Citrulline Supplementation Improves Microvascular Function and Muscle Strength in Middle-Aged and Older Adults with Type 2 Diabetes
Abstract
Background: Patients with type 2 diabetes (T2D) develop vascular complications due to arginine deficiency-induced microvascular endothelial dysfunction, which is related to the loss of muscle strength (MS) associated with aging. Thus, increased nitric oxide (NO)-mediated vasodilation may improve MS. We investigated the impact of the NO precursor citrulline on microvascular function (endothelial and muscle reactivity) and MS in T2D patients.
Methods: Sixteen participants with T2D (53-72 years, nine females) were randomized to citrulline supplementation (CITS, 6 g/day) or placebo for 4 weeks prior to an 8-week washout period, followed by the opposite supplement for 4 weeks in a crossover trial. Endothelial function (log-transformed reactive hyperemia index, LnRHI), forearm muscle reactivity (near-infrared spectroscopy-derived tissue oxygen index (TOI) reperfusion indices), plasma arginine levels (ARG), and handgrip strength (HGSrel) and calf MS (CMSrel) adjusted for body weight were measured at baseline and 4 weeks for each condition.
Results: CITS increased the LnRHI (∆0.11 ± 0.16 vs. ∆-0.08 ± 0.24, p p p p p p rel (∆0.02 ± 0.03 vs. ∆-0.01 ± 0.02 kg/kg, p rel were correlated (r = 0.37, p < 0.05).
Conclusions: This study showed that CITS improves microvascular endothelial function, muscle microvascular reactivity, and calf muscle strength in middle-aged and older patients with T2D.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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