Effect of Arginine Supplementation in the Metabolic Syndrome

Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement36 enrolled

Overview

The purpose of this study is to determine whether oral supplementation with one form of arginine improves vascular endothelial function in healthy subjects with risk factors associated with the metabolic syndrome

The study is a randomized crossover study including 32 subjects with risk factors associated with metabolic syndrome. In a cross-over design, each subject received oral arginine and placebo, in a randomized order, and were studied the day preceding the first day of administration of arginine (or placebo) and after 4 weeks of arginine (or placebo) supplementation. The two periods of supplementation were separated by a washout period of at least 4 weeks. The subject were studied in the morning (when before supplementation) and in a whole day (when after supplementation). The mornings cessions consisted of fasting blood draw and vascular explorations, including a measurement of endothelium-dependent brachial artery reactivity ("Flow mediated dilation"), directly coupled to a measurement of post-ischemic digital reactivity (with the Endo-PAT method), completed by a measurement of non-endothelium-dependent brachial artery reactivity. An analysis of the pulse wave geometry was also performed. The whole-day cession consisted of the same fasting vascular explorations. Blood tests were performed fasting and repeated 2, 4 and 6 h after ingestion of a high-fat meal (900 kcal). Measurements of Flow mediated dilation was repeated 4h and postischemic digital reactivity were repeated 2, 4 and 6 h after ingestion of the high fat meal.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Masking

TRIPLE

Enrollment

Conditions

Overweight Hypertriglyceridemic Waist

Interventions

One form of arginineDIETARY_SUPPLEMENT

3 capsules containing 0.5g of one form of L-arginine (1.5g) 3 times daily (4.5g per day) for 1 month

placeboDIETARY_SUPPLEMENT

3 capsules containing 0.5g cellulose (non active product) 3 times daily (4.5g per day) for 1 month

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria : * Age between 18 to 60 years old * Overweight (BMI between 25 and 30 kg/m²) * 'Hypertriglyceridemic waist' (waist circumference \> 94cm for men or \> 88cm for women and fasting triglyceride levels \> 150 mg/dL) Exclusion Criteria : * Obesity (BMI\> 30 kg / m²) * Cardiac or vascular diseases * Diabetes * Thyroid disease * Systolic blood pressure \> 150 mmHg or diastolic blood pressure \> 90 mmHg * Tobacco consumption \> 6 cigarettes per week * Alcohol consumption\> 2 drinks per day * Any medication (except contraceptive treatment) or dietary supplement intake that could not be arrested more than a week before the first visit for the duration of the study. * Persons under guardianship * Positive Hepatitis B virus (HBV), Hepatitis C virus (HCV) and HIV * Hemoglobin \< 14 g/dl (for men) or \<12 g / dl (for women) * Participation in a clinical trial within 6 months preceding the study * Pregnant and lactating women * For women, menstrual cycle with a duration different from 28 (± 1) days (the cycle is not controlled by a contraceptive treatment at 28 days, or he does not appear spontaneously with regularity) * Subjects with allergies to final product components * Contraindications to arginine intake, namely asthmatics subjects, people prone to herpes, patients with liver cirrhosis and renal failure * Hypotensive patients for whom the use of nitroglycerin is contraindicated.

Locations (1)

Centre de Recherche sur Volontaires (CRV), Hospital Avicenne

Bobigny, Île-de-France Region, France

Outcomes

Primary Outcomes

Physiological assessment of endothelial function in postprandial and fasting (Endothelial function was assessed by flow-mediated dilation (FMD) and peripheral arterial tonometry (EndoPAT)

Endothelial function was assessed by flow-mediated dilation (FMD) and peripheral arterial tonometry (EndoPAT). FMD technique was used during the fasting test. The RHI measurements were performed the morning fasting and 2, 4, and 6 hours after administration of the high-fat meal, in the case of exploration days after supplementation. In terms of the 4h measurement, it was coupled to a FMD assessment. FMD was calculated as the percentage change in artery diameter at peak dilation compared with baseline and is reported as a percentage. The Reactive Hyperemia Index (RHI) was calculated as the ratio of the average pulse wave amplitude during hyperemia (60 to 120 s of the postocclusion period) to the average pulse wave amplitude during baseline in the occluded hand divided by the same values in the control hand and then multiplied by a baseline correction factor.

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Evaluation of plasma vascular cell adhesion molecule-1 (VCAM-1) of endothelial function in postprandial and fasting

Fasting plasma concentrations of VCAM-1 will be determined using two custom mixed assay kits with antibody-coated beads using the Luminex xMAP technology platform for multiplexing of immunochemical bioassays.

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Evaluation of plasma intercellular adhesion molecule (ICAM-1) of endothelial function in postprandial and fasting

Fasting plasma concentrations of ICAM-1 will be determined using two custom mixed assay kits with antibody-coated beads using the Luminex xMAP technology platform for multiplexing of immunochemical bioassays.

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Evaluation of plasma E-Selectin of endothelial function in postprandial and fasting

Data from ClinicalTrials.gov

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Secondary Outcomes

Asymmetric Dimethyl-L-Arginine (ADMA) measurement

\- Fasting ADMA concentrations were measured by an enzyme-linked immunosorbent assay.

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Amino acids measurement

Fasting amino acids contents was assayed by High-performance liquid chromatography (HPLC).

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Nitrite measurement

Fasting nitrite were analyzed by Gas chromatography-mass spectrometry (GC-MS).

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Complete blood count (CBC) analysis

Fasting and postprandial complete blood count (CBC) (was assayed using "classical clinical biochemical analyzers".

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Insulin and glucose measurement

The fasting insulin and the fasting and postprandial glucose were assayed using "classical clinical biochemical analyzers".

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Lipid profile analysis

\- The fasting lipid profile (triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol) and the postprandial evolution of triglycerides were measured and were assayed using "classical clinical biochemical analyzers".

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment

Metabolomic analysis

Fasting metabolomic analysis with metabolomic approaches

Time frame: Before the supplementation at day 0 and after the supplementation (1month after) at day 29 for each treatment