Effects of Acetyl L-Carnitine Supplementation on Clinical, Metabolic and Inflammatory Symptoms in Obese, Diabetic, Postmenopausal Women With Osteoarthritis: Randomized Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Change in C-Reactive Protein (CRP)
Study Overview
Brief Summary
OA is a degenerative bone disease more common in postmenopausal women. Diabetes and obesity are common risk factors for the development of OA. The common symptoms include pain and disability of the affected joint, leading to mobility issues. Acetyl L-carnitine due to its known anti-inflammatory, chondroprotective, and improved insulin-sensitizing effects may help in alleviating the symptoms and progression of OA in obese diabetic postmenopausal women.
Detailed Description
Osteoarthritis (OA) is a chronic degenerative joint disease that commonly affects older adults and is associated with pain, stiffness, reduced mobility, and disability. The coexistence of obesity and type 2 diabetes mellitus may aggravate the progression and severity of OA through metabolic dysfunction, chronic low-grade inflammation, oxidative stress, and altered adipokine profiles. Postmenopausal women are particularly vulnerable because hormonal changes contribute to increased inflammation, obesity, insulin resistance, and joint degeneration.
Acetyl L-Carnitine is a naturally occurring compound involved in mitochondrial energy metabolism. Previous studies have demonstrated anti-inflammatory, antioxidant, and metabolic benefits of Acetyl L-Carnitine, including improvements in insulin resistance, lipid metabolism, oxidative stress, and inflammatory cytokine production. Experimental studies have also suggested chondroprotective effects through enhancement of cartilage matrix synthesis and mitochondrial function.
This double-blind, placebo-controlled randomized clinical trial will enroll 100 obese, diabetic, postmenopausal women with radiologically confirmed osteoarthritis. Participants will be randomly assigned to receive either Acetyl L-Carnitine (1.5 g twice daily) or placebo for 12 weeks in addition to conventional osteoarthritis treatment.
Clinical outcomes will include assessment of osteoarthritis symptoms using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), radiological severity using the Kellgren-Lawrence grading system, perceived stress, and depression, anxiety and stress scores. Laboratory outcomes will include glycemic profile, lipid profile, insulin resistance markers, inflammatory biomarkers (CRP and IL-6), oxidative stress markers, adipokines, stress hormones, and complete blood count parameters.
The study seeks to determine whether Acetyl L-Carnitine supplementation can improve clinical, metabolic, inflammatory, and radiological outcomes in obese, diabetic, postmenopausal women with osteoarthritis.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Care Provider, Investigator)
Masking Description
This is a double-blind placebo-controlled trial. Participants will receive either Acetyl L-Carnitine or placebo. Investigators, healthcare providers, participants, and outcome assessors will remain unaware of treatment allocation throughout the study.
Eligibility Criteria
- Ages
- 55 Years to 65 Years (Adult, Older Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Age 55-65 years
- •Duration of menopause 2-15 years.
- •Duration of diabetes 5-15 years
- •BMI Obese ≥30 kg/m2
- •Grade≥2 K&L on radiologic examination
Exclusion Criteria
- •Female patients with osteoarthritis meeting the following criteria will be excluded from the study;
- •Age˂55 ˃65yrs
- •Post-menopausal duration of ˂2yrs
- •Duration of diabetes ˂ 5years
- •Patients with alcohol abuse, asthma, cardiac disease, chronic gastric problems (malabsorption, crohn's disease chronic diarrhea), non-diabetes related renal disease,ovariectomy, rheumatoid arthritis or other rheumatic inflammatory diseases, smoking
- •Patients taking steroids (oral/ injections)
- •Patients with a history of parathyroid and thyroid surgery/dysfunction
Arms & Interventions
Acetyl L-Carnitine Group
Participants will receive conventional treatment for osteoarthritis, including NSAIDs, COX-2 inhibitors, or acetaminophen as prescribed, together with Acetyl L-Carnitine capsules 1.5 g orally twice daily (total daily dose 3 g) after meals for 12 weeks. Participants will continue their usual oral antihyperglycemic medications but will not receive insulin.
Intervention: Acetyl-l-carnitine (Drug)
Placebo Control Group
Participants will receive matching placebo capsules administered orally at a dose of two capsules daily after meals for 12 weeks, in addition to conventional osteoarthritis treatment, including NSAIDs, COX-2 inhibitors, or acetaminophen as prescribed.
