Keywords
How to Cite
Abstract
Cardiovascular (CVD) and metabolic diseases (such as obesity and diabetes) are currently major health problems worldwide. One of the most important pathophysiological connections between these conditions is the presence of nitric oxide (NO), which is constantly produced from a conditionally essential amino acid, namely L-arginine. NO is an important paracrine substance secreted by the endothelium to regulate vascular tone. The development and progression of atherosclerosis is associated with endothelial dysfunction and a decrease in the bioavailability of NO. It has been established that obesity is also associated with a decrease in NO production caused by a violation of the bioavailability of its substrate, arginine, and an increase in the arginine content in the endothelium prevents hypertension, which is often combined with obesity. L-arginine is an amino acid required by the enzyme, endothelial NO synthase (eNOS), to produce NO. Purpose — bibliographic review of scientific publications. Results. This review discusses the physiological role of NO in the functioning of various body systems. Data on the metabolism of L-arginine, its bioavailability and mechanisms of action are given. The literature data on the effectiveness and safety of the use of various doses of L-arginine in patients with obesity, diabetes mellitus, insulin resistance (IR) and arterial hypertension are analyzed. Conclusion. Issues of dose and duration of arginine use today require further study. The results of many studies that evaluated the use of arginine in obese
adults suggest that arginine can be a safe, inexpensive, and effective therapeutic agent for obesity and has a positive effect on the correction of metabolic processes, namely IR. The appointment of L-arginine as an adjunctive therapy to the main treatment regimen was confirmed in arterial hypertension, diabetes mellitus and IP. An analysis of the literature indicates that the administration of L-arginine demonstrated its safety in the range of the upper limit of
30 g per day, on the other hand, in most sources, a dose of 6 to 12 g per day was used.
References
De Rosa S, Arcidiacono B, Chiefari E, Brunetti A, Indolfi C, Foti DP. Type 2 Diabetes Mellitus and Cardiovascular Disease: Genetic and Epigenetic. Front Endocrinol. 2018;9:2.
Fayh AP, Krause M, Rodrigues-Krause J, Ribeiro JL, Ribeiro JP, Friedman R, Moreira JC, Reischak-Oliveira A. Effects of L-arginine supplementation on blood flow, oxidative stress status and exercise responses in young adults with uncomplicated type I diabetes. Eur J Nutr. 2013;52:975-983.
Krause M, Rodrigues-Krause J, O’Hagan C, Medlow P, Davison G, Susta D, Boreham C, Newsholme P, O’Donnell M, Murphy C et al. The effects of aerobic exercise training at two different intensities in obesity and type 2 diabetes: implications for oxidative stress, low-grade inflammation and nitric oxide production. Eur J Appl
Physiol. 2014;114:251-60.
Rodrigues-Krause J, Farinha JB, Krause M, Reischak-Oliveira A. Effects of dance interventions on cardiovascular risk with ageing: Systematic review and meta-analysis. Complement Med.т2016;29:16-28.
Tousoulis D, Antoniades C, Tentolouris C, Goumas G, Stefanadis C. L-Arginine in cardiovascular disease: dream or reality? Vasc Med. 2002;7:203-11.
Kashyap VS, Lakin RO, Campos P, Allemang M, Kim A, Sarac TP, Hausladen A, Stamler JS. The LargPAD Trial: Phase IIA evaluation of l-arginine infusion in patients with peripheral arterial disease. J Vasc Surg. 2017;66:187-94.
Dimova R, Tankova T, Chakarova N. Siscovick DS, Barringer TA, Fretts AM, Wu JH, Lichtenstein AH, Costello RB, Kris-Etherton PM, Jacobson TA, Engler MB, Alger HM et al. Omega‑3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinic. J Nutr. 2017;147:1607-15.
Siscovick DS, Barringer TA, Fretts AM, Wu JH, Lichtenstein AH, Costello RB. K-EPM, Jacobson T.A. EMBAHM et al. Omega‑3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association. 2017, 135, e867–e884. Circulation. 2017;135:867-84.
Newsholme P, Rebelato E, Abdulkader F, Krause M, Carpinelli A CR. Reactive oxygen and nitrogen species generation, antioxidant defenses, and beta-cell function: a critical role for amino acids. 2012, 214, 11-20. J Endocrinol. 2012;214:11-20.
Бабушкина АВ. L-аргинин с точки зрения доказательной медицины. Український кардіологічний журнал. 2009;6(74):1-9. (Babushkina AB. L-arginine in terms of evidence-based medicine. Ukrainian Cardiology Journal. 2009; 6 (74): 1-9.)
Алмакаева ЛГ, Литвинова ЕВ. Аргинин и его применение в медицине и фармации. Ліки України. 2011;1 (5):23-6. (Almakaeva LG, Litvinova E.V. Arginine and its use in medicine and pharmacy. Medicines of Ukraine. 2011; 1 (5): 23-6.)
Tousoulis D, Boger RH AC, Al E. Mechanisms of disease: L-arginine in coronary atherosclerosisa clinical perspective. Nat Clin Pr Cardiovasc Med. 2007;4:274-84.
Трещинская МА. Теоретические и практические аспекты применения L-аргинина с целью профилактики цереброваскулярной патологии. Український медичний часопис. [Internet] 2011. (Treschinskaya MA. Theoretical and practical aspects of the use of L-arginine for the prevention of cerebrovascular pathology. Ukrainian medical chronicle. [Internet] 2011.
Лутай МІ, Бугаєнко ВВ, Моїсеєнко ОІ, Муштенко ЛО, Слободський ВА. Значення L-аргініну в лікуванні хворих із серцево-судинною патологією. Український кардіологічний журнал. 2011;4:96-107. (Lutai MI, Bugaenko VV, Moiseenko OI, Mushtenko LO, Slobodskaya VA. The value of L-arginine in the treatment of patients with cardiovascular pathology. Ukrainian Cardiology Journal. 2011; 4: 96-107.)
Brunini TMC, Mendes-ribeiro AC, Ellory JC, Mann GE. Platelet nitric oxide synthesis in uremia and malnutrition: A role for L-arginine supplementation in vascular protection? Cardiovasc Res. 2007;73:359-67.