{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:05:26Z","timestamp":1779883526260,"version":"3.53.1"},"reference-count":59,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Post-COVID-19 syndrome is associated with endothelial dysfunction (ED) and various sequelae, particularly in individuals who experienced critical illness during the acute phase, affecting lung function and the musculoskeletal system. L-citrulline, a nonessential amino acid, has been shown to improve endothelial function, systemic inflammation, blood pressure, and physical performance. This study aimed to assess the effects of L-citrulline supplementation on ED and body composition in patients with post-COVID-19 syndrome. Methods: We conducted an open-label randomized controlled clinical trial at the Instituto Nacional de Enfermedades Respiratorias in Mexico City, Mexico, from February 2021 to May 2022. Eligible subjects were adults aged \u226518 years who recovered from COVID-19 and required hospitalization during acute COVID-19. Participants were randomized 1:1 into two groups: (1) the L-citrulline group (4 g\/day) and (2) the control group. The intervention lasted three months. Endothelial-related biomarkers, including endothelin-1, sE-selectin, ICAM-1, and VCAM-1, were investigated. Body composition was measured using electrical bioimpedance, and aerobic capacity was assessed with the 6 min walk test (6MWT). Treatment effects were analyzed using two-way repeated-measures ANOVA (group \u00d7 time). Results: In total, 43 subjects participated in the study. After three months of follow-up, the intervention group showed a decrease in ICAM-1 (\u221232.59 ng\/mg of protein; 95% CI \u221252.85 to \u221212.33 vs. \u22122.31 ng\/mg of protein, CI 95%: \u221221.59 to 16.95, p = 0.034) and an increase in 6MWT (141.2 m; 95% CI: 98.40 to 184 vs. 67.70 m, CI 95%: 30.62 to 104.78, p = 0.011) compared with the control group. No differences in body composition were observed between the groups at follow-up. Conclusions: L-citrulline supplementation for three months decreased ICAM-1 and increased 6MWT.<\/jats:p>","DOI":"10.3390\/nu18111706","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:03:27Z","timestamp":1779879807000},"page":"1706","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of L-Citrulline Supplementation on Endothelial Function and Body Composition in Post-COVID-19 Syndrome: A Randomized Clinical Trial"],"prefix":"10.3390","volume":"18","author":[{"given":"Salgado-Fern\u00e1ndez Mar\u00eda","family":"Fernanda","sequence":"first","affiliation":[{"name":"Licenciatura en Nutriolog\u00eda, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Ciudad de M\u00e9xico C.P. 09230, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2305-141X","authenticated-orcid":false,"given":"Orea-Tejeda","family":"Arturo","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Investigaci\u00f3n Cardiopulmonar y Metab\u00f3lica del Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas, Calzada de Tlalpan 4502 Col Sec XVI, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1894-745X","authenticated-orcid":false,"given":"Sierra-Vargas Martha","family":"Patricia","sequence":"additional","affiliation":[{"name":"Departamento de Investigaci\u00f3n en Toxicolog\u00eda y Medicina Ambiental, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3378-1769","authenticated-orcid":false,"given":"Gonz\u00e1lez-Islas","family":"Dulce","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Investigaci\u00f3n Cardiopulmonar y Metab\u00f3lica del Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas, Calzada de Tlalpan 4502 Col Sec XVI, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-2841","authenticated-orcid":false,"given":"Debray-Garc\u00eda","family":"Yazm\u00edn","sequence":"additional","affiliation":[{"name":"Departamento de Investigaci\u00f3n en Toxicolog\u00eda y Medicina Ambiental, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1761-9443","authenticated-orcid":false,"given":"Aztatzi-Aguilar Octavio","family":"Gamaliel","sequence":"additional","affiliation":[{"name":"Laboratorio de Toxicolog\u00eda Inhalatoria e Integrativa, Centro de Investigaci\u00f3n y de Estudios Avanzados del Instituto Polit\u00e9cnico Nacional, Ciudad de M\u00e9xico C.P. 14330, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galicia-Amor","family":"Susana","sequence":"additional","affiliation":[{"name":"Departamento de Rehabilitaci\u00f3n Pulmonar, Instituto Nacional de Enfermedades Respiratorias, Ismael