Association of l-Arginine Supplementation with Markers of Endothelial Function in Patients with Cardiovascular or Metabolic Disorders: A Systematic Review and Meta-Analysis

Study answer

What this study found

Overall, oral L-arginine did not improve endothelial function versus placebo across the pooled trials. In the main meta-analysis, blood flow showed no overall benefit (SMD 0.30; 95% CI -0.85 to 1.46; N = 469; p = 0.60), and neither NOx (mean difference 4.41 µmol/L; 95% CI -0.50 to 9.32; N = 336; p = 0.08) nor ADMA (mean difference -0.04 µmol/L; 95% CI -0.15 to 0.08; N = 290; p = 0.53) changed significantly. Sensitivity analyses suggested a possible positive blood flow effect after removing highly heterogeneous studies (SMD 0.59; 95% CI 0.10 to 1.08; N = 323), and NOx improved in obese/type 2…

Study & population

Systematic review and meta-analysis of 13 randomized controlled trials in adults with cardiovascular disease, obesity, impaired glucose tolerance/metabolic syndrome, and/or type 2 diabetes.

Intervention

Oral L-arginine supplementation was tested across 13 randomized placebo-controlled trials in doses ranging from 3 g/day to 15 g/day, using tablets, capsules, powder, bars, or effervescent tablets; treatment durations ranged from 3 days to 18 months.

Key limitation

The evidence base was small and highly heterogeneous, with substantial variation in dose, duration, formulation, and patient population.

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Original abstract