Effect of l-arginine supplementation on C-reactive protein and other inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials |
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| Institution: | 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;1. Experimental Pathology Institute, Faculty of Medicine, University of Coimbra, Portugal;2. Biophysics Institute, Faculty of Medicine, University of Coimbra, Portugal;3. Institute of Integrated Clinical Practice, Dentistry Department, Faculty of Medicine, University of Coimbra, Portugal;4. Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal;5. CNC.IBILI Consortium, University of Coimbra, Portugal;6. Radiation Oncology Department, Coimbra University Hospital Centre, Portugal;7. Coimbra Chemistry Centre, Faculty of Sciences and Technology, University of Coimbra, Portugal;1. School of Chinese Medicine, China Medical University, Taichung, Taiwan;2. Genetic Center, Proteomics Core Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan;3. Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan;4. National Cancer Institute, National Institutes of Health, Gaithersburg, MD, USA;5. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan;6. Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan;7. Division of Hepato-Gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan;8. Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan;1. Department of Cardiology, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China;2. Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China;3. Internal Medicine Division, Tieying Hospital of Fengtai District, Beijing, China;4. Department of Cardiovasology, Beijing Chinese Medicine Hospital, Capital Medical University, Beijing, China;1. Yuquan Hospital, TsingHua University, No. 5 Shijingshan Road, Shijingshan District, Beijing, 100040, China;2. Tianjin University of Traditional Chinese Medicine, No. 88 Yuquan Road, Anshan West Road, Nankai District, Tianjin 300193, China;3. Department of Thoracic Surgery, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China;4. Beijing Shijitan Hospital, Capital Medical University, No. 10 Tie Yi Road, Yang Fang Dian, Haidian District, Beijing 100038, China |
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| Abstract: | ObjectivesWe 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.MethodsA 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.ResultsSearch 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.ConclusionResults 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. |
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| Keywords: | Inflammatory biomarkers C-reactive protein interleukin-6 TNFα Meta-analysis |
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