Decreased diabetes risk over 9 year after 18-month oral l -arginine treatment in middle-aged subjects with impaired glucose tolerance and metabolic syndrome (extension evaluation of l -arginine study)

摘要: This study aimed to determine whether l-arginine supplementation lasting for 18 months maintained long-lasting effects on diabetes incidence, insulin secretion and sensitivity, oxidative stress, endothelial function during 108 months among subjects at high risk of developing type 2 diabetes. One hundred forty-four middle-aged with impaired glucose tolerance metabolic syndrome were randomized in 2006 an (6.4 g orally/day) or placebo therapy 18 months. period was followed by a 90-month follow-up. The primary outcome diagnosis the 108 month period. Secondary outcomes included changes (proinsulin/c-peptide ratio), sensitivity (IGI/HOMA-IR), stress (AOPPs), vascular function. After 18 month participation, that still free willing continue their participation (104 subjects) further until diagnosis, time span about 9 years from baseline. Although results derived intervention demonstrated no differences probability becoming diabetics, end study, cumulative incidence 40.6% group 57.4% group. adjusted HR (l-arginine vs. placebo) 0.66; 95% CI 0.48, 0.91; p < 0.02). Proinsulin/c-peptide ratio (p < 0.001), IGI/HOMA-IR (p < 0.01), AOPP (p < 0.05) levels ameliorated compared placebo. These may suggest administration could delay development T2DM long effect be mediated, some extent, l-arginine-induced reduction stress.