L-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with Simvastatin Monotherapy: A Randomized Double-Blind Placebo-Controlled Study

Lipids. 2017 Jan;52(1):1-9. doi: 10.1007/s11745-016-4216-z. Epub 2016 Dec 2.

Abstract

Lipoprotein (a) [Lp(a)] is an independent risk factor for cardiovascular disease. There are currently limited therapeutic options to lower Lp(a) levels. L-Carnitine has been reported to reduce Lp(a) levels. The aim of this study was to compare the effect of L-carnitine/simvastatin co-administration with that of simvastatin monotherapy on Lp(a) levels in subjects with mixed hyperlipidemia and elevated Lp(a) concentration. Subjects with levels of low-density lipoprotein cholesterol (LDL-C) >160 mg/dL, triacylglycerol (TAG) >150 mg/dL and Lp(a) >20 mg/dL were included in this study. Subjects were randomly allocated to receive L-carnitine 2 g/day plus simvastatin 20 mg/day (N = 29) or placebo plus simvastatin 20 mg/day (N = 29) for a total of 12 weeks. Lp(a) was significantly reduced in the L-carnitine/simvastatin group [-19.4%, from 52 (20-171) to 42 (15-102) mg/dL; p = 0.01], but not in the placebo/simvastatin group [-6.7%, from 56 (26-108) to 52 (27-93) mg/dL, p = NS versus baseline and p = 0.016 for the comparison between groups]. Similar significant reductions in total cholesterol, LDL-C, apolipoprotein (apo) B and TAG were observed in both groups. Co-administration of L-carnitine with simvastatin was associated with a significant, albeit modest, reduction in Lp(a) compared with simvastatin monotherapy in subjects with mixed hyperlipidemia and elevated baseline Lp(a) levels.

Keywords: L-Carnitine; Lipoprotein (a); Simvastatin; Triglycerides.

Publication types

  • Clinical Trial, Phase III
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Apolipoprotein B-100 / metabolism
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / prevention & control*
  • Carnitine / administration & dosage*
  • Carnitine / pharmacology
  • Cholesterol / blood
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hyperlipoproteinemia Type V / drug therapy*
  • Hyperlipoproteinemia Type V / metabolism
  • Lipoprotein(a) / metabolism*
  • Male
  • Middle Aged
  • Prospective Studies
  • Simvastatin / administration & dosage*
  • Simvastatin / pharmacology
  • Treatment Outcome
  • Triglycerides / metabolism
  • Young Adult

Substances

  • APOB protein, human
  • Apolipoprotein B-100
  • Lipoprotein(a)
  • Triglycerides
  • Cholesterol
  • Simvastatin
  • Carnitine