Review explores L-carnitine mechanisms for MASLD, a condition affecting over one-third globally

This systematic review article synthesizes literature on metabolic dysfunction-associated steatotic liver disease (MASLD) and the dietary supplement L-carnitine. It reports that MASLD affects over one-third of the global population and is independently associated with increased risks of cardiovascular disease, chronic kidney disease, and extrahepatic malignancies. The condition can progress silently to liver fibrosis, cirrhosis, and hepatocellular carcinoma.

The review focuses on the proposed molecular mechanisms of L-carnitine, which include enhancement of lipid metabolism, improvement of insulin sensitivity, stabilization of hepatocyte function, and reduction of inflammation, fibrosis, and tumorigenesis. No specific clinical trial results, effect sizes, or comparative data for L-carnitine are presented in the abstract. The review describes associations and theoretical pathways rather than causal evidence from intervention studies.

Key limitations stem from the nature of the publication as a review article. No new primary data, meta-analysis results, or quantitative synthesis of L-carnitine's effects are reported. Safety, tolerability, adverse events, and discontinuation rates for L-carnitine are not addressed. The funding sources and potential conflicts of interest are also not reported.

For clinical practice, this review highlights the significant global burden of MASLD and its systemic associations. It outlines a theoretical rationale for investigating L-carnitine but provides no evidence of its therapeutic efficacy or safety profile in patients. The findings should be interpreted as a summary of proposed biological mechanisms, not as clinical evidence supporting the use of L-carnitine for MASLD management.