КАРНІТИН, ІНСУЛІНОРЕЗИСТЕНТНІСТЬ ТА ДЕПРЕСІЯ (огляд лiтератури)

Alexandr Serhiyenko; Veronika Sehin; Marta Hotsko; Adrian Oliinyk; Victoria Serhiyenko

doi:10.21856/j-PEP.2026.2.07

Authors

Serhiyenko A. A. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine https://orcid.org/0000-0001-7519-2279
Sehin V. V. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine https://orcid.org/0009-0008-8244-4735
Hotsko M. E. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine https://orcid.org/0000-0003-3490-6196
Oliinyk A. Y. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine https://orcid.org/0009-0002-0582-997X
Serhiyenko V. O. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine https://orcid.org/0000-0002-6414-0956

DOI:

https://doi.org/10.21856/j-PEP.2026.2.07

Keywords:

insulin resistance, carnitine, acetyl-L-carnitine, depression, review

Abstract

Disruption of insulin signaling pathways in the central nervous system (CNS) is considered one of the main mechanisms of insulin resistance (IR), which is a key factor in the development of type 2 diabetes mellitus (T2DM) and depression. Obesity and T2DM often cause IR in CNS neurons, which leads to suppression of the dopaminergic system and the emergence of depressive behavior. Mitochondrial dysfunction is regarded as a key pathophysiological mechanism associated with processes commonly encountered in depression, such as neurotoxicity, impaired neuroplasticity, low-grade chronic inflammation (LGCI), and IR.

Changes in acylcarnitines (ACs) have been reported to be potentially associated with IR, cardiovascular disease, and depression. Acetyl-L-carnitine (ALC) is known to be an epigenetic modulator of glutamatergic neurotransmission. Enhanced mitochondrial metabolism of ALC plays an important role in the rapid regulation of both central and peripheral IR. Recent studies highlight the crucial role of ACs in immune and metabolic pathways, which link lipid metabolism to mitochondrial function; insufficient energy production from these pathways contributes to metabolic stress, LGCI, and IR, all of which are associated with the pathophysiology of depression. ACs also affect the immune response by modulating the production of inflammatory cytokines.

Due to its numerous properties related to neuroplasticity, ALC has the potential to become an innovative antidepressant with a unique mechanism of action. ALC's ability to influence neuroplasticity, transmembrane modulation, and neurotransmitter regulation may play a key role in the treatment of depression.

The aim of this review was to discuss the role of carnitine and acetyl-L-carnitine in the prevention/treatment of insulin resistance and depression, as well as to analyze new trends and directions for future research. A literature search was conducted using the databases Web of Science, Scopus, The Cochrane Library, MedLine, EMBASE, Global Health, etc.

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CARNITINE, INSULIN RESISTANCE, AND DEPRESSION (literature review)

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