The impact of L-citrulline supplementation on glucose homeostasis, lipid profile, and some inflammatory factors in overweight and obese patients with type 2 diabetes: A double-blind randomized placebo-controlled trial.

2021-04-20
Phytotherapy research : PTR 35(6)
- Samaneh Azizi
- Reza Mahdavi
- Majid Mobasseri
- Soghra Aliasgharzadeh
- Fatemeh Abbaszadeh
- Mehrangiz Ebrahimi-Mameghani

PubMed: 33876875
DOI: 10.1002/ptr.6997

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 54
Population: overweight and obese patients with type 2 diabetes
Methods: participants assigned to L-citrulline (3 g/day) or placebo groups
Duration: 8 weeks

This study investigated the impact of L-citrulline on glucose homeostasis, lipid profile, and inflammatory factors in overweight and obese patients with type 2 diabetes (T2D). In total, 54 participants with T2D were assigned to L-citrulline (3 g/day L-citrulline) or placebo groups and tested for 8 weeks. Serum levels of insulin, fasting glucose, hemoglobin A1c (HbA1c), lipid profile, tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and L-citrulline were measured pre- and post-intervention. Totally, 45 patients were enrolled in the research. L-citrulline supplementation decreased serum levels of insulin (p = .025), glucose (p = .032), HbA1c (p = .001), HOMA-IR (p = .037), TNF-α (p = .036), and hs-CRP (p = .027) significantly. At the end of the study, despite the significant decrease in serum levels of triglyceride (p = .027) and the increase in high-density lipoprotein cholesterol levels (p < .001) in the L-citrulline group, no significant differences were found for these parameters between the groups. Moreover, no significant inter- and intra-group changes were observed for dietary intakes, anthropometric indices, total and low-density lipoprotein cholesterol levels (p > .05). In conclusion, L-citrulline supplementation might improve glucose homeostasis, some lipid factors and inflammatory markers in overweight and obese patients with T2D.

Research Insights

L-Citrulline→Improved Insulin Sensitivity
L-citrulline supplementation decreased ... HOMA-IR (p = .037)
Effect
Beneficial
Effect size
Moderate
Dose
3 g/day
L-Citrulline→Increased High-Density Lipoprotein Cholesterol
Despite ... the increase in high-density lipoprotein cholesterol levels (p < .001) in the L-citrulline group, no significant differences were found for these parameters between the groups.
Effect
Neutral
Effect size
Small
Dose
3 g/day
L-Citrulline→Reduced Blood Cholesterol
no significant inter- and intra-group changes were observed for ... total ... cholesterol levels (p > .05)
Effect
Neutral
Effect size
Small
Dose
3 g/day
L-Citrulline→Reduced Fasting Blood Glucose Levels
L-citrulline supplementation decreased serum levels of ... glucose (p = .032)
Effect
Beneficial
Effect size
Moderate
Dose
3 g/day
L-Citrulline→Reduced Hemoglobin A1c
L-citrulline supplementation decreased serum levels of ... HbA1c (p = .001)
Effect
Beneficial
Effect size
Moderate
Dose
3 g/day
L-Citrulline→Reduced High-Sensitivity C-Reactive Protein Level
L-citrulline supplementation decreased serum levels of ... hs-CRP (p = .027)
Effect
Beneficial
Effect size
Small
Dose
3 g/day
L-Citrulline→Reduced Insulin Levels
L-citrulline supplementation decreased serum levels of insulin (p = .025)
Effect
Beneficial
Effect size
Moderate
Dose
3 g/day
L-Citrulline→Reduced LDL Cholesterol
no significant inter- and intra-group changes were observed for ... low-density lipoprotein cholesterol levels (p > .05)
Effect
Neutral
Effect size
Small
Dose
3 g/day
L-Citrulline→Reduced Triglyceride Levels
Despite the significant decrease in serum levels of triglyceride (p = .027) ... no significant differences were found for these parameters between the groups.
Effect
Neutral
Effect size
Small
Dose
3 g/day
L-Citrulline→Reduced Tumor Necrosis Factor Alpha
L-citrulline supplementation decreased serum levels of ... TNF-α (p = .036)
Effect
Beneficial
Effect size
Small
Dose
3 g/day