The ameliorative effects of L-carnitine on decidualization in high-fat diet-induced rats and human endometrial stromal cells

Hairu Cao; Dandan Qi; Na Sun; Ping Sun; Peng Xue; Pingping Sun; Huagang Ma

doi:10.1016/j.rbmo.2026.105513

The ameliorative effects of L-carnitine on decidualization in high-fat diet-induced rats and human endometrial stromal cells

Hairu Cao, Dandan Qi, Na Sun, Ping Sun, Peng Xue, Pingping Sun, Huagang Ma

In: Reproductive BioMedicine Online · 2026 · pp. 105513 · doi:10.1016/j.rbmo.2026.105513 · W7125978082

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Abstract

Research questionDoes L-carnitine ameliorate impairment of endometrial decidualization in high-fat diet-induced obese rats and human endometrial stromal cells (HESC) treated with palmitic acid-treated?DesignObese female rats (n = 10 per group; 5 weeks old at commencement of dietary intervention) induced by a high-fat diet for 8 weeks were administered L-carnitine at doses of 135, 400 and 1200 mg/kg/day via oral gavage for 5 weeks, with metformin serving as the control. After mating, uterine specimens were collected on gestational day 7 and analysed by various techniques, including haematoxylin and eosin staining, and Western blotting. Additionally, palmitic acid was used to induce lipid accumulation in immortalized HESC, followed by treatment with L-carnitine to investigate its effects on decidualization processes.ResultsCompared with metformin, the administration of L-carnitine (400 mg/kg/day) restored the number of embryo implantation sites and decidualization in vivo. L-carnitine was found to increase the expression of sirtuin 1 (SIRT1) and Forkhead box class O 1 (FOXO1), while simultaneously decreasing expression of acetyl-FOXO1. In vitro, L-carnitine reversed the palmitic acid-induced suppression of decidualization markers and restored mitochondrial polarization. Notably, L-carnitine treatment restored SIRT1/FOXO1 signalling pathways and enhanced the expression of the progesterone receptor in vivo and in vitro.ConclusionsL-carnitine ameliorates impaired endometrial decidualization in rats fed a high-fat diet and HESC treated with palmitic acid via the SIRT1/FOXO1/progesterone receptor pathway.

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