date 2025 Feb 8

PMID 39921845

Authors

Farnoush Fallah

Reza Mahdavi

Affiliations

Soon will be listed here.

Abstract

Obesity, a chronic disease with pandemic proportions, is recognized as a major risk factor for cardiometabolic disorders due to its association with atherogenic dyslipidemia, a common characteristic attributed to visceral adiposity in patients with obesity. Atherogenic and visceral-obesity indices have been conceded as surrogate cardiovascular diseases (CVD) indicators surpassing the conventional markers due to stronger predictive power for obesity-induced cardiometabolic risk and CVD mortality rate. Nutraceuticals have been suggested as emerging approaches to counteract obesity-associated cardiometabolic disorders. Considering the evidence addressing the ameliorating effects of either L-carnitine or biotics on metabolic indices, also the reports addressing higher efficacy of concomitant supplementation versus single-therapies, this clinical trial was conducted to assess the effects of L-carnitine + multi-species/multi-strain synbiotic combined supplementation compared to L-carnitine mono-therapy on atherogenic-indices, body composition, visceral obesity, and appetite sensations in 46 metabolically healthy women with obesity, randomly assigned to co-supplementation (L-carnitine-tartrate (2 × 500 mg/dl) + synbiotic (one capsule/day)) or mono-therapy (L-carnitine-tartrate (2 × 500 mg/dl) + maltodextrin (one capsule/day)) groups for 8 weeks. L-carnitine + synbiotic co-supplementation led to a significantly greater reduction in atherogenic-indices including atherogenic-index-of-plasma (AIP), Castelli's-risk-index-I (CRI-I), Castelli's-risk-index-II (CRI-II), atherogenic-coefficient (AC), lipoprotein-combine index (LCI), systolic blood pressure (SBP), fat-mass (FM) weight/percent, visceral-adiposity index (VAI), waste-to-height ratio (WHtR), body-adiposity index (BAI), and appetite sensation scores compared to L-carnitine mono-therapy. L-carnitine + synbiotic combined supplementation was more efficient in improving atherogenic-indices as cardiovascular risk markers, body composition, visceral obesity, and appetite sensations in metabolically healthy women with obesity. Therefore, simultaneous supplementation of L-carnitine + synbiotic might be considered a promising approach to ameliorate cardiometabolic risk factors in healthy individuals with obesity. Further longer period studies are required to confirm these findings. (Iranian Registry of Clinical Trials (IRCT; https://irct.behdasht.gov.ir/trial/28048 ).

References

Bluher M . Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019; 15(5):288-298. DOI: 10.1038/s41574-019-0176-8. View

Valenzuela P, Carrera-Bastos P, Castillo-Garcia A, Lieberman D, Santos-Lozano A, Lucia A . Obesity and the risk of cardiometabolic diseases. Nat Rev Cardiol. 2023; 20(7):475-494. DOI: 10.1038/s41569-023-00847-5. View

Bamba V, Rader D . Obesity and atherogenic dyslipidemia. Gastroenterology. 2007; 132(6):2181-90. DOI: 10.1053/j.gastro.2007.03.056. View

Tchernof A, Despres J . Pathophysiology of human visceral obesity: an update. Physiol Rev. 2013; 93(1):359-404. DOI: 10.1152/physrev.00033.2011. View

Millan J, Pinto X, Munoz A, Zuniga M, Rubies-Prat J, Pallardo L . Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag. 2009; 5:757-65. PMC: 2747394. View

Li Y, Feng Y, Li S, Ma Y, Lin J, Wan J . The atherogenic index of plasma (AIP) is a predictor for the severity of coronary artery disease. Front Cardiovasc Med. 2023; 10:1140215. PMC: 10333749. DOI: 10.3389/fcvm.2023.1140215. View

Ashwell M, Gunn P, Gibson S . Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2011; 13(3):275-86. DOI: 10.1111/j.1467-789X.2011.00952.x. View

Bosy-Westphal A, Muller M . Diagnosis of obesity based on body composition-associated health risks-Time for a change in paradigm. Obes Rev. 2021; 22 Suppl 2:e13190. DOI: 10.1111/obr.13190. View

Bray G . Medical consequences of obesity. J Clin Endocrinol Metab. 2004; 89(6):2583-9. DOI: 10.1210/jc.2004-0535. View

10.

Feng Q, Besevic J, Conroy M, Omiyale W, Woodward M, Lacey B . Waist-to-height ratio and body fat percentage as risk factors for ischemic cardiovascular disease: a prospective cohort study from UK Biobank. Am J Clin Nutr. 2024; 119(6):1386-1396. PMC: 11196863. DOI: 10.1016/j.ajcnut.2024.03.018. View

11.

Amato M, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M . Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010; 33(4):920-2. PMC: 2845052. DOI: 10.2337/dc09-1825. View

12.

Bergman R, Stefanovski D, Buchanan T, Sumner A, Reynolds J, Sebring N . A better index of body adiposity. Obesity (Silver Spring). 2011; 19(5):1083-9. PMC: 3275633. DOI: 10.1038/oby.2011.38. View

13.

Bray G, Kim K, Wilding J . Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017; 18(7):715-723. DOI: 10.1111/obr.12551. View

14.

Xia Y, Kelton C, Guo J, Bian B, Heaton P . Treatment of obesity: Pharmacotherapy trends in the United States from 1999 to 2010. Obesity (Silver Spring). 2015; 23(8):1721-8. DOI: 10.1002/oby.21136. View

15.

Kushner R . Weight loss strategies for treatment of obesity. Prog Cardiovasc Dis. 2014; 56(4):465-72. DOI: 10.1016/j.pcad.2013.09.005. View

16.

Saper R, Eisenberg D, Phillips R . Common dietary supplements for weight loss. Am Fam Physician. 2004; 70(9):1731-8. View

17.

Fallah F, Mahdavi R . Ameliorating effects of L-carnitine and synbiotic co-supplementation on anthropometric measures and cardiometabolic traits in women with obesity: a randomized controlled clinical trial. Front Endocrinol (Lausanne). 2023; 14:1237882. PMC: 10622781. DOI: 10.3389/fendo.2023.1237882. View

18.

Askarpour M, Hadi A, Symonds M, Miraghajani M, Sadeghi O, Sheikhi A . Efficacy of l-carnitine supplementation for management of blood lipids: A systematic review and dose-response meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2019; 29(11):1151-1167. DOI: 10.1016/j.numecd.2019.07.012. View

19.

Talenezhad N, Mohammadi M, Ramezani-Jolfaie N, Mozaffari-Khosravi H, Salehi-Abargouei A . Effects of l-carnitine supplementation on weight loss and body composition: A systematic review and meta-analysis of 37 randomized controlled clinical trials with dose-response analysis. Clin Nutr ESPEN. 2020; 37:9-23. DOI: 10.1016/j.clnesp.2020.03.008. View

20.

Askarpour M, Hadi A, Miraghajani M, Symonds M, Sheikhi A, Ghaedi E . Beneficial effects of l-carnitine supplementation for weight management in overweight and obese adults: An updated systematic review and dose-response meta-analysis of randomized controlled trials. Pharmacol Res. 2019; 151:104554. DOI: 10.1016/j.phrs.2019.104554. View