Intervention: Placebo (Drug)
Outcomes
Primary Outcomes
Change in C-Reactive Protein (CRP)
Time Frame: Baseline and Week 12
Change in serum CRP concentration from baseline following 12 weeks of Acetyl L-Carnitine supplementation.
Change in Fasting Blood Glucose
Time Frame: Baseline and Week 12
Change in fasting blood glucose levels from baseline following 12 weeks of intervention.
Change in Glycated Hemoglobin (HbA1c)
Time Frame: Baseline and Week 12
Change in HbA1c levels from baseline following 12 weeks of intervention.
Change in Insulin Resistance (HOMA-IR)
Time Frame: Baseline and Week 12
Change in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) from baseline following 12 weeks of intervention.
Change in Serum Insulin
Time Frame: Baseline and Week 12
Change in fasting serum insulin concentration from baseline following 12 weeks of intervention.
Change in Serum Leptin
Time Frame: Baseline and Week 12
Change in serum leptin concentration from baseline following 12 weeks of intervention.
Change in Serum Adiponectin
Time Frame: Baseline and Week 12
Change in serum adiponectin concentration from baseline following 12 weeks of intervention.
Change in Adrenocorticotropic Hormone (ACTH)
Time Frame: Baseline and Week 12
Change in serum ACTH concentration from baseline following 12 weeks of intervention
Change in Malondialdehyde (MDA)
Time Frame: Baseline and Week 12
Change in serum malondialdehyde levels as a marker of oxidative stress from baseline following 12 weeks of intervention.
Change in Advanced Glycation End Products (AGEs)
Time Frame: Baseline and Week 12
Change in serum AGEs levels from baseline following 12 weeks of intervention.
Change in WOMAC Osteoarthritis Score
Time Frame: Baseline and Week 12
Change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score from baseline following 12 weeks of intervention.
Change in Kellgren-Lawrence Radiographic Grade
Time Frame: Baseline and Week 12
Change in osteoarthritis radiographic severity assessed by the Kellgren-Lawrence grading system from baseline following 12 weeks of intervention.
Serum C-Reactive Protein Concentration
Time Frame: Baseline and Week 12
Change in Serum C-Reactive Protein (CRP) Concentration (mg/L) from baseline following 12 weeks of Acetyl L-Carnitine supplementation.
Fasting Blood Glucose Concentration
Time Frame: Baseline and Week 12
Change in fasting blood glucose levels (mg/dL) from baseline following 12 weeks of intervention.
Glycated Hemoglobin (HbA1c) Percentage
Time Frame: Baseline and Week 12
Change in HbA1c levels (%) from baseline following 12 weeks of intervention.
Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)
Time Frame: Baseline and Week 12
Change in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) Score from baseline following 12 weeks of intervention.
Fasting Serum Insulin Concentration
Time Frame: Baseline and Week 12
Change in fasting serum insulin concentration (µIU/mL) from baseline following 12 weeks of intervention.
Serum Leptin Concentration
Time Frame: Baseline and Week 12
Change in serum leptin concentration (ng/mL) from baseline following 12 weeks of intervention.
Serum Adiponectin Concentration
Time Frame: Baseline and Week 12
Change in serum adiponectin concentration (µg/mL) from baseline following 12 weeks of intervention.
Serum Adrenocorticotropic Hormone (ACTH) Concentration
Time Frame: Baseline and Week 12
Change in serum ACTH concentration from baseline following 12 weeks of intervention
Serum Malondialdehyde (MDA) Concentration
Time Frame: Baseline and Week 12
Change in serum malondialdehyde levels as a marker of oxidative stress from baseline following 12 weeks of intervention.
Serum Advanced Glycation End Products (AGEs) Concentration
Time Frame: Baseline and Week 12
Change in serum AGEs levels from baseline following 12 weeks of intervention.
WOMAC Osteoarthritis Index total Score
Time Frame: Baseline and Week 12
Change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score from baseline following 12 weeks of intervention.
Kellgren-Lawrence Radiographic Grade
Time Frame: Baseline and Week 12
Change in osteoarthritis radiographic severity assessed by the Kellgren-Lawrence grading system from baseline following 12 weeks of intervention.
Secondary Outcomes
- Change in Interleukin-6 (IL-6)(Baseline and Week 12)
- Interleukin-6 (IL-6)(Baseline and Week 12)