Cos\u00edo Villegas, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hern\u00e1ndez-L\u00f3pez","family":"Samantha","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Investigaci\u00f3n Cardiopulmonar y Metab\u00f3lica del Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas, Calzada de Tlalpan 4502 Col Sec XVI, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renteria-Serralde","family":"Getsemani","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Investigaci\u00f3n Cardiopulmonar y Metab\u00f3lica del Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas, Calzada de Tlalpan 4502 Col Sec XVI, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cruz-Gij\u00f3n","family":"Gabriela","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Investigaci\u00f3n Cardiopulmonar y Metab\u00f3lica del Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas, Calzada de Tlalpan 4502 Col Sec XVI, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maldonado-Vargas","family":"Valeria","sequence":"additional","affiliation":[{"name":"Unidad Cl\u00ednica de Investigaci\u00f3n Cardiopulmonar y Metab\u00f3lica del Servicio de Cardiolog\u00eda, Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas, Calzada de Tlalpan 4502 Col Sec XVI, Ciudad de M\u00e9xico C.P. 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.7150\/ijbs.7502","article-title":"The vascular endothelium and human diseases","volume":"9","author":"Rajendran","year":"2013","journal-title":"Int. J. Biol. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.micinf.2020.05.006","article-title":"COVID-19 accelerates endothelial dysfunction and nitric oxide deficiency","volume":"22","author":"Green","year":"2020","journal-title":"Microbes Infect."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1016\/j.hrthm.2020.06.026","article-title":"COVID-19 cardiac injury: Implications for long-term surveillance and outcomes in survivors","volume":"17","author":"Mitrani","year":"2020","journal-title":"Heart Rhythm."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1093\/cvr\/cvaa140","article-title":"COVID-19 as a cardiovascular disease: The potential role of chronic endothelial dysfunction","volume":"116","author":"Almansa","year":"2020","journal-title":"Cardiovasc. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.thromres.2020.08.039","article-title":"COVID-19 and cardiovascular consequences: Is the endothelial dysfunction the hardest challenge?","volume":"196","author":"Vianello","year":"2020","journal-title":"Thromb. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/s12967-022-03346-2","article-title":"Endothelial dysfunction and altered endothelial biomarkers in patients with post-COVID-19 syndrome and chronic fatigue syndrome (ME\/CFS)","volume":"20","author":"Haffke","year":"2022","journal-title":"J. Transl. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1055\/s-2001-19137","article-title":"Relationship between plasma Endothelin-1 and glycemic control in type 2 diabetes mellitus","volume":"33","author":"Aybar","year":"2001","journal-title":"Horm. Metab. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.yjmcc.2022.03.007","article-title":"Endothelin-1 is increased in the plasma of patients hospitalised with COVID-19","volume":"167","author":"Abraham","year":"2022","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1007\/s15010-025-02627-4","article-title":"Endothelin-1 in combination with CRB-65 enhance risk stratification in COVID-19 patients","volume":"53","author":"Farhat","year":"2025","journal-title":"Infection"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1002\/JLB.2MR0220-549R","article-title":"ICAM-1: A master regulator of cellular responses in inflammation, injury resolution, and tumorigenesis","volume":"108","author":"Bui","year":"2020","journal-title":"J. Leukoc. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1161\/ATVBAHA.120.314558","article-title":"Overcoming Barriers: The Endothelium As a Linchpin of Coronavirus Disease 2019 Pathogenesis?","volume":"40","author":"Gustafson","year":"2020","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1093\/cvr\/cvx086","article-title":"New insights into the role of adipose tissue in thrombosis","volume":"113","author":"Vilahur","year":"2017","journal-title":"Cardiovasc. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"214","DOI":"10.2174\/18715222113139990008","article-title":"Effects of Oral L-Citrulline Supplementation on Lipoprotein Oxidation and Endothelial Dysfunction in Humans with Vasospastic Angina","volume":"13","author":"Morita","year":"2013","journal-title":"Immunol. Endocr. Metab. Agents Med. Chem."