Change of C-reactive protein and tumor necrosis factor-a levels in Diabetes Mellitus type 2 and L-arginine-L-glutamate

Abstract

The Purpose of our study was to determine C-reactive protein (CRP) and tumor necrosis factor- a (TNF-a) levels in patients with nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus and their correction with NO synthesis precursor L-arginine-L-glutamate. Materials and methods: We examined 30 patients with type 2 diabetes aged 35 to 65, who had symptoms of NAFLD. The functional state of liver, changes in plasma levels of pro-inflammatory cytokine TNF-a and CRP were evaluated in patients treated with L-arginine-L-glutamate. Results: It was determined that in patients with type 2 diabetes and NAFLD the levels of TNF-a and CRP were significantly higher than in patients with type 2 diabetes and healthy subjects. A statistically significant decrease of TNF-a and CRP levels was established 8-10 days after the beginning of administration of L-arginine-L-glutamate in patients with type 2 diabetes and NAFLD as compared to the control group (patients with type 2 diabetes who did not take L-arginine-L-glutamate). The treatment was followed by improvement of functional liver tests (bilirubin, general cholesterol, triglycerides, (3-lipoproteins, alaninaminotransferase, and general protein) and liver ultrasound picture. Conclusions: Thus, administration of the NO-synthesis precursor L-arginine-L-glutamate in patients with diabetes mellitus type 2 and NAFLD contributes to the decrease of systemic inflammation, in particular - C-reactive protein and tumor necrosis factor- a and improvement of functional liver tests.