Determination of the reference range of endogenous plasma carnitines in healthy adults

Background: L-carnitine is an endogenous substance, vital in the transport of fatty acids across the inner mitochondrial membrane for oxidation. Disturbances in carnitine homeostasis can have a significant impact on human health; therefore, it is critical to define normal endogenous concentrations for L-carnitine and its esters to facilitate the diagnosis of carnitine deficiency disorders. This study was conducted to determine the normal concentrations of a number of carnitines in healthy adults using three analytical methods. The impact of age and gender on carnitine concentrations was also examined. Methods: Blood samples were collected from 60 healthy subjects of both genders and various ages. Plasma samples were analysed for endogenous carnitine concentrations by radioenzymatic assay, high-performance liquid chromatography and electrospray tandem mass spectrometry. Results: Precision and accuracy of results obtained for each assay were within acceptable limits. Average endogenous concentrations obtained from the three analytical methods in this study were in the range of 38-44, 6-7 and 49-50 mu mol/L for L-carnitine, acetyl-L-carnitine and total carnitine, respectively. Comparison of results between the genders indicated that males had significantly higher endogenous plasma L-carnitine and total carnitine concentrations than females. Age was found to have no impact on plasma carnitine concentrations. Conclusion: These results are useful in the evaluation of biochemical or metabolic disturbances and in the diagnosis and treatment of patients with carnitine deficiency.