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Maharaj, A., Fischer, S.M., Dillon, K.N., Kang, Y., Martinez, M.A., and Figueroa, A. (2022). Effects of L-Citrulline Supplementation on Endothelial Function and Blood Pressure in Hypertensive Postmenopausal Women. Nutrients, 14.","DOI":"10.3390\/nu14204396"},{"key":"ref_16","first-page":"34","article-title":"Effects of arginine and citrulline supplementation on inflammatory markers in critically ill patients","volume":"2","author":"Barkhidarian","year":"2016","journal-title":"J. Nutr. Sci. Diet."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.ijcard.2010.10.004","article-title":"Short-term effects of L-citrulline supplementation on arterial stiffness in middle-aged men","volume":"155","author":"Ochiai","year":"2012","journal-title":"Int. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/j.jacc.2010.03.063","article-title":"Modest visceral fat gain causes endothelial dysfunction in healthy humans","volume":"56","author":"Orban","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"5510","DOI":"10.1038\/s41598-023-32046-0","article-title":"Association between asymmetric dimethylarginine and sarcopenia in community-dwelling older women","volume":"13","author":"Yokoro","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"103339","DOI":"10.1016\/j.ctim.2026.103339","article-title":"Synergistic effect of long-term L-citruline supplementation combined with exercise on body composition in adults: A systematic review and meta-analysis of randomized controlled trials","volume":"98","author":"Wang","year":"2026","journal-title":"Complement. Ther. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e70267","DOI":"10.1002\/jcsm.70267","article-title":"Skeletal Muscle and Circulating microRNAs Adaptations to 12-Week HIIT With or Without L-Citrulline in Obese Older Adults","volume":"17","author":"Millet","year":"2026","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/S0021-9258(19)52451-6","article-title":"Protein measurement with the Folin phenol reagent","volume":"193","author":"Lowry","year":"1951","journal-title":"J. Biol. Chem."},{"key":"ref_23","unstructured":"Lohman, T.G., Roche, A.F., and Martorell, R. (1988). Anthropometric Standardization Reference Manual, Human Kinetics Books."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1093\/ajcn\/41.4.810","article-title":"Assessment of fat-free mass using bioelectrical impedance measurements of the human body","volume":"41","author":"Lukaski","year":"1985","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.clnu.2012.08.001","article-title":"Low phase angle determined by bioelectrical impedance analysis is associated with malnutrition and nutritional risk at hospital admission","volume":"32","author":"Kyle","year":"2013","journal-title":"Clin. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.clnu.2014.07.010","article-title":"Assessing appendicular skeletal muscle mass with bioelectrical impedance analysis in free-living Caucasian older adults","volume":"34","author":"Sergi","year":"2015","journal-title":"Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.clnesp.2017.01.010","article-title":"Handgrip strength: Reference values and its relationship with bioimpedance and anthropometric variables","volume":"19","year":"2017","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002). ATS statement: Guidelines for the six-minute walk test. Am. J. Respir. Crit. Care Med., 166, 111\u2013117.","DOI":"10.1164\/ajrccm.166.1.at1102"},{"key":"ref_29","first-page":"20","article-title":"Estimaci\u00f3n de la Ingesta por Recordatorio de 24 Horas","volume":"31","author":"Ferrari","year":"2013","journal-title":"Diaeta"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12986-022-00684-2","article-title":"Protective and therapeutic effectiveness of taurine supplementation plus low calorie diet on metabolic parameters and endothelial markers in patients with diabetes mellitus: A randomized, clinical trial","volume":"19","author":"Moludi","year":"2022","journal-title":"Nutr. Metab."