Search JIM Advanced Search

Journal of Integrative Medicine ›› 2020, Vol. 18 ›› Issue (4): 284-291.doi: 10.1016/j.joim.2020.05.001

• Systematic Review • Previous Articles     Next Articles

Effects of L-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials

Esmaeil Yousefi Rada, Behzad Nazarianb, Somayeh Sabooria, Ebrahim Falahia, Azita Hekmatdoostc,d   

  1. a. Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad 6813833946, Iran
    b. Student Research Committee, Lorestan University of Medical Sciences, Khorramabad 6813833946, Iran
    c. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
    d. Division of Gastroenterology, Hepatology and Nutrition, British Columbia’s Children’s Hospital and Child and Family Research Institute, the University of British Columbia, British Columbia 6048752345, Canada
  • Received:2020-01-20 Accepted:2019-05-28 Online:2020-07-10 Published:2020-05-28

Objective
This meta-analysis was performed to assess the effects of L-arginine supplementation on indices of glycemic control, including fasting blood glucose (FBG), hemoglobin A1c (HbA1c), serum insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels in randomized controlled trials (RCTs).

Search strategy
This study conducted a systematic review of RCTs published in PubMed, Scopus, Web of Science, Cochrane Library and Embase, up to 5 May, 2018.

Inclusion criteria
Studies were included in this meta-analysis if they were RCTs with parallel design and reported sufficient data on participants before and after intervention, and outcomes of glycemic profile parameters in both the arginine supplementation and control groups.

Data extraction and analysis
The screening of titles and abstracts was performed independently by two reviewers. Selected articles were considered if they met the study’s inclusion criteria. The quality of included studies was assessed by using the Cochrane Collaboration modified tool. From 710 articles retrieved in the initial search, only 10 trials were suitable for pooling the effects of arginine supplementation on serum glucose, insulin, HOMA-IR and HbA1c levels, with effect sizes of nine, eight, five and five, respectively.

Conclusion
Although the results of this study confirmed that supplementation with L-arginine could have significant effects on some glycemic profile indices of participants in clinical trials, the clinical importance of this reduction may not be meaningful.

Results
Pooled random-effect analysis revealed that L-arginine supplementation could significantly decrease FBG level (weighted mean difference [WMD]: 3.35 mg/dL; 95% confidence interval [CI] = [–06.55, –00.16]; = 0.04) and serum insulin level (WMD: –2.19 μIU/mL; 95% CI = [–3.70, –0.67]; P = 0.005). However, the effects of L-arginine supplementation on HOMA-IR and HbA1c were not significant. Results of subgroup analysis showed that supplementation with L-arginine could significantly decrease serum insulin levels when the dosage of L-arginine is > 6.5 g/d (WMD: –3.49 μIU/mL; 95% CI= [–5.59, –1.38]; P = 0.001), when the duration of supplementation is ≤ 12.8 weeks (WMD: –3.76; 95% CI = [–6.50, –0.98]; P= 0.008), when the participants are not diabetic patients (WMD: –2.54 μIU/mL; 95% CI= [–4.50, –0.50]; P= 0.01) and when the baseline serum level of insulin was > 20 μIU/mL (WMD: –3.98; 95% CI = [–6.31, –1.65]; P = 0.001).

Key words: L-arginine, Fasting blood glucose, Insulin resistance, Hemoglobin A1c, Glycemic profile, Meta-analysis

