Schulze Friedrich, Glos Sabrina, Petruschka Dörte, Altenburg Christiane, Maas Renke, Benndorf Ralf, Schwedhelm Edzard, Beil Ulrich, Böger Rainer H
Center for Experimental Medicine, Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany.
Nutr Res. 2009 May;29(5):291-7. doi: 10.1016/j.nutres.2009.04.004.
We recently noticed a possible triglyceride-lowering effect during dietary supplementation with L-arginine. The major limitation of prior studies on L-arginine, however, was that triglyceride levels were not the primary end point, and patients were not necessarily hypertriglyceridemic. Therefore, we conducted a 2-arm, randomized, double-blind study in 33 hypertriglyceridemic patients to investigate the hypothesis that oral L-arginine may lower serum triglyceride levels in hypertriglyceridemic patients on and off statins. The study consisted of a 6-week run-in phase, 6 weeks of treatment with L-arginine (n = 22, 1.5 g bid) or placebo (n = 11), and a 6-week extension period where simvastatin (20 mg qd) was added. All patients received dietary advice during each study visit. Routine and lipid laboratory parameters were determined in the local routine clinical laboratory. Treatment with L-arginine alone had no effects on serum lipids compared to placebo. The combination of L-arginine with simvastatin led to a significantly stronger reduction in triglycerides compared to placebo plus simvastatin (-140.5 +/- 149.2 mg/dL vs -56.1 +/- 85.0 mg/dL; P = .048). In addition, we found simvastatin-induced increases in aspartate transaminase and fibrinogen to be attenuated by L-arginine as compared to placebo. We conclude from our data that L-arginine enhances the effects of simvastatin on lipid metabolism, but it has no triglyceride-lowering effects when given alone.
我们最近注意到，在补充L-精氨酸的饮食期间可能存在降低甘油三酯的作用。然而，先前关于L-精氨酸的研究的主要局限性在于，甘油三酯水平并非主要终点，而且患者不一定是高甘油三酯血症患者。因此，我们对33名高甘油三酯血症患者进行了一项双臂、随机、双盲研究，以调查口服L-精氨酸是否可降低服用和未服用他汀类药物的高甘油三酯血症患者的血清甘油三酯水平这一假设。该研究包括一个为期6周的导入期、6周的L-精氨酸治疗期（n = 22，每日两次，每次1.5 g）或安慰剂治疗期（n = 11），以及一个为期6周的延长期，在此期间添加辛伐他汀（每日20 mg）。每次研究访视时，所有患者均接受饮食建议。在当地常规临床实验室测定常规和血脂实验室参数。与安慰剂相比，单独使用L-精氨酸治疗对血脂无影响。与安慰剂加辛伐他汀相比，L-精氨酸与辛伐他汀联合使用导致甘油三酯的降低更为显著（-140.5±149.2 mg/dL对-56.1±85.0 mg/dL；P = 0.048）。此外，我们发现，与安慰剂相比，L-精氨酸可减轻辛伐他汀引起的天冬氨酸转氨酶和纤维蛋白原的升高。我们从数据中得出结论，L-精氨酸可增强辛伐他汀对脂质代谢的作用，但单独使用时无降低甘油三酯的作用。
