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Complement Ther Med. 2019 Dec;47:102226. doi: 10.1016/j.ctim.2019.102226. Epub 2019 Oct 31.

Effect of l-arginine supplementation on C-reactive protein and other inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials.

Author information

1
Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
2
Razi Herbal Medicines Research Center, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
3
Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran. Electronic address: abbasnezhad.amir@lums.ac.ir.

Abstract

OBJECTIVES:

We carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of L-arginine on inflammatory biomarkers including C-reactive protein (CRP), interleukin-6 (IL-6) and TNFα.

METHODS:

A systematic search was carried out in PubMed, Embase, Scopus, Cochrane library databases and ISI web of sciences to retrieve the RCTs which examined the effect of L-arginine supplementation on inflammatory biomarkers up to October 2019, with no language and time restriction. Meta-analysis was performed using a random effects model, and I2 index was used to evaluate the heterogeneity.

RESULTS:

Search yielded 2452 publications. Eleven RCTs were eligible. Results indicated that L-arginine supplementation had no significant effect on inflammatory biomarkers including CRP, IL-6 and TNFα. However, when subgroup analysis was performed, we found that L-arginine supplementation increased CRP levels in subjects with ages >60 years old, participants with baseline circulating CRP levels >3 mg/dl, patients with cancer and when used in enteral formula.

CONCLUSION:

Results of the present meta-analysis indicated that L-arginine supplementation increased the circulating concentrations of CRP in subjects with ages >60 years old, subjects with higher levels of CRP, patients with cancer and when used in enteral formula. Therefore, L-arginine should be used with caution in these subjects. However, further well designed, large-scale studies are needed.

KEYWORDS:

C-reactive protein; Inflammatory biomarkers; Meta-analysis; TNFα; interleukin-6; l-arginine

PMID:
31780028
DOI:
10.1016/j.ctim.2019.102226

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