human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Insulin resistance , a key component of the metabolic syndrome , is a risk factor for diabetes mellitus and cardiovascular disease .  Acetyl-l-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance . In this sequential off-on-off pilot study , we prospect ively evaluated the effects of 24-week oral acetyl-l-carnitine ( 1 g twice daily ) therapy on the glucose disposal rate ( GDR ) , assessed by hyperinsulinemic euglycemic clamps , and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori segregated into 2 groups with GDR ≤7.9 ( n=16 ) or > 7.9 ( n=16 ) mg/kg per minute , respectively .  Baseline GDR and systolic blood pressure were negatively correlated ( n=32 ; P=0.001 ; r=−0.545 ) , and patients with GDR ≤7.9 mg/kg per minute had higher systolic/diastolic blood pressure than those with higher GDR . Acetyl-l-carnitine increased GDR from 4.89±1.47 to 6.72±3.12 mg/kg per minute ( P=0.003 , Bonferroni-adjusted ) and improved glucose tolerance in patients with GDR ≤7.9 mg/kg per minute , whereas it had no effects in those with higher GDRs . Changes in GDR were significantly different between groups ( P=0.017 , ANCOVA ) . Systolic blood pressure decreased from 144.0±13.6 to 135.1±8.4 mm Hg and from 130.8±12.4 to 123.8±10.8 mm Hg in the lower and higher GDR groups , respectively ( P<0.05 for both ; P<0.001 overall ) and progressively recovered toward baseline over 8 weeks posttreatment . Total and high molecular weight adiponectin levels followed specular trends . Diastolic blood pressure significantly decreased only in those with higher GDRs . Treatment was well tolerated in all of the patients . Acetyl-l-carnitine safely ameliorated arterial hypertension , insulin resistance , impaired glucose tolerance , and hypoadiponectinemia in subjects at increased cardiovascular risk . Whether these effects may translate into long-term cardioprotection is worth investigating L-Carnitine ( L-C ) transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement . In a double-blind investigation to test the weight loss efficacy of L-C , 36 moderately overweight premenopausal women were pair matched on Body Mass Index ( BMI ) and r and omly assigned to two groups ( N = 18 ) . For 8 weeks the L-C group ingested 2 g twice daily of L-C , while the placebo ( P ) group ingested the same amount of lactose . All subjects walked for 30 min ( 60 - 70 % maximum heart rate ) 4 days/week . Body composition , resting energy expenditure ( REE ) and substrate utilization were estimated before and after treatment . For the subjects who completed the study ( 15 P , 13 L-C ) , no significant changes in mean total body mass ( TBM ) , fat mass FM , and resting lipid utilization occurred over time , nor were there any significant differences between groups for any variable . Conversely REE increased significantly for all subjects , but no between group differences existed . Five of the L-C group experienced nausea or diarrhea and consequently did not complete the study . Eight weeks of L-C ingestion and walking did not significantly alter the TBM or FM of overweight women , thereby casting doubt on the efficacy of L-C supplementation for weight loss BACKGROUND AND OBJECTIVE Molecular mechanisms of most anti-obesity drugs are remained to be clear . MicroRNAs that are noncoding RNA molecules supposed to regulate biological processes concomitant to obesity and have attracted a lot of attention to themselves . The miR-27a and miR-143 expression levels in obese and non-obese rats during weight changes and L-carnitine ( LC ) effects on them was investigated in this study . MATERIAL S AND METHODS In the present study 12 male Wistar rats were r and omly divided into  normal fat diet and high fat diet groups to develop obesity . After 8 weeks rats were weighted and half of diet induced obese rats were r and omly selected to receive 200 mg LC kg -1 b.wt . for 4 weeks . At the end epididymal fat was isolated to investigate expression level of microRNAs by real-time PCR . RESULTS After 12 weeks , high fat diet in comparison with normal fat diet mediated significant decrease and increase in expression levels of miR-27a and miR-143 , respectively . These changes were modified in groups , which had received LC in a 4 weeks period . Furthermore , rats in this group gained less weight . CONCLUSION Findings of this study suggest that the changes of microRNAs expression probably play a role in pathogenesis