Alcohol Drinks Induce Acute Lowering in Circulating l-Arginine in Obese and Type 2 Diabetic Subjects

Since low serum l-arginine (Arg) and high asymmetric dimethylarginine (ADMA) can predict microvascular complications in type 2 diabetes mellitus (T2DM), we tested whether Arg and ADMA are affected by diet and physical activity in overweight/obese and T2DM subjects. We tested the effects on serum Arg and ADMA of single loads of dextrose, protein, fat, or alcohol (similar to 300 calories each); one episode of physical exercise; and 12 weeks of standard lifestyle modification (dietary and physical activity counseling). Alcohol drink was followed by similar to 30% lowering in Arg. Arg and ADMA increased after a protein load but remained stable after glucose or fat load or 30 min of treadmill walk. Following 12 weeks of lifestyle modification, ADMA declined only in subjects achieving weight loss >5%. In conclusion, alcohol is a previously unrecognized acute suppressor of serum Arg. Lifestyle modification lowers ADMA in subjects who achieve weight loss >5%.Clinical Trial Registration Number: NCT04406402.

Automated summary

Low serum l-arginine and high asymmetric dimethylarginine can predict microvascular complications in type 2 diabetes mellitus. This study investigated the effects of diet and physical activity on overweight/obese and T2DM subjects. The results showed that alcohol lowers l-arginine levels, while protein intake increases l-arginine and asymmetric dimethylarginine levels. Lifestyle modification only reduces asymmetric dimethylarginine levels in subjects who achieve weight loss >5%.