Supplementation with L-arginine favorably influences plasminogen activator inhibitor type 1 concentration in obese patients. A randomized, double blind trial.
BACKGROUND
Elevated plasminogen activator inhibitor type 1 (PAI 1) plays an important role in the pathogenesis of excess blood coagulability in obese patients. L-arginine supplementation has shown to be associated with enhanced cardiovascular and metabolic health. The aim of the study was to assess the effect of L-arginine supplementation on PAI 1 concentration and to evaluate the relation to changes in nitric oxide (NO) plasma level, insulin sensitivity (M value), and total antioxidant status (TAS) in obese patients.


METHODS
A randomized, double-blind, placebo-controlled study was conducted from March 2010 to June 2011. Eightyeight obese patients were randomly assigned to receive either 9 g of L-arginine or placebo daily for 6 months. At baseline and after 6 months, selected anthropometrical measurements and blood biochemical analyses were performed, and PAI 1, NO, TAS levels were assessed. Insulin sensitivity was evaluated using the hyperinsulinemic euglycemic clamp technique.


RESULTS
We found that 6-month L-arginine supplementation resulted in significant decrease of PAI 1. Significant increase of NO, TAS, and insulin sensitivity level were noticed. In a group of patients treated with L-arginine, negative correlation between a change of insulin sensitivity value and a change of PAI 1 concentration was found.


CONCLUSIONS
The present findings demonstrate favorable influence of L-arginine supplementation on PAI 1 concentration in obese patients. Beneficial influence is related to insulin sensitivity improvement. The potential therapeutic role of L-arginine administration in patients with obesity needs further investigation.
Department of Internal Medicine, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, Szamarzewskiego 84 Str., 60-569 Poznan, Poland. pawelbogdanski@wp.pl
P
P
Bogdanski
M
M
Szulinska
J
J
Suliburska
D
D
Pupek-Musialik
A
A
Jablecka
H
H
Witmanowski
D000328:Adult; D000975:Antioxidants / Q000378:metabolism; D001120:Arginine / Q000008:administration & dosage* / Q000494:pharmacology; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D009765:Obesity / Q000097:blood* / Q000188:drug therapy* / Q000378:metabolism; D009994:Osmolar Concentration; D010919:Placebos; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*
D000975:Antioxidants; D010919:Placebos; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D009569:Nitric Oxide; D001120:Arginine