of obesity , might be modulated by means of dietary agents and supplements and modify weight gain trend BACKGROUND A previous study has demonstrated that L-carnitine reduces plasma lipoprotein(a ) ( Lp[a ] ) levels in patients with hypercholesterolemia . OBJECTIVE To test a tolerable Lp(a)-reducing agent in diabetic patients , we assessed the effect of a dietary supplementation of L-carnitine on plasma lipid levels , particularly Lp(a ) , of patients with type 2 diabetes mellitus ( DM ) and hypercholesterolemia . METHODS In this 6-month , r and omized , double-masked , placebo-controlled clinical trial , patients were enrolled , assessed , and followed up at the Diabetic and Metabolic Diseases Center of the Department of Internal Medicine and Therapeutics at the University of Pavia , Pavia , Italy . All study patients had newly diagnosed type 2 DM that was managed through dietary restriction alone throughout the study , as well as hypercholesterolemia . Patients were r and omized to 1 of 2 groups . One group received L-carnitine , one 1-g tablet BID . The other group received a corresponding placebo . We assessed body mass index , fasting plasma glucose , postpr and ial plasma glucose , glycosylated hemoglobin , fasting plasma insulin , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , apolipoprotein ( apo ) A-I , apo B , and Lp(a ) at baseline and at 1 , 3 , and 6 months of treatment . RESULTS This study included 94 patients . The treatment group included 24 men and 22 women ( mean [ SD ] age , 52 [ 6 ] years ) . The placebo group included 23 men and 25 women ( mean [ SD ] age , 50 [ 7 ] years ) . The baseline characteristics of the groups did not differ significantly . The mean ( SD ) body weight , height , and body mass index were 78.2 ( 5.8 ) kg , 1.70 ( 0.04 ) m , and 27.3 ( 2.5 ) kg/m(2 ) , respectively , in the L-carnitine group and 77.6 ( 6.4 ) kg , 1.71 ( 0.05 ) m , and 26.8 ( 2.2 ) kg/m(2 ) , respectively , in the placebo group . In the treatment group , Lp(a ) was significantly reduced at 3 and 6 months compared with baseline ( P < 0.05 ) and P < 0.01 , respectively ) . We observed a significant improvement after 6 months ( P < 0.05 ) in the Lp(a ) value in patients taking L-carnitine compared with those taking placebo . Between-group differences in other variables did not reach a level of significance at months 3 and 6 . No drug-related adverse events were reported or observed . CONCLUSION In this preliminary study , after 3 and 6 months , L-carnitine significantly lowered the plasma Lp(a ) level compared with placebo in selected hypercholesterolemic patients with newly diagnosed type 2 DM The aim of the study was to evaluate the effects of 12-month treatment with sibutramine plus L-carnitine compared with sibutramine alone on body weight , glycemic control , insulin resistance , and inflammatory state in type 2 diabetes mellitus patients . Two hundred fifty-four patients with uncontrolled type 2 diabetes mellitus ( glycated hemoglobin [ HbA(1c ) ] > 8.0 % ) in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy . We evaluated at baseline and after 3 , 6 , 9 , and 12 months these parameters : body weight , body mass index , HbA(1c ) , fasting plasma glucose , postpr and ial plasma glucose , fasting plasma insulin , homeostasis model assessment of insulin resistance index , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , leptin , tumor necrosis factor-α , adiponectin , vaspin , and high-sensitivity C-reactive protein .  Sibutramine plus L-carnitine gave a faster improvement of fasting plasma glucose , postpr and ial plasma glucose , lipid profile , leptin , tumor necrosis factor-α , and high-sensitivity C-reactive protein compared with sibutramine alone . Furthermore , there was a better improvement of body weight , HbA(1c ) , fasting plasma insulin , homeostasis model assessment of insulin resistance index , vaspin , and adiponectin  with sibutramine plus L-carnitine compared with sibutramine alone . Sibutramine plus L-carnitine gave a better and faster improvement of all the analyzed parameters compared with sibutramine alone without giving any severe adverse effect To evaluate the effects of 1-year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight , glycemic and lipid control , and inflammatory parameters in obese type 2 diabetic patients . Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus ( T2DM ) [ glycated hemoglobin ( HbA(1c ) ) > 8.0 % ] in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day . We evaluated the following parameters at baseline and after 3 , 6 , 9 , and 12 months : body weight , body mass index ( BMI ) , glycated hemoglobin ( HbA(1c ) ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triglycerides ( Tg ) , adiponectin ( ADN ) , leptin , tumor necrosis factor-α ( TNF-α ) , vaspin , and high-sensitivity C-reactive protein ( Hs-CRP ) . We observed a better decrease in body weight , glycemic profile , HOMA-IR , LDL-C , and ADN and a faster improvement in FPI , TC , Tg , leptin , TNF-α , Hs-CRP  with orlistat plus L-carnitine compared to orlistat alone . We also recorded an improvement in vaspin  with orlistat plus l-carnitine not reached with orlistat alone . Orlistat plus L-carnitine gave a better improvement in body weight , glycemic and lipid profile compared to orlistat alone ; furthermore , a faster and better improvement in inflammatory parameters was observed with orlistat plus L-carnitine compared to orlistat alone INTRODUCTION Carnitine supplementation may improve the general health and quality of life of hemodialysis patients by improving adipokines levels . The aim of the study was to investigate the effects of L-carnitine supplementation on leptin levels , adiponectin levels , and body weight of hemodialysis patients . MATERIAL S AND METHODS Fifty hemodialysis patients were r and omly divided into the carnitine group , who received oral L-carnitine , 1 g/L for 3 months , and the control group . Anthropometric measurements and serum levels of adipokines were measured at baseline and at the end of the intervention . RESULTS Forty-two participants completed the study . Serum leptin concentrations decreased after 12 weeks of the intervention in both groups , but these changes were not significant . The mean change of leptin concentration were , -1.7 ± 19.0 µg/mL and -7.1 ± 20.0 µg/mL in the carnitine group and the control group , respectively ( P = .39 ) . The mean ad 
    Output:
    
agent
Conclusion l-carnitine consumption does not reduce serum leptin significantly .
However , a significant effect on leptin was observed in diabetic patients and patients who received doses more than 3 mg per day in the course of < 12 weeks
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Insulin resistance , a key component of the metabolic syndrome , is a risk factor for diabetes mellitus and cardiovascular disease .  Acetyl-l-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance . In this sequential off-on-off pilot study , we prospect ively evaluated the effects of 24-week oral acetyl-l-carnitine ( 1 g twice daily ) therapy on the glucose disposal rate ( GDR ) , assessed by hyperinsulinemic euglycemic clamps , and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori segregated into 2 groups with GDR ≤7.9 ( n=16 ) or > 7.9 ( n=16 ) mg/kg per minute , respectively .  Baseline GDR and systolic blood pressure were negatively correlated ( n=32 ; P=0.001 ; r=−0.545 ) , and patients with GDR ≤7.9 mg/kg per minute had higher systolic/diastolic blood pressure than those with higher GDR . Acetyl-l-carnitine increased GDR from 4.89±1.47 to 6.72±3.12 mg/kg per minute ( P=0.003 , Bonferroni-adjusted ) and improved glucose tolerance in patients with GDR ≤7.9 mg/kg per minute , whereas it had no effects in those with higher GDRs . Changes in GDR were significantly different between groups ( P=0.017 , ANCOVA ) . Systolic blood pressure decreased from 144.0±13.6 to 135.1±8.4 mm Hg and from 130.8±12.4 to 123.8±10.8 mm Hg in the lower and higher GDR groups , respectively ( P<0.05 for both ; P<0.001 overall ) and progressively recovered toward baseline over 8 weeks posttreatment . Total and high molecular weight adiponectin levels followed specular trends . Diastolic blood pressure significantly decreased only in those with higher GDRs . Treatment was well tolerated in all of the patients . Acetyl-l-carnitine safely ameliorated arterial hypertension , insulin resistance , impaired glucose tolerance , and hypoadiponectinemia in subjects at increased cardiovascular risk . Whether these effects may translate into long-term cardioprotection is worth investigating L-Carnitine ( L-C ) transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement . In a double-blind investigation to test the weight loss efficacy of L-C , 36 moderately overweight premenopausal women were pair matched on Body Mass Index ( BMI ) and r and omly assigned to two groups ( N = 18 ) . For 8 weeks