Volume 1, Issue 1 (November 2016)                   JNFS 2016, 1(1): 17-27 | Back to browse issues page

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PhD Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract:   (1242 Views)

Background: The prevalence of hypertension in patients with type 2 diabetes (T2D) is approximately twice as much as healthy people. This study was designed to determine the effect of L-arginine supplementation on blood pressure in patients with T2D. Methods: In a double-blind randomized clinical trial, 75 T2D were randomly divided into three groups (3 g/d and 6g/d of L-arginine and placebo) for 3 months. Height, weight, waist circumference, dietary intake, and blood pressure (BP) were measured before and after intervention. Results: In patients who received 3g/d L-arginine, no significant difference was observed between BP before and after the intervention, however, subgroup analysis among patients with high BP showed significant reduction in systolic (P = 0.036) and diastolic BP (P = 0.027) after L-arginine supplementation. After 3 months of intervention, systolic and diastolic BP were significantly different compared to the baseline values and also with placebo value in patients receiving 6g/d of L-arginine (P < 0.05). Conclusions: The daily intake of 6g of L-arginine for 3 months in T2D may improve BP. Taking 3g/d of this supplement may help to improve BP only in patients with hypertension.

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Type of article: orginal article | Subject: public specific
Received: 2016/05/10 | Accepted: 2016/07/13 | Published: 2016/09/4

