Abstract:
Chronic diseases often have a relapsing and remitting course with substantial impact on function and quality of life (QL). For chronic illnesses where there is no cure, it is important to recognize that therapy really makes people feel better. Thus, survival per se is no longer perceived to be the only end point; the goal is to improve, restore, or preserve QL.
Quality of life and supportive care are complementary concepts in the care of cancer patients. Nutritional support is a critical component of supportive care. However, both palliative and curative treatment of cancer should be accompanied by specific and patient-tailored nutritional intervention aiming at improving performance status and QL. Among the oral nutritional supplements, L-carnitine with its nutritional, antioxidant, antimyopathic effects is one of the most promising. Several studies, carried out in cancer patients as well as in other chronic illnesses, demonstrated the ability of L-carnitine supplementation to in ameliorating QL, particularly fatigue, and other symptoms, such as weight loss, pain, neuropathy and chemotherapy side effects, which in turn influence patient’s QL. In detail a recently published study of our group demonstrated the ability of L-carnitine oral supplementation (6g/day for 4 weeks) to induce increase of LBM, amelioration of fatigue and appetite. Several authors, in accordance to our results, showed that L-carnitine supplemented to cancer patients with fatigue and carnitine deficiency was able to ameliorate fatigue, sleep disorders and mood. Beside cancer patients, L-carnitine supplementation demonstrated to be able to improve quality of life in hemodialized patients and to ameliorate fatigue in celiac disease and multiple sclerosis patients as well as in elderly subjects. More clinical trials, however, are needed to identify those patients and diseases that may derive the greatest benefit from the supplementation with this agent. Indeed, while several studies have examined the role of L-carnitine supplementation in different comorbid conditions, very few have assessed its effect on QL.
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Abbreviations
- AIDS:
-
acquired immune deficiency syndrome
- BDI:
-
beck depression inventory
- CACS:
- CoA:
-
coenzyme A
- COPD:
-
chronic obstructive pulmonary disease
- CPT:
-
carnitine palmitoyltransferase
- CRF:
-
chronic renal failure
- CRP:
-
C-reactive protein
- EORTC-QLQ-C30:
-
European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire
- ESRD:
-
end-stage renal disease
- IL:
-
interleukin
- LBM:
-
lean body mass
- MFSI-SF:
-
multidimensional fatigue symptom inventory-short form
- MMSE:
-
mini-mental state examination
- MPA:
-
medroxyprogesterone acetate
- OS:
- QL:
-
quality of life
- ROS:
-
reactive oxygen species
- SF-36:
-
medical outcome study 36-item short form
- TNF:
-
tumor necrosis factor
- VAS:
-
visual analogue scales
- WHO:
-
World Health Organization
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Appendix 1
Appendix 1
1.1 Most commonly used QL questionnaires and related scoring system
1.2 Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF)
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Mantovani, G., Macciò, A., Madeddu, C., Gramignano, G. (2010). L-Carnitine Supplementation on Quality of Life and Other Health Measures. In: Preedy, V.R., Watson, R.R. (eds) Handbook of Disease Burdens and Quality of Life Measures. Springer, New York, NY. https://doi.org/10.1007/978-0-387-78665-0_120
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