Effect Of L-carnitine On Serum Lipids In Elderly Hemodialysis Patients

Objective : To investigate the effect of L-Carnitine on serum lipids in elderly hemodialysis patients and whether L-Carnitine has a certain time effect on the improvement of serum lipids in elderly hemodialysis patients.Methods:Sixty patients aged 60-78 years(68.83±5.34)with dialysis age of at least one year were selected to divided into control group and observation group,each group have30 patients.They all received regular hemodialysis from January 2018 to December 2018 in the hemodialysis room of our hospital.There was no significant difference between the two groups in baseline data(P > 0.05),indicating comparability.The control group was given routine hemodialysis,twice a week,each time for 4h.The observation group was given routine hemodialysis,twice a week,each time for 4h,and intravenous injection of1 g levocarnitine(diluted to 10 ml with normal saline)was given after each routine hemodialysis.Patients in both groups did not use statins during the treatment process,and continued to receive treatment for the original underlying disease.Both groups were treated continuously and followed up for 6 months.The changes of total cholesterol,triglyceride,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the two groups were compared before,3 months and 6 months after dialysis.We use SPSS 22.0 statistical software to analysis the datas.We use mean ± standard deviation(x±s)to analysis the Measurement data,difference between groups was compared by T test,counting data was expressed as number of cases and percentage(%),and comparison between groups was performed by c2 test.Repeated measurement data were analyzed by ANOVA.P < 0.05 was considered statistically significant.Results:1.Before,3 months and 6 months after dialysis,the total cholesterol levels in the observation group were(4.60±1.70 mmol/L,4.14±1.13 mmol/L,4.74±0.80 mmol/L),and those in the control group were(4.62±1.75 mmol/L,4.57±1.40 mmol/L,4.64±1.59mmol/L),respectively.There was no significant difference in total cholesterol level between the two groups at three time points(t=0.064,0.098,0.094,all P > 0.05).Before,3months and 6 months after dialysis,the LDL cholesterol levels in the observation group were(2.50±0.99 mmol/L,2.36±0.88 mmol/L,2.72±0.53 mmol/L),and those in the control group were(2.42±0.97 mmol/L,2.32±0.87 mmol/L,2.35±0.73 mmol/L),respectively.There was no significant difference in LDL cholesterol levels between the two groups at three time points(t=0.348,0.374,0.339,all P > 0.05).Before,3 months and6 months after dialysis,the triglyceride levels in the observation group were(1.93±0.46mmol/L,1.43±0.48 mmol/L,1.05±0.43 mmol/L),and those in the control group were(1.84±0.39 mmol/L,1.73±0.63 mmol/L,1.71±0.40 mmol/L),respectively.,There was no statistically significant difference in the triglyceride level before dialysis between the two groups(t=0.773,P > 0.05),but there was statistically significant difference in the triglyceride level after 3 and 6 months of dialysis between the two groups(t=2.061,4.397,both P < 0.05).Before,3 months and 6 months after dialysis,the HDL cholesterol in the observation group was(0.94±0.20 mmol/L,1.30±0.32 mmol/L,1.56±0.42 mmol/L),and the HDL cholesterol in the control group was(0.91±0.35 mmol/L,0.96±0.26 mmol/L,1.25±0.36 mmol/L),respectively.There was no statistically significant difference in HDL cholesterol level between the two groups before dialysis(t=0.370,P > 0.05).There was statistically significant difference in HDL cholesterol level between the two groups after dialysis for 3 months and 6 months(t=4.476,2.984,both P < 0.05).2.The triglyceride level of observation group before dialysis,3 months after dialysis and6 months after dialysis were(1.93±0.46 mmol/L,1.43±0.48 mmol/L,1.05±0.43 mmol/L),respectively.The results showed that the triglyceride level after dialysis was lower than that before dialysis,with statistical significance(F=42.457,P < 0.001).The levels of triglyceride in control group were(1.84±0.39 mmol/L,1.73±0.63 mmol/L,1.71±0.40mmol/L)before,3 and 6 months after dialysis,respectively,and there was no significant difference in the levels of triglyceride before and after dialysis(F=1.148,P > 0.05).At each time point,the triglyceride level in the observation group was lower than that in the control group after 3 months and 6 months of dialysis,with statistical difference(P <0.05).There was an interaction between before and after dialysis and whether or not to use levocarnitine on dialysis(F=14.755,P < 0.001).3.There were significant differences in HDL cholesterol levels at different time points before and after dialysis(F=60.914,P < 0.001).HDL-C levels in the observation group were(0.94±0.20 mmol/L,1.30±0.32 mmol/L,1.56±0.42 mmol/L)before dialysis,3months and 6 months after dialysis,and those in the control group were(0.91±0.35mmol/L,0.96±0.26 mmol/L,1.25±0.36 mmol/L,respectively.The HDL-C level in the observation group was significantly higher than that in the control group at each time point(F=10.832,P=0.002),and the difference was statistically significant.Comparedwith the control group,the level of high-density lipoprotein cholesterol in observatigroup increased 3 months and 6 months after dialysis,and the difference was statisticasignificant(P<0.05).There was an interaction between before and after dialysis awhether or not to use levocarnitine on dialysis(F=7.648,P=0.001).Conclusion:L-carnitine can significantly increase the level of high-density lipoprotein cholesterol and reduce the level of triglyceride in elderly maintenance hemodialysis patients,and there is a time effect,but has no significant impact on the total cholesterol and low-density lipoprotein cholesterol levels.