1. Adams MR, Forsyth CJ, Jessup W, Robinson J & Celermajer DS 1995. Oral L-arginine inhibits platelet aggregation but does not enhance endothelium-dependent dilation in healthy young men. Journal of the American College of Cardiology.26(4): 1054-1061.
2. Adams MR, et al. 1997. Oral L-arginine improves endothelium-dependent dilatation and reduces monocyte adhesion to endothelial cells in young men with coronary artery disease. Atherosclerosis.129(2): 261-269.
3. Adler AI, et al. 2000. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. Bmj.321(7258): 412-419.
4. Amezcua J, Dusting G, Palmer R & Moncada S 1988. Acetylcholine induces vasodilatation in the rabbit isolated heart through the release of nitric oxide, the endogenous nitrovasodilator. British journal of pharmacology.95(3): 830-834.
5. Ast J, et al. 2011. Supplementation with L-arginine does not influence arterial blood pressure in healthy people: a randomized, double blind, trial. Eur Rev Med Pharmacol Sci.15(12): 1375-1384.
6. Azimi-Nezhad M, et al. 2008. Prevalence of type 2 diabetes mellitus in Iran and its relationship with gender, urbanisation, education, marital status and occupation. Singapore medical Journal.49(7): 571.
7. Bode-Boger S, et al. 1994. L-arginine infusion decreases peripheral arterial resistance and inhibits platelet aggregation in healthy subjects. Clinical science.87(3): 303-310.
8. Bode-Böger SM, et al. 1996. l-Arginine Induces Nitric Oxide–Dependent Vasodilation in Patients With Critical Limb Ischemia A Randomized, Controlled Study. Circulation.93(1): 85-90.
9. Böger RH, et al. 1997. Dietary L-arginine reduces the progression of atherosclerosis in cholesterol-fed rabbits comparison with lovastatin. Circulation.96(4): 1282-1290.
10. Burke JP, et al. 1999. Rapid rise in the incidence of type 2 diabetes from 1987 to 1996: results from the San Antonio Heart Study. Archives of Internal Medicine.159(13): 1450-1456.
11. Chan N & Vallance P 2002. The L-arginine-nitric oxide pathway. In An Introduction to Vascular Biology: From Basic Science to Clinical Practice (ed. H. Beverley J, P. Lucilla, S. Michael and H. Alison W), p. 216. University of Cambridge: United kingdom.
12. Chen Y & Reaven G 1997. Insulin resistance and atherosclerosis. Diabetes Reviews.5(4): 331-342.
13. Chin-Dusting JP, et al. 1996a. Effects of in vivo and in vitro L-arginine supplementation on healthy human vessels. Journal of cardiovascular pharmacology.28(1): 158-166.
14. Chin-Dusting JP, et al. 1996b. Dietary supplementation with L-arginine fails to restore endothelial function in forearm resistance arteries of patients with severe heart failure. Journal of the American College of Cardiology.27(5): 1207-1213.
15. Cocks T & Angus J 1983. Endothelium-dependent relaxation of coronary arteries by noradrenaline and serotonin. Nature.305, : 627-630.
16. Delavari AR MHA, Norozinejad A, Yarahmadi SH 2004. Country programme of prevention and control of diabetes. Seda Publication: Tehran, Iran.
17. Esteghamati A, et al. 2008. prevalence of diabetes and impaired fasting glucose in the adult population of Iran national survey of risk factors for non-communicable diseases of Iran. Diabetes care.31(1): 96-98.
18. Evans RW, Fernstrom JD, Thompson J, Morris SM & Kuller LH 2004. Biochemical responses of healthy subjects during dietary supplementation with L-arginine. The Journal of nutritional biochemistry.15(9): 534-539.
19. Facchinetti F, et al. 2007. L-arginine supplementation in patients with gestational hypertension: a pilot study. Hypertension in pregnancy.26(1): 121-130.
20. Garthwaite J & Boulton C 1995. Nitric oxide signaling in the central nervous system. Annual review of physiology.57(1): 683-706.
21. Garthwaite J, Charles SL & Chess-Williams R 1988. Endothelium-derived relaxing factor release on activation of NMDA receptors suggests role as intercellular messenger in the brain.
22. Giugliano D, et al. 1997a. Vascular effects of acute hyperglycemia in humans are reversed by L-arginine evidence for reduced availability of nitric oxide during hyperglycemia. Circulation.95(7): 1783-1790.
23. Giugliano D, et al. 1997b. L-arginine for testing endothelium-dependent vascular functions in health and disease. The American journal of physiology.273(3 Pt 1): E606-612.
24. Herman W, Konzelman Jr J & Prisant L 2004. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. New national guidelines on hypertension: a summary for dentistry. J Am Dent Assoc.135(5): 576-584.
25. Huynh NT & Tayek JA 2002. Oral arginine reduces systemic blood pressure in type 2 diabetes: its potential role in nitric oxide generation. Journal of the American College of Nutrition.21(5): 422-427.
26. Iyengar R, Stuehr DJ & Marletta MA 1987. Macrophage synthesis of nitrite, nitrate, and N-nitrosamines: precursors and role of the respiratory burst. Proceedings of the National Academy of Sciences.84(18): 6369-6373.
27. Katusic Z, Shepherd J & Vanhoutte P 1984. Vasopressin causes endothelium-dependent relaxations of the canine basilar artery. Circulation research.55(5): 575-579.
28. Kelly BS, et al. 2001. Oral arginine improves blood pressure in renal transplant and hemodialysis patients. Journal of Parenteral and Enteral Nutrition.25(4): 194-202.
29. Lechin F, et al. 2006. The effects of oral arginine on neuroautonomic parameters in healthy subjects. Journal of Applied Research in Clinical and Experimental Therapeutics.6(3): 201.
30. Lerman A, Burnett JC, Higano ST, McKinley LJ & Holmes DR 1998. Long-term L-arginine supplementation improves small-vessel coronary endothelial function in humans. Circulation. 97(21): 2123-2128.
31. Lucotti P, et al. 2006. Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in obese, insulin-resistant type 2 diabetic patients. American Journal of Physiology-Endocrinology and Metabolism.291(5): E906-E912.
32. Luiking YC, Engelen MP & Deutz NE 2010. Regulation of nitric oxide production in health and disease. Current opinion in clinical nutrition and metabolic care.13(1): 97.
33. Marietta M, et al. 1997. L-arginine infusion decreases platelet aggregation through an intraplatelet nitric oxide release. Thrombosis research.88(2): 229-235.
34. Martina V, et al. 2008. Long-term N-acetylcysteine and L-arginine administration reduces endothelial activation and systolic blood pressure in hypertensive patients with type 2 diabetes. Diabetes Care.31(5): 940-944.
35. Miller AL 2006. The effects of sustained-release-L-arginine formulation on blood pressure and vascular compliance in 29 healthy individuals. Alternative medicine review: a journal of clinical therapeutic.11(1): 23-29.
36. Mimran A, Ribstein J & DuCailar G 1995. Contrasting effect of antihypertensive treatment on the renal response to L-arginine. Hypertension.26(6): 937-941.
37. Mirfattahi M, et al. 2012. Effect of L-arginine Supplementation on Blood Pressure in overweight Patients with prediabetes. Iranian Journal of Diabetes and Lipid Disorders.11(4): 393-399. (In Farsi)
38. Palmer RM, Ashton D & Moncada S 1988. Vascular endothelial cells synthesize nitric oxide from L-arginine. Nature.333(6174): 664-666.
39. Palmer RM, Ferrige A & Moncada S 1987. Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature.327: 524-526.
40. Radomski M, Palmer R & Moncada S 1987. Endogenous nitric oxide inhibits human platelet adhesion to vascular endothelium. The Lancet.330(8567): 1057-1058.
41. Rajapakse NW & Mattson DL 2009. Role of L‐arginine in nitric oxide production in health and hypertension. Clinical and Experimental Pharmacology and Physiology.36(3): 249-255.
42. Rector TS, et al. 1996. Randomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure. Circulation.93(12): 2135-2141.
43. Rees DD, Palmer RM, Hodson HF & Moncada S 1989. A specific inhibitor of nitric oxide formation from l‐arginine attenuates endothelium‐dependent relaxation. British journal of pharmacology.96(2): 418-424.
44. Rytlewski K, Olszanecki R, Korbut R & Zdebski Z 2005. Effects of prolonged oral supplementation with l‐arginine on blood pressure and nitric oxide synthesis in preeclampsia. European journal of clinical investigation.35(1): 32-37.
45. Steinberg H, Brechtel G, Johnson A, Fineberg N & Baron A 1994. Insulin-mediated skeletal muscle vasodilation is nitric oxide dependent. A novel action of insulin to increase nitric oxide release. Journal of clinical investigation.94(3): 1172.
46. Unit ES 2005. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins. Lancet.366(9493): 1267-1278.
47. Vincent SR 1994. Nitric oxide: a radical neurotransmitter in the central nervous system. Progress in neurobiology.42(1): 129-160.