[1] Ming-min Xu, Pei Guo, Qing-yu Ma, Xuan Zhou, Yu-long Wei, Lu Wang, Yue Chen, Yu Guo. Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis. Journal of Integrative Medicine, 2022, 20(4): 305-320.
[2] Ting-ting Lu, Cun-cun Lu, Mei-xuan Li, Li-xin Ke, Hui Cai, Ke-hu Yang. Reporting and methodological quality of meta-analyses of acupuncture for patients with migraine: A methodological investigation with evidence map. Journal of Integrative Medicine, 2022, 20(3): 213-220.
[3] Deng-chao Wang, Miao Yu, Wen-xian Xie, Li-yan Huang, Jian Wei, Yue-hua Lei. Meta-analysis on the effect of combining Lianhua Qingwen with Western medicine to treat coronavirus disease 2019. Journal of Integrative Medicine, 2022, 20(1): 26-33.
[4] Jun-peng Yao, Li-ping Chen, Xian-jun Xiao, Ting-hui Hou, Si-yuan Zhou, Ming-min Xu, Kai Wang, Yu-jun Hou, Lin Zhang, Ying Li. Effectiveness and safety of acupuncture for treating functional constipation: An overview of systematic reviews. Journal of Integrative Medicine, 2022, 20(1): 13-25.
[5] Yang-hao-tian Wu, Wen-bo He, Yin-yan Gao, Xue-mei Han. Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis. Journal of Integrative Medicine, 2021, 19(6): 493-502.
[6] Yi Yuan, Rui-Ting Wang, Jun Xia, Hui-Juan Cao. Interventions for preventing influenza: an overview of Cochrane systematic reviews and a Bayesian network meta-analysis. Journal of Integrative Medicine, 2021, 19(6): 503-514.
[7] Qiu-yu Tong, Ran Liu, Kun Zhang, Yuan Gao, Guang-wei Cui, Wei-dong Shen. Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis. Journal of Integrative Medicine, 2021, 19(1): 20-28.
[8] Liang Dai, Ka Kei Chan, Jian-chun Mao, Yu Tian, Jun-hua Gu, Jun Zhou, Linda L.D. Zhong. Modified Zhibai Dihuang pill, a traditional Chinese medicine formula, on steroid withdrawal in systemic lupus erythematosus: A systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(6): 478-491.
[9] Arthur Yin Fan, Sherman Gu, Sarah Faggert Alemi, Research Group for Evidence-based Chinese Medicine. Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(5): 385-394.
[10] Jafar Abolghasemi, Mohammad Ali Farboodniay Jahromi, Mohammad Hossein Sharifi, Zohreh Mazloom, Leila Hosseini, Nasrindokht Zamani, Majid Nimrouzi. Effects of Zataria oxymel on obesity, insulin resistance and lipid profile: A randomized, controlled, triple-blind trial. Journal of Integrative Medicine, 2020, 18(5): 401-408.
[11] Xian-jun Xiao, Lei-xiao Zhang, Yun-zhou Shi, Jun-peng Yao, Wei Cao, Ying Liu, Zi-hao Zou, Si-yuan Zhou, Ming-ling Chen, Chun-xiao Li, Qian-hua Zheng, Ying Li. Cupping therapy for patients with chronic urticaria: A systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(4): 303-312.
[12] Dong-dong Yu, Liang-zhen You, Wan-qiu Huang, Hui Cao, Fan-jing Wang, Xiu-qin Tang, Zhao-hui Fang, Guo-ming Shen, Yu-xiang Guan. Effects of traditional Chinese exercises on blood glucose and hemoglobin A1c levels in patients with prediabetes: A systematic review and meta-analysis. Journal of Integrative Medicine, 2020, 18(4): 292-302.
[13] Sonia Chew Wen Phang, Uma Devi Palanisamy, Khalid Abdul Kadir. Effects of geraniin (rambutan rind extract) on blood pressure and metabolic parameters in rats fed high-fat diet. Journal of Integrative Medicine, 2019, 17(2): 100-106.
[14] Jia Xu, Fu-qing Zhang, Jian Pei, Jun Ji . Acupuncture for migraine without aura: A systematic review and meta-analysis. Journal of Integrative Medicine, 2018, 16(5): 312-321.
[15] Mehranghiz Ebrahimi-Mameghani, Mohammad Asghari-Jafarabadi, Khatereh Rezazadeh. TCF7L2-rs7903146 polymorphism modulates the effect of artichoke leaf extract supplementation on insulin resistance in metabolic syndrome: A randomized, double-blind, placebo-controlled trial. Journal of Integrative Medicine, 2018, 16(5): 329-334.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[3] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[4] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50
[5] . Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication (Chinese version, part two). Journal of Chinese Integrative Medicine, 2010, 8(11): 1001-1005
[6] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[7] Hong Liu , Guo-liang Zhang, Li Shen , Zhen Zeng, Bao-luo Zhou, Cheng-hai Liu, Guang Nie . Application and evaluation of a pseudotyped virus assay for screening herbs for anti-H5Nl avian influenza virus. Journal of Chinese Integrative Medicine, 2010, 8(11): 1036-1040
[8] Zhao-guo Li . A discussion of English translation of 1995 and 1997 Chinese National Standards of Traditional Chinese Medical Terminologies for Clinical Diagnosis and Treatment. Journal of Chinese Integrative Medicine, 2010, 8(11): 1090-1096
[9] Rui Jin, Bing Zhang. A complexity analysis of Chinese herbal property theory: the multiple formations of herbal property (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(11): 1198-1205
[10] Hui-min Liu, Xian-bo Wang, Yu-juan Chang, Li-li Gu. Systematic review and meta-analysis of randomized controlled trials of integrative medicine therapy for treatment of chronic severe hepatitis. Journal of Chinese Integrative Medicine, 2012, 10(11): 1211-1228