Plasma acetyl-l-carnitine and l-carnitine in major depressive episodes: a case–control study before and after treatment

肉碱 优势比 内科学 背景(考古学) 置信区间 医学 重性抑郁障碍 胃肠病学 内分泌学 抗抑郁药 生物 古生物学 扁桃形结构 海马体
作者
Abd El Kader Ait Tayeb,Romain Colle,Khalil El‐Asmar,Kenneth Chappell,Cécile Acquaviva,Denis J. David,Sévérine Trabado,Philippe Chanson,Bruno Fève,Laurent Becquemont,Céline Verstuyft,Emmanuelle Corruble
出处
期刊:Psychological Medicine [Cambridge University Press]
卷期号:53 (6): 2307-2316 被引量:5
标识
DOI:10.1017/s003329172100413x
摘要

Abstract Background Major depressive disorder (MDD) is the main cause of disability worldwide, its outcome is poor, and its underlying mechanisms deserve a better understanding. Recently, peripheral acetyl- l -carnitine (ALC) has been shown to be lower in patients with major depressive episodes (MDEs) than in controls. l -Carnitine is involved in mitochondrial function and ALC is its short-chain acetyl-ester. Our first aim was to compare the plasma levels of l -carnitine and ALC, and the l -carnitine/ALC ratio in patients with a current MDE and healthy controls (HCs). Our second aim was to assess their changes after antidepressant treatment. Methods l -Carnitine and ALC levels and the carnitine/ALC ratio were measured in 460 patients with an MDE in a context of MDD and in 893 HCs. Depressed patients were re-assessed after 3 and 6 months of antidepressant treatment for biology and clinical outcome. Results As compared to HC, depressed patients had lower ALC levels ( p < 0.00001), higher l -carnitine levels ( p < 0.00001) and higher l -carnitine/ALC ratios ( p < 0.00001). ALC levels increased [coefficient: 0.18; 95% confidence interval (CI) 0.12–0.24; p < 0.00001], and l -carnitine levels (coefficient: −0.58; 95% CI −0.75 to −0.41; p < 0.00001) and l -carnitine/ALC ratios (coefficient: −0.41; 95% CI −0.47 to −0.34; p < 0.00001), decreased after treatment. These parameters were completely restored after 6 months of antidepressant. Moreover, the baseline l -carnitine/ALC ratio predicted remission after 3 months of treatment (odds ratio = 1.14; 95% CI 1.03–1.27; p = 0.015). Conclusions Our data suggest a decreased mitochondrial metabolism of l -carnitine into ALC during MDE. This decreased mitochondrial metabolism is restored after a 6-month antidepressant treatment. Moreover, the magnitude of mitochondrial dysfunction may predict remission after 3 months of antidepressant treatment. New strategies targeting mitochondria should be explored to improve treatments of MDD.
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