Nasca · Proceedings of the National Academy of Sciences of the United States of America 2018 · case-control study · n=?

Acetyl-l-carnitine deficiency in patients with major depressive disorder.

Cited 152 times in the scientific literature.

Level 4 - case-series / case-control

Multi-center case-control study comparing biomarker levels between clinical cases and matched controls

PubMed 30061399 · doi:10.1073/pnas.1801609115 · record verified 2026-08-28

What was done

Following rodent mechanistic studies, circulating acetyl-l-carnitine (LAC) and free carnitine levels were measured in patients with major depressive disorder (MDD) and age- and sex-matched healthy controls across two independent study centers. Secondary exploratory analyses evaluated associations with depression severity, age of onset, treatment-resistant depression (TRD), and childhood trauma.

What was found

The abstract reports no numerical values, concentrations, or statistical significance metrics. Circulating LAC levels, but not free carnitine, were reported as decreased in MDD patients compared with healthy controls at both centers. Greater LAC decreases correlated with greater severity, earlier onset, and TRD status, with female sex and childhood emotional neglect predicting lower LAC in TRD patients.

Why it matters

This study identifies acetyl-l-carnitine deficiency as a candidate biomarker for a severe, treatment-resistant endophenotype of depression that may inform targeted clinical trials.

Limits

The abstract gives no sample sizes, demographic parameters, exact biomarker concentrations, or effect sizes. As an observational case-control design, it cannot prove that low LAC causes depressive symptoms, and subgroup findings reflect exploratory secondary analyses.

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