Search

Introduction—There is evidence that both carnitine and coenzyme Q10 (Co Q), which are important for the functioning of myocardial mitochondria, are deficient in patients with congestive heart failure, in association with increased pro-inflammatory cytokines. It is possible that supplementation with ubiquinol and L-carnitine may protect these patients by decreasing inflammation.Subjects and methods— In a randomized, double-blind, placebo-controlled trial, the effects of carni Q-gel (2250 mg/d L-carnitine and 270 mg/d hydrosoluble ubiquinol) were examined for 12 weeks.Thirty-one patients with heart failure received intervention (group A) and another 31 patients served as controls (group B). Serum levels of interleukin (IL)-6, tumour necrosis factor (TNF)-alpha and IL-10 could be studied among 29 patients in each group. Statistical analysis was conducted by analysis of variance and chi square test.Results— Echocardiography ejection fractions were lower at baseline (38.8 + 7.6 vs. 39.3 + 6.7% in the intervention and control groups, respectively) among both group of patients, indicating class II-IV heart failure. Serum concentration of interleukin-6 (IL-6), a pro-inflammatory cytokine, was high (18.7 ± 5.8 vs. 15.0 + 3.3 pg/ml, normal 0.0-3.9) and IL-10 (anti-inflammatory) was normal (3.4 ± 1.5 vs. 2.9 ± 1.0 pg/ml, the normal range is 1.5-3.1 pg/ml) in both groups at baseline.After 12 weeks, there was a marked reduction in IL-6 in the intervention group without such changes in the control group (7.6 ± 1.5 vs. 11.4 ± 2.5 pg/ml, P< 0.01. IL-10 showed only the non-significant decrease in both groups from the baseline levels (3.2 ± 1.0 vs. 2.8 ± 0.9 pg/ml).TNF-alpha, which was comparable at baseline (17.6 ± 4.3 vs. 20.0 ± 5.3 pg/ml), also showed a greater decline in the carni Q-gel group compared to the placebo group (12.5 ± 3.3 vs. 17.2 ± 3.2 pg/ml, P< 0.05). Baseline serum CoQ levels (0.21 ± 0.11 vs. 0.19 ± 0.10 μg/ml) were low; however, after 12 weeks, serum CoQ showed a significant increase in the carni Q-gel group as compared to the control group (2.7 ± 1.2 and 0.76 ± 0.14 μg/ml, respectively). After 12 weeks of treatment, the quality of life visual analogous scale revealed that dyspnoea, palpitation and fatigue, (NYHA class II-III-IV), which were present at rest in all patients at baseline, showed beneficial effects in the intervention group compared to the placebo group. The six-minute walk test showed that there was a significant greater benefit in walking, from the baseline distance in the intervention group (208 ± 15.8 vs. 281 ± 20.6 metres, P<0.02) compared to the placebo group (218.4 ± 17.6 vs. 260.7 ± 19.3 metres, P < 0.05). The symptom scale indicated that the majority of patients showed improvement in the intervention group compared to the control group (28 vs. 16 patients, respectively, P< 0.05).Three patients in the intervention group had nausea and vomiting, which were controlled with symptomatic treatment.Conclusions— These findings indicate that treatment with ubiquinol + L-carnitine can cause a significant reduction in the pro-inflammatory cytokines that are neurohumoural precursors related to sympathetic and parasympathetic activity, which is impaired in patients with heart failure. There was no adverse effect on IL-10.There was a significant improvement in quality of life as well as decrease in NYHA-defined heart failure.

Objective and design — The objective of the study was to find out the prevalence of overweight, obesity, undernutrition and physical activity status in the urban populations of India. Cross-sectional surveys were conducted in 6-12 urban streets in each of five cities in five different regions of India using a common study protocol and criteria of diagnosis.Subjects and methods— A total of 6940 subjects (3433 women and 3507 men) aged 25 years and above were randomly selected from the cities of Moradabad (n = 2002), Trivandrum (n = 1602), Calcutta (n = 900), Nagpur (n = 894) and Bombay (n = 1542). Evaluation and validation were performed by a physician and dietitian-administered questionnaire at Moradabad. After pooling of data, all subjects were divided into various age groups for men and women. Obesity (body mass index = 30 ≥ kg/m2) and overweight (BMI ≥ 25-29.9 kg/m2and > 23 kg/m2) as well as waist-hip ratio (> 0.85 in women and > 0.88 in men, central obesity) were calculated and physical activity status assessed by a validated questionnaire.Results— The overall prevalence of obesity was 6.8% (7.8 vs. 6.2%, P < 0.05) and overweight 33.5% (35.0 vs. 32.0%, P < 0.05) among women and men, respectively.The highest prevalence of obesity (7.8%) and overweight (36.9%) was found among subjects aged 35 to 44 years in both sexes. The prevalence of obesity was significantly (P < 0.05) greater in Trivandrum (8.5%), Calcutta (7.1%) and Bombay (8.3%) compared to Moradabad (6.2%) among women and in Trivandrum (7.4%) and Bombay (7.2%), compared to Nagpur (5.0%) among men.There was a significant decreasing trend in obesity (P < 0.05) and overweight (P < 0.05) with increasing age above 35-44 years in both sexes.The overall prevalence of subjects > 23 kg/m2was 50.8% and central obesity 52.6%.The overall prevalence of sedentary behaviour was 59.3% among women and 58.5% among men. Both sedentary behaviour and mild activity showed a significant increasing trend in women after the age of 35-44 years. In men, such a trend was observed above the age of 45 years. Sedentary behaviour was significantly (P < 0.05) greater in Trivandrum, Calcutta, and Bombay compared to Nagpur. Sedentary behaviour was significantly (P < 0.001) associated with obesity in both sexes, compared to non-obese men and women. The overall prevalence of undernutrition was 5.5% (n = 380) which was significantly more common in Moradabad, north and Nagpur, central India compared to other cities.Conclusions— Obesity, overweight and central obesity and sedentary behaviour coexist with undernutrition, and have become a public health problem in all the five cities of India.The prevalence of obesity and sedentary behaviour was significantly greater in Trivandrum, Calcutta and Bombay compared to Moradabad and Nagpur. Sedentary behaviour was significantly associated with obesity compared to non-obese subjects in both sexes, which may be due to greater economic development in metro cities.