| 特集名 | 透析とカルニチン | |
|---|---|---|
| 題名 | カルニチンと筋肉 | |
| 発刊年月 | 2000年 02月 | |
| 著者 | 高橋 利和 | 徳島大学医学部臨牀検査学講座 |
| 著者 | 橋本 泰樹 | 市立静岡病院腎臓内科 |
| 著者 | 土井 俊夫 | 徳島大学医学部臨牀検査学講座 |
| 【 要旨 】 | カルニチンはミトコンドリア基質内への長鎖脂肪酸の移送に重要な役割を担っており，ミトコンドリア内では，移送された長鎖脂肪酸がβ酸化を受けエネルギー産生が行われる．維持透析患者においては，このカルニチンが血中・筋肉中ともに低下していることが知られており，(1) 透析時の除去，(2) 腎での合成低下，(3) 食事制限による摂取低下がおもな理由と考えられている．透析患者においては筋痙攣や倦怠感といったさまざまな筋肉症状をよく認め，これらの症状にカルニチンの投与が有効なことも多く，その補充によりI型を主体とした筋線維の萎縮の改善や運動能力の改善が認められたという報告もある．さらにカルニチンの補充は，維持透析患者のQOLに対しても改善効果があることがわかった． | |
| Theme | Dialysis Therapy and Carnitine | |
|---|---|---|
| Title | Carnitine and muscle tissue | |
| Author | Toshikazu Takahashi | Department of Laboratory Medicine, Faculty of Medicine, Tokushima University |
| Author | Yasuki Hashimoto | Department of Nepfrology, Shizuoka City Hospital |
| Author | Toshio Doi | Department of Laboratory Medicine, Faculty of Medicine, Tokushima University |
| [ Summary ] | Carnitine is a molecule required for energy metabolism. It facilitates the transport of long-chain fatty acids across the mitochondrial membrane for beta-oxidation and subsequent energy production in skeletal muscle. Patients on haemodialysis generally display decreased free carnitine levels both in plasma and skeletal muscle when compared to control values. On the other hand, various muscle symptoms (including cramps, fatigue, and weakness) are well recognized among patients on maintenance hemodialysis. Carnitine may be useful in treating some patients with these symptoms, related to HD. Moreover, carnitine has specific trophic effects on type 1 fibers, which are characterized by an oxidative metabolism, carnitine supplementation therapy muscle atrophy and exercise performance. We studied the effects of carnitine supplementation therapy on QOL of patients receiving hemodialysis, using a disease specific questionnaire. All categories significantly improved. The category of fatigue was the most improved. In conclusion, carnitine had a positive effect on some measures of perceived QOL inpatients who were receiving maintenance hemodialysis. |
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