{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:31:59Z","timestamp":1790645519072,"version":"4.1.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2009,8,1]],"date-time":"2009-08-01T00:00:00Z","timestamp":1249084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:p>Abstract<\/jats:p>\n                  <jats:p>Studies with l-arginine supplementation have shown inconsistent effects on endothelial function. The generation of guanidinoacetate (GAA) from l-arginine with subsequent formation of creatine and homocysteine and consumption of methionine may reduce the pool of l-arginine available for nitric oxide generation. Experimental studies suggest that creatine supplementation might block this pathway. We sought to determine the effects of l-arginine, creatine, or the combination on endothelium-dependent vasodilation and homocysteine metabolism in patients with coronary artery disease. Patients with coronary artery disease were randomized to l-arginine (9 g\/day), creatine (21 g\/day), l-arginine plus creatine, or placebo for 4 days ( n\u00a0=\u00a026\u201329\/group). Brachial artery flow-mediated dilation and plasma levels of l-arginine, creatine, homocysteine, methionine, and GAA were measured at baseline and follow-up. l-Arginine and creatine supplementation had no effects on vascular function. l-Arginine alone increased GAA ( p\u00a0&lt;\u00a00.01) and the ratio of homocysteine to methionine ( p\u00a0&lt;\u00a00.01), suggesting increased methylation demand. The combination of creatinine and l-arginine did not suppress GAA production or prevent the increase in homocysteine-to-methionine ratio. Unexpectedly, creatine supplementation (alone or in combination with l-arginine) was associated with an 11\u201320% increase in homocysteine concentration ( p\u00a0&lt;\u00a00.05), which was not attributable to worsened renal function, providing evidence against an effect of creatine on decreasing methylation demand. In conclusion, the present study provides no evidence that l-arginine supplementation improves endothelial function and suggests that l-arginine may increase methylation demand. Creatine supplementation failed to alter the actions of l-arginine on vascular function or suppress methylation demand. The unexpected increase in homocysteine levels following creatine supplementation could have adverse effects and merits further study, since creatine is a commonly used dietary supplement.<\/jats:p>","DOI":"10.1177\/1358863x08100834","type":"journal-article","created":{"date-parts":[[2009,8,3]],"date-time":"2009-08-03T06:33:12Z","timestamp":1249281192000},"page":"239-248","source":"Crossref","is-referenced-by-count":62,"title":["The effect of l-arginine and creatine on vascular function and homocysteine metabolism"],"prefix":"10.1177","volume":"14","author":[{"given":"Eiman","family":"Jahangir","sequence":"first","affiliation":[{"name":"Boston University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A","family":"Vita","sequence":"additional","affiliation":[{"name":"Boston University School of 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