the L-C group ingested 2 g twice daily of L-C , while the placebo ( P ) group ingested the same amount of lactose . All subjects walked for 30 min ( 60 - 70 % maximum heart rate ) 4 days/week . Body composition , resting energy expenditure ( REE ) and substrate utilization were estimated before and after treatment . For the subjects who completed the study ( 15 P , 13 L-C ) , no significant changes in mean total body mass ( TBM ) , fat mass FM , and resting lipid utilization occurred over time , nor were there any significant differences between groups for any variable . Conversely REE increased significantly for all subjects , but no between group differences existed . Five of the L-C group experienced nausea or diarrhea and consequently did not complete the study . Eight weeks of L-C ingestion and walking did not significantly alter the TBM or FM of overweight women , thereby casting doubt on the efficacy of L-C supplementation for weight loss BACKGROUND AND OBJECTIVE Molecular mechanisms of most anti-obesity drugs are remained to be clear . MicroRNAs that are noncoding RNA molecules supposed to regulate biological processes concomitant to obesity and have attracted a lot of attention to themselves . The miR-27a and miR-143 expression levels in obese and non-obese rats during weight changes and L-carnitine ( LC ) effects on them was investigated in this study . MATERIAL S AND METHODS In the present study 12 male Wistar rats were r and omly divided into  normal fat diet and high fat diet groups to develop obesity . After 8 weeks rats were weighted and half of diet induced obese rats were r and omly selected to receive 200 mg LC kg -1 b.wt . for 4 weeks . At the end epididymal fat was isolated to investigate expression level of microRNAs by real-time PCR . RESULTS After 12 weeks , high fat diet in comparison with normal fat diet mediated significant decrease and increase in expression levels of miR-27a and miR-143 , respectively . These changes were modified in groups , which had received LC in a 4 weeks period . Furthermore , rats in this group gained less weight . CONCLUSION Findings of this study suggest that the changes of microRNAs expression probably play a role in pathogenesis of obesity , might be modulated by means of dietary agents and supplements and modify weight gain trend BACKGROUND A previous study has demonstrated that L-carnitine reduces plasma lipoprotein(a ) ( Lp[a ] ) levels in patients with hypercholesterolemia . OBJECTIVE To test a tolerable Lp(a)-reducing agent in diabetic patients , we assessed the effect of a dietary supplementation of L-carnitine on plasma lipid levels , particularly Lp(a ) , of patients with type 2 diabetes mellitus ( DM ) and hypercholesterolemia . METHODS In this 6-month , r and omized , double-masked , placebo-controlled clinical trial , patients were enrolled , assessed , and followed up at the Diabetic and Metabolic Diseases Center of the Department of Internal Medicine and Therapeutics at the University of Pavia , Pavia , Italy . All study patients had newly diagnosed type 2 DM that was managed through dietary restriction alone throughout the study , as well as hypercholesterolemia . Patients were r and omized to 1 of 2 groups . One group received L-carnitine , one 1-g tablet BID . The other group received a corresponding placebo . We assessed body mass index , fasting plasma glucose , postpr and ial plasma glucose , glycosylated hemoglobin , fasting plasma insulin , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , apolipoprotein ( apo ) A-I , apo B , and Lp(a ) at baseline and at 1 , 3 , and 6 months of treatment . RESULTS This study included 94 patients . The treatment group included 24 men and 22 women ( mean [ SD ] age , 52 [ 6 ] years ) . The placebo group included 23 men and 25 women ( mean [ SD ] age , 50 [ 7 ] years ) . The baseline characteristics of the groups did not differ significantly . The mean ( SD ) body weight , height , and body mass index were 78.2 ( 5.8 ) kg , 1.70 ( 0.04 ) m , and 27.3 ( 2.5 ) kg/m(2 ) , respectively , in the L-carnitine group and 77.6 ( 6.4 ) kg , 1.71 ( 0.05 ) m , and 26.8 ( 2.2 ) kg/m(2 ) , respectively , in the placebo group . In the treatment group , Lp(a ) was significantly reduced at 3 and 6 months compared with baseline ( P < 0.05 ) and P < 0.01 , respectively ) . We observed a significant improvement after 6 months ( P < 0.05 ) in the Lp(a ) value in patients taking L-carnitine compared with those taking