Dual role of LC in human health, insights of beneficial short term usage and potentially harmful long term complications

AspectDescription
Gut microbiota composition
  • Alteration of microbial diversity

  • ↑ F/B ratio

Gut dysbiosis
  • Associated with long term consumption of LC

  • Growth of TMA producing bacteria

  • ↑ F/B ratio and TMAO level

  • Contributes to systemic inflammation, impairment of gut barrier function, triggering pro-inflammatory conditions

SCFAs production
  • Faecalibacterium prausnitzii, Bacteroides spp., and Clostridium spp., produce beneficial SCFAs like acetate, propionate, and butyrate

  • Essential for maintaining intestinal health, controlling immune responses, reducing inflammation, and protecting the intestinal barrier

  • Particularly butyrate, produced by species like Faecalibacterium prausnitzii, are vital for gut epithelial integrity, reducing inflammation and supporting immune function

  • Acetate and propionate, produced by Bacteroides species, also have immune-modulatory effects, promoting a balanced gut environment

Role of TMAO in inflammation
  • Conversion of LC into TMA and subsequently TMAO can lead to oxidative stress and inflammation, which may counteract the benefits of LC

  • ↑ TMAO levels are associated with increased cardiovascular risk and may negatively affect metabolic health by triggering systemic inflammation

Fatty acid metabolism
  • LC plays a crucial role in fatty acid metabolism by transporting long-chain fatty acids into mitochondria, where they undergo β-oxidation to produce acetyl-CoA

  • Acetyl-CoA is a key substrate in the citric acid cycle, which generates ATP, providing energy for cellular activities

Amino acid metabolism
  • LC aids in the metabolism of BCAAs such as leucine, isoleucine, and valine

  • It helps transaminate these amino acids, converting them into keto acids for efficient energy generation

Mitochondrial activity
  • Enhances mitochondrial biogenesis, reduces oxidative stress, and supports cellular metabolism

Dual role in health
  • LC’s impact on gut microbiota and metabolic pathways is complex, as it can have both beneficial and detrimental effects

  • While LC helps with fatty acid oxidation, energy production, and SCFA generation, its conversion to TMAO can exacerbate inflammation and oxidative stress, highlighting the importance of a balanced microbiota for optimal health

  • While short term consumption shows benefits, long term consumption is linked to adverse cardiovascular complications

F/B: Firmicutes-to-Bacteroidetes; LC: L-carnitine; TMA: trimethylamine; TMAO: trimethylamine-N-oxide; ATP: adenosine triphosphate; BCAAs: branched-chain amino acids; SCFAs: short-chain fatty acids