{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T07:09:43Z","timestamp":1762240183787,"version":"build-2065373602"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The carnitine system may play an essential role in bone metabolism. However, existing epidemiological studies on the association between carnitine and bone mineral density (BMD) are still controversial. No human study has examined the association of carnitine and osteoporotic fracture. The objective of this research was to examine the association of carnitine levels with BMD and recent osteoporotic fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used cross-sectional and case\u2013control studies to examine the associations of carnitine levels with BMD and recent osteoporotic fracture. The cross-sectional study identified 135 participants aged \u226545\u202fyears from the Second Hospital of Jilin University. The case\u2013control study identified 44 recent fracture cases and 88 healthy controls aged 50 and older. Multivariable linear regression models were used to test the associations of carnitine with BMD, and conditional logistic regression models were used to analyze the association between carnitine levels and fracture. We used targeted metabolomics technology to measure 27 types of plasma carnitine levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the cross-sectional study, the average age was 57.6\u202f\u00b1\u202f5.0\u202fyears, with 29 participants (21.5%) being female. We observed no significant association between total carnitine levels and BMD (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). In the case\u2013control study, 23 participants (52.3%) were diagnosed with hip fracture. Greater total carnitine levels were negatively associated with the risk of osteoporotic fractures (adjusted odds ratio: 0.43, 95% confidence interval: 0.22\u20130.85). The magnitude of the associations was comparable for hip and non-hip fractures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Carnitine was not associated with BMD but was negatively associated with osteoporotic fracture. The low carnitine levels among fracture cases may be due to the post-fracture inflammatory and catabolic stress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2025.1664866","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T07:05:21Z","timestamp":1762239921000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of plasma carnitine levels with bone mineral density and recent osteoporotic fracture"],"prefix":"10.3389","volume":"12","author":[{"given":"Zhaoyue","family":"Shang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongliang","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanlin","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William D.","family":"Leslie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Lix","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Kan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuman","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/1743-7075-7-30","article-title":"Role of carnitine in disease","volume":"7","author":"Flanagan","year":"2010","journal-title":"Nutr Metab"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1016\/j.mam.2004.06.006","article-title":"Carnitine: a nutritional, biosynthetic, and functional perspective","volume":"25","author":"Steiber","year":"2004","journal-title":"Mol Asp Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1124\/pharmrev.121.000408","article-title":"Acylcarnitines: nomenclature, biomarkers, therapeutic potential, drug targets, and clinical trials","volume":"74","author":"Dambrova","year":"2022","journal-title":"Pharmacol Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.arr.2010.02.005","article-title":"Mechanistic contribution of carnitine deficiency to geriatric frailty","volume":"9","author":"Crentsil","year":"2010","journal-title":"Ageing Res Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/8115173","article-title":"Correlation between acylcarnitine and peripheral neuropathy in type 2 diabetes mellitus","volume":"2022","author":"An","year":"2022","journal-title":"J Diabetes Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/bcpt.12384","article-title":"Treatment with carnitine enhances bone fracture healing under osteoporotic and\/or inflammatory conditions","volume":"117","author":"Aydin","year":"2015","journal-title":"Basic Clin Pharmacol Toxicol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1177\/1535370213502614","article-title":"The role of carnitine on ovariectomy and inflammation-induced osteoporosis in rats","volume":"238","author":"Orsal","year":"2013","journal-title":"Exp Biol Med (Maywood)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"997358","DOI":"10.3389\/fphys.2022.997358","article-title":"Mitochondrial fatty acid \u03b2-oxidation is important for normal osteoclast formation in growing female mice","volume":"13","author":"Kushwaha","year":"2022","journal-title":"Front Physiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2019\/5678548","article-title":"L-carnitine reduces oxidative stress and promotes cells differentiation and bone matrix proteins expression in human osteoblast-like cells","volume":"2019","author":"Terruzzi","year":"2019","journal-title":"Biomed Res Int"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s12986-018-0296-5","article-title":"Metabolomic profiles associated with bone mineral density in US Caucasian women","volume":"15","author":"Zhao","year":"2018","journal-title":"Nutr Metab (Lond)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"628","DOI":"10.3390\/metabo11090628","article-title":"A distinctive human metabolomics alteration associated with osteopenic and osteoporotic patients","volume":"11","author":"Aleidi","year":"2021","journal-title":"Metabolites"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1520229","DOI":"10.3389\/fendo.2024.1520229","article-title":"A real-world analysis of 1,823 hospitalized osteoporotic fractures in Northeast China","volume":"15","author":"Meng","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1179521","DOI":"10.3389\/fendo.2023.1179521","article-title":"Global biomarkers of oxidative stress and fractures: a matched case-control study","volume":"14","author":"Yang","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.foodchem.2013.06.137","article-title":"Analytical approaches to determination of carnitine in biological materials, foods and dietary supplements","volume":"142","author":"D\u0105browska","year":"2014","journal-title":"Food Chem"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e0280734","DOI":"10.1371\/journal.pone.0280734","article-title":"Serum