placebo . Between-group differences in other variables did not reach a level of significance at months 3 and 6 . No drug-related adverse events were reported or observed . CONCLUSION In this preliminary study , after 3 and 6 months , L-carnitine significantly lowered the plasma Lp(a ) level compared with placebo in selected hypercholesterolemic patients with newly diagnosed type 2 DM The aim of the study was to evaluate the effects of 12-month treatment with sibutramine plus L-carnitine compared with sibutramine alone on body weight , glycemic control , insulin resistance , and inflammatory state in type 2 diabetes mellitus patients . Two hundred fifty-four patients with uncontrolled type 2 diabetes mellitus ( glycated hemoglobin [ HbA(1c ) ] > 8.0 % ) in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy . We evaluated at baseline and after 3 , 6 , 9 , and 12 months these parameters : body weight , body mass index , HbA(1c ) , fasting plasma glucose , postpr and ial plasma glucose , fasting plasma insulin , homeostasis model assessment of insulin resistance index , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , leptin , tumor necrosis factor-α , adiponectin , vaspin , and high-sensitivity C-reactive protein .  Sibutramine plus L-carnitine gave a faster improvement of fasting plasma glucose , postpr and ial plasma glucose , lipid profile , leptin , tumor necrosis factor-α , and high-sensitivity C-reactive protein compared with sibutramine alone . Furthermore , there was a better improvement of body weight , HbA(1c ) , fasting plasma insulin , homeostasis model assessment of insulin resistance index , vaspin , and adiponectin  with sibutramine plus L-carnitine compared with sibutramine alone . Sibutramine plus L-carnitine gave a better and faster improvement of all the analyzed parameters compared with sibutramine alone without giving any severe adverse effect To evaluate the effects of 1-year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight , glycemic and lipid control , and inflammatory parameters in obese type 2 diabetic patients . Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus ( T2DM ) [ glycated hemoglobin ( HbA(1c ) ) > 8.0 % ] in therapy with different oral hypoglycemic agents or insulin  were enrolled in this study and r and omized to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day . We evaluated the following parameters at baseline and after 3 , 6 , 9 , and 12 months : body weight , body mass index ( BMI ) , glycated hemoglobin ( HbA(1c ) ) , fasting plasma glucose ( FPG ) , postpr and ial plasma glucose ( PPG ) , fasting plasma insulin ( FPI ) , homeostasis model assessment insulin resistance index ( HOMA-IR ) , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , triglycerides ( Tg ) , adiponectin ( ADN ) , leptin , tumor necrosis factor-α ( TNF-α ) , vaspin , and high-sensitivity C-reactive protein ( Hs-CRP ) . We observed a better decrease in body weight , glycemic profile , HOMA-IR , LDL-C , and ADN and a faster improvement in FPI , TC , Tg , leptin , TNF-α , Hs-CRP  with orlistat plus L-carnitine compared to orlistat alone . We also recorded an improvement in vaspin  with orlistat plus l-carnitine not reached with orlistat alone . Orlistat plus L-carnitine gave a better improvement in body weight , glycemic and lipid profile compared to orlistat alone ; furthermore , a faster and better improvement in inflammatory parameters was observed with orlistat plus L-carnitine compared to orlistat alone INTRODUCTION Carnitine supplementation may improve the general health and quality of life of hemodialysis patients by improving adipokines levels . The aim of the study was to investigate the effects of L-carnitine supplementation on leptin levels , adiponectin levels , and body weight of hemodialysis patients . MATERIAL S AND METHODS Fifty hemodialysis patients were r and omly divided into the carnitine group , who received oral L-carnitine , 1 g/L for 3 months , and the control group . Anthropometric measurements and serum levels of adipokines were measured at baseline and at the end of the intervention . RESULTS Forty-two participants completed the study . Serum leptin concentrations decreased after 12 weeks of the intervention in both groups , but these changes were not significant . The mean change of leptin concentration were , -1.7 ± 19.0 µg/mL and -7.1 ± 20.0 µg/mL in the carnitine group and the control group , respectively ( P = .39 ) . The mean ad 
    Output:
    