Effect of L-arginine, L-citrulline and micronutrient supplementation on elevated triglyceride levels and metabolic syndrome severity score

Metabolic syndrome (MetS) is characterized by a cluster of metabolic disturbances, including elevated triglyceride (TAG) levels, obesity, and hypertension, and is associated with an increased risk of coronary heart disease and type 2 diabetes mellitus. Dietary interventions involving L-arginine (L-Arg), L-citrulline (L-Cit) and micronutrients may support numerous physiological functions and improve health during metabolic disturbances. We hypothesized that L-Arg, L-Cit, and micronutrient supplementation decreases elevated TAG levels (≥150 mg/dL) and improves metabolic health. This proof-of-principle study was an eight-week randomized double-blind intervention involving 60 obese individuals (age: 59.9 ± 7.5 years, BMI: 33.6 ± 4.7 kg/m 2 , TAG level: 211 ± 71.2 mg/dL). The study aimed to investigate the potential effects of L-Arg, L-Cit, and micronutrient supplementation on TAG levels and the MetS severity score based on waist circumference (WC). After eight-weeks of supplementation, the verum group showed a significant decrease in TAG levels compared to placebo (p < 0.001), and significant reductions in LDL-C (p = 0.038), systolic blood pressure (BP) (p = 0.040), and body fat mass (p = 0.045). In contrast, no effects were observed on fasting glucose, WC or diastolic BP. Participants in the verum group showed a significant decrease in the MetS severity score (p = 0.041), suggesting an improvement in metabolic health, while those in the placebo group showed no changes. This proof-of-principle study indicate that L-Arg, L-Cit, and micronutrient supplementation may reduce TAG levels and potentially improve overall metabolic health in obese individuals with elevated TAG. Confirmatory studies are needed to substantiate these exploratory findings. • L-arginine and L-citrulline with micronutrients may decrease elevated triglycerides • Metabolic syndrome severity score captures temporal changes in cardiometabolic risk • L-arginine and L-citrulline with micronutrients improve overall metabolic health