Rodríguez-Carrillo Alan Arturo, Espinoza-Vargas Mario Ramón, Vargas-Ortiz Katya, Ibarra-Reynoso Lorena Del Rocío, Olvera-Juárez Monserrat, Gómez-Ojeda Armando, Garay-Sevilla Ma Eugenia, Figueroa Arturo
Department of Medical Sciences, Division of Health Sciences, University of Guanajuato, Campus León, León CP. 37320, Guanajuato, Mexico.
Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA.
Nutrients. 2025 Jan 23;17(3):402. doi: 10.3390/nu17030402.
Metabolic-dysfunction-associated steatotic liver disease (MASLD) and obesity contribute to vascular dysfunction through oxidative stress, heightening cardiovascular risk. Oral supplementation with L-citrulline (L-cit), a precursor of L-arginine (L-arg) and nitric oxide, and high-intensity interval training (HIIT) may improve vascular function and cardiometabolic health.
This study aimed to evaluate the combined effects of L-cit supplementation and HIIT on arterial stiffness, body composition, glucose metabolism, lipid profile, and blood pressure (BP) in adolescents with MASLD and obesity.
In this double-blind, placebo-controlled, randomized clinical trial (ClinicalTrials.gov (NCT05778266), 44 adolescents (15-19 years) with MASLD and obesity were assigned to HIIT + L-cit (n = 14), HIIT + placebo (n = 14), or L-cit (n = 15) for 12 weeks. HIIT sessions (85% and 60% peak heart rate during intense and recovery periods) occurred thrice weekly. Training volume progressively increased, and participants performed 20 min of HITT per session in the last 8 weeks.
Outcomes included pulse wave velocity (PWV), augmentation index (Aix75), VO2peak, body composition, BP, glucose and lipid profiles, and hepatic steatosis. Compared to L-cit, HIIT + L-cit improved non-high-density lipoprotein cholesterol ( = 0.04), very-low-density lipoprotein cholesterol ( = 0.01), triglycerides ( = 0.02), and VO2peak ( = 0.001). No significant between-group changes were found in PWV, AIx75, hepatic steatosis, and body composition. HIIT + placebo improved VO2peak ( = 0.002), and L-cit decreased the degree of steatosis ( = 0.038).
HIIT + L-cit supplementation enhanced lipid profile and cardiorespiratory fitness, while HIIT + placebo improved cardiorespiratory capacity, and L-cit alone decreased hepatic steatosis. Thus, L-cit could be an adjuvant strategy to manage obesity-related MASLD in adolescents.
代谢功能障碍相关脂肪性肝病（MASLD）和肥胖通过氧化应激导致血管功能障碍，增加心血管疾病风险。口服补充L-瓜氨酸（L-cit），即L-精氨酸（L-arg）和一氧化氮的前体，以及高强度间歇训练（HIIT）可能改善血管功能和心脏代谢健康。
本研究旨在评估补充L-瓜氨酸和HIIT对患有MASLD和肥胖的青少年的动脉僵硬度、身体成分、葡萄糖代谢、血脂谱和血压（BP）的联合影响。
在这项双盲、安慰剂对照、随机临床试验（ClinicalTrials.gov注册号：NCT05778266）中，44名患有MASLD和肥胖的青少年（15 - 19岁）被分配到HIIT + L-瓜氨酸组（n = 14）、HIIT + 安慰剂组（n = 14）或L-瓜氨酸组（n = 15），为期12周。HIIT训练（高强度期和恢复期分别为峰值心率的85%和60%）每周进行三次。训练量逐渐增加，参与者在最后8周每次进行20分钟的HIIT训练。
观察指标包括脉搏波速度（PWV）、增强指数（Aix75）、峰值摄氧量（VO2peak）、身体成分、血压、血糖和血脂谱以及肝脂肪变性。与L-瓜氨酸组相比，HIIT + L-瓜氨酸组改善了非高密度脂蛋白胆固醇（P = 0.04）、极低密度脂蛋白胆固醇（P = 0.01）、甘油三酯（P = 0.02）和峰值摄氧量（P = 0.001）。在PWV、Aix75、肝脂肪变性和身体成分方面，组间未发现显著变化。HIIT + 安慰剂组改善了峰值摄氧量（P = 0.002），L-瓜氨酸组降低了脂肪变性程度（P = 0.038）。
补充HIIT + L-瓜氨酸可改善血脂谱和心肺适能，HIIT + 安慰剂可提高心肺功能，单独补充L-瓜氨酸可减轻肝脂肪变性。因此，L-瓜氨酸可能是管理青少年肥胖相关MASLD的一种辅助策略。
