Influence of L-citrulline supplementation along with conventional treatment and its effect on inflammatory markers in patients with non-alcoholic fatty liver disease

This study evaluated the effect of L-citrulline supplementation combined with conventional therapy on inflammatory and hepatic markers in patients with non-alcoholic fatty liver disease (NAFLD). A total of 110 patients aged 35-45 years were enrolled in a 12-week quasi-experimental study and divided into two groups: G0 (conventional treatment only) and G1 (conventional treatment plus 2 g/day L-citrulline). Anthropometric measurements and biochemical parameters, including lipid profile, liver function tests, C-reactive protein (CRP), and tumor necrosis factor (TNF)-α, as well as dietary intake, were collected at baseline and post-intervention. The mean age was 42.03±4.89 years in G0 and 44.7±4.22 years in G1. Body mass index (BMI) and weight did not change significantly in either group. L-citrulline supplementation in G1 significantly reduced low-density lipoprotein and total cholesterol levels and improved high-density lipoprotein (p<0.05). TNF-α levels also decreased significantly in the treatment group (p=0.0032), whereas CRP and aspartate aminotransferase showed no significant changes. These findings indicate that L-citrulline supplementation, as an adjunct to conventional therapy, improves inflammatory and lipid parameters in NAFLD patients, particularly TNF-α, low-density lipoprotein, and total cholesterol, without affecting BMI, weight, or CRP. Future multicenter randomized studies are recommended to confirm these results.