metabolomic analysis of the dose-response effect of dietary choline in overweight male cats fed at maintenance energy requirements","volume":"18","author":"Rankovic","year":"2023","journal-title":"PLoS One"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"851870","DOI":"10.5402\/2011\/851870","article-title":"Increased excretion of c4-carnitine species after a therapeutic acetylsalicylic acid dose: evidence for an inhibitory effect on short-chain fatty acid metabolism","volume":"2011","author":"Mels","year":"2011","journal-title":"ISRN Pharmacol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1002\/bmc.2995","article-title":"Separation of carnitine and acylcarnitines in biological samples: a review","volume":"27","author":"Mansour","year":"2013","journal-title":"Biomed Chromatogr"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e2613","DOI":"10.1210\/clinem\/dgab180","article-title":"An updated reference for calculating bone mineral density T-scores","volume":"106","author":"Xue","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1002\/jbmr.5650090802","article-title":"The diagnosis of osteoporosis","volume":"9","author":"Kanis","year":"1994","journal-title":"J Bone Miner Res"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1016\/j.bone.2009.01.373","article-title":"FRAX and its applications to clinical practice","volume":"44","author":"Kanis","year":"2009","journal-title":"Bone"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1515\/med-2016-0036","article-title":"Clinical value of self-assessment risk of osteoporosis in Chinese","volume":"11","author":"Zhang","year":"2016","journal-title":"Open Med (Wars)"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1001\/archinte.1979.03630450011006","article-title":"Some health benefits of physical activity. The Framingham study","volume":"139","author":"Kannel","year":"1979","journal-title":"Arch Intern Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1093\/biostatistics\/kxz010","article-title":"The functional false discovery rate with applications to genomics","volume":"22","author":"Chen","year":"2021","journal-title":"Biostatistics"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12986-023-00752-1","article-title":"Effect of a 3-month L-carnitine supplementation and resistance training program on circulating markers and bone mineral density in postmenopausal women: a randomized controlled trial","volume":"20","author":"Olek","year":"2023","journal-title":"Nutr Metab (Lond)"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1007\/s00198-019-04892-0","article-title":"Discovery of potential biomarkers for osteoporosis using LC-MS\/MS metabolomic methods","volume":"30","author":"Wang","year":"2019","journal-title":"Osteoporos Int"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"42","DOI":"10.5582\/bst.2015.01000","article-title":"L-carnitine affects osteoblast differentiation in NIH3T3 fibroblasts by the IGF-1\/PI3K\/Akt signalling pathway","volume":"9","author":"Ge","year":"2015","journal-title":"Biosci Trends"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1360959","DOI":"10.3389\/fnut.2024.1360959","article-title":"Association between amino acids and recent osteoporotic fracture: a matched incident case-control study","volume":"11","author":"Liang","year":"2024","journal-title":"Front Nutr"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1093\/gerona\/62.4.420","article-title":"Cytokines and C-reactive protein production in hip-fracture-operated elderly patients","volume":"62","author":"Beloosesky","year":"2007","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1054\/npep.2000.0803","article-title":"Elevation of plasma CGRP and SP levels in orthopedic patients with fracture neck of femur","volume":"34","author":"Onuoha","year":"2000","journal-title":"Neuropeptides"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e64605","DOI":"10.1371\/journal.pone.0064605","article-title":"Perilipin-mediated lipid droplet formation in adipocytes promotes sterol regulatory element-binding protein-1 processing and triacylglyceride accumulation","volume":"8","author":"Takahashi","year":"2013","journal-title":"PLoS One"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1016\/j.dld.2019.09.002","article-title":"L-carnitine supplementation attenuates NAFLD progression and cardiac dysfunction in a mouse model fed with methionine and choline-deficient diet","volume":"52","author":"Mollica","year":"2020","journal-title":"Dig Liver Dis"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1007\/BF03261931","article-title":"Carnitine and acylcarnitines: pharmacokinetic, pharmacological and clinical aspects","volume":"51","author":"Reuter","year":"2012","journal-title":"Clin Pharmacokinet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2337\/db12-0466","article-title":"Acylcarnitines: reflecting or inflicting insulin resistance?","volume":"62","author":"Schooneman","year":"2013","journal-title":"Diabetes"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"33","DOI":"10.2307\/4593493","article-title":"Osteoporosis in women 45 years and over related to subsequent fractures","volume":"84","author":"Iskrant","year":"1969","journal-title":"Public Health Rep (1896)"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.maturitas.2020.05.004","article-title":"How to manage osteoporosis before the age of 50","volume":"138","author":"Rozenberg","year":"2020","journal-title":"Maturitas"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1080\/07315724.1999.10718830","article-title":"L-carnitine improves glucose disposal in type 2 diabetic patients","volume":"18","author":"Mingrone","year":"1999","journal-title":"J Am Coll Nutr"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1196\/annals.1320.007","article-title":"Therapeutic effects of L-carnitine and propionyl-L-carnitine on cardiovascular diseases: a review","volume":"1033","author":"Ferrari","year":"2004","journal-title":"Ann N Y Acad Sci"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1053\/jren.2003.50010","article-title":"History of L-carnitine: implications for renal disease","volume":"13","author":"Matera","year":"2003","journal-title":"J Ren Nutr"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1664866\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T07:05:22Z","timestamp":1762239922000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1664866\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":38,"alternative-id":["10.3389\/fnut.2025.1664866"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2025.1664866","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"article-number":"1664866"}}