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周辺動脈疾患におけるL-アルギニン補給:利益はなく,害はあり得る
Andrew M Wilson1, Randall Harada, Nandini Nair
1Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, Calif 94305, USA.
Circulation
|June 27, 2007
まとめ
長期にわたるL-アルギニン補給は,周辺動脈疾患 (PAD) の患者における酸化窒素の合成または血管機能を改善しませんでした. この研究では,クラウディケーション距離に対するプラセボと比較して,利点と潜在的に有害な効果は見つかりませんでした.
科学分野:
- 心血管科学の研究について
- 血管生物学 血管生物学
- 薬理学 薬理学とは
背景:
- L-アルギニンは,血管拡張剤である酸化窒素の前駆体です.
- 短期間のL-アルギニン補給は,周辺動脈疾患 (PAD) の治療に有望であることが示されました.
- PADにおける血管の反応性と機能能力に対する長期的な影響は不明である.
研究 の 目的:
- PAD患者の血管反応性および機能能力に対するL-アルギニンの長期的な効果を評価する.
- L-アルギニンサプリメントがPADにおける酸化窒素の可用性を改善するかどうかを評価する.
主な方法:
- NO-PAIN研究は,6ヶ月のランダム化臨床試験でした.
- PADによる断続的なクラウディケーションを持つ133人の被験者は,経口L-アルギニン (3g/d) またはプラセボを受けた.
- プライマリエンドポイント:トレッドミルのテストによる絶対的クラウディケーション距離の変化.
主要な成果:
- L-アルギニンは血のL-アルギニン濃度を上昇させたが,酸化窒素の可用性マーカーを改善しなかった.
- 絶対的クラウディケーション距離は両方のグループで改善されたが,L-アルギニン群では改善が少ない (28.3% vs 11.5%).
- 機能能力に対するプラセボ効果は,L-アルギニン群で弱まった.
結論:
- 長期にわたるL-アルギニンの投与は,PADにおける酸化窒素の合成または血管の反応性を強化しません.
- 長期にわたるL-アルギニンは,中断性クラウジケーションとPADの患者に有益ではありません.
- この発見は,以前に観察された潜在的な短期的利益と対照的である.
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