},{"key":"ref_31","first-page":"90","article-title":"El endotelio: Estructura, funci\u00f3n y disfunci\u00f3n endotelial","volume":"34","year":"2017","journal-title":"Med. Leg. Costa Rica"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e575","DOI":"10.1016\/S2352-3026(20)30216-7","article-title":"Endotheliopathy in COVID-19-associated coagulopathy: Evidence from a single-centre, cross-sectional study","volume":"7","author":"Goshua","year":"2020","journal-title":"Lancet Haematol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.tcm.2008.11.004","article-title":"Monocyte-endothelial cell interactions in the development of atherosclerosis","volume":"18","author":"Mestas","year":"2008","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_34","first-page":"730","article-title":"Intracellular Adhesion Molecule-1 (ICAM-1) Levels in Convalescent COVID-19 Serum: A Case Report","volume":"51","author":"Loeffler","year":"2021","journal-title":"Ann. Clin. Lab. Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"37733","DOI":"10.1038\/s41598-025-25475-6","article-title":"Circulating vascular biomarkers in relation to physiological indices of aortic stiffness and endothelial function in hypertension","volume":"15","author":"Jekell","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kang, Y., Dillon, K.N., Martinez, M.A., Maharaj, A., Fischer, S.M., and Figueroa, A. (2022). Combined L-Citrulline Supplementation and Slow Velocity Low-Intensity Resistance Training Improves Leg Endothelial Function, Lean Mass, and Strength in Hypertensive Postmenopausal Women. Nutrients, 15.","DOI":"10.3390\/nu15010074"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Allerton, T.D., Proctor, D.N., Stephens, J.M., Dugas, T.R., Spielmann, G., and Irving, B.A. (2018). l-Citrulline Supplementation: Impact on Cardiometabolic Health. Nutrients, 10.","DOI":"10.3390\/nu10070921"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1161\/01.ATV.0000051384.43104.FC","article-title":"Endothelial dysfunction: A marker of atherosclerotic risk","volume":"23","author":"Bonetti","year":"2003","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Tosato, M., Calvani, R., Picca, A., Ciciarello, F., Galluzzo, V., Coelho-J\u00fanior, H.J., Di Giorgio, A., Di Mario, C., Gervasoni, J., and Gremese, E. (2022). Effects of l-Arginine Plus Vitamin C Supplementation on Physical Performance, Endothelial Function, and Persistent Fatigue in Adults with Long COVID: A Single-Blind Randomized Controlled Trial. Nutrients, 14.","DOI":"10.3390\/nu14234984"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.numecd.2014.03.003","article-title":"Mediterranean dietary pattern, inflammation and endothelial function: A systematic review and meta-analysis of intervention trials","volume":"24","author":"Schwingshackl","year":"2014","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"102200","DOI":"10.1016\/j.dsx.2021.102200","article-title":"The effect of vitamin D supplementation on flow-mediated dilatation, oxidized LDL and intracellular adhesion molecule 1 on type 2 diabetic patients with hypertension: A randomized, placebo-controlled, double-blind trial","volume":"15","author":"Qasemi","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s11154-023-09793-6","article-title":"Phase angle and COVID-19: A systematic review with meta-analysis","volume":"24","author":"Tinahones","year":"2023","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.clnu.2024.11.008","article-title":"Phase angle as a marker of muscle quality: A systematic review and meta-analysis","volume":"43","author":"Prado","year":"2024","journal-title":"Clin. Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"de Blasio, F., Scalfi, L., Castellucci, B., Sacco, A.M., Berlingieri, G.M., Capitelli, L., Alicante, P., Sanduzzi, A., and Bocchino, M. (2022). Poor Nutritional Status and Dynapenia Are Highly Prevalent in Post-Acute COVID-19. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.888485"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1161\/CIRCULATIONAHA.106.184461","article-title":"Assessment of functional capacity in clinical and research settings: A scientific statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing","volume":"116","author":"Arena","year":"2007","journal-title":"Circulation"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e46096","DOI":"10.1097\/MD.0000000000046096","article-title":"The impacts of sarcopenia and its components on heart failure patients: A systematic review and network meta-analysis","volume":"104","author":"Tran","year":"2025","journal-title":"Medicine"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1519\/JSC.0b013e3181cb28e0","article-title":"Citrulline malate enhances athletic anaerobic performance and relieves muscle soreness","volume":"24","author":"Jakeman","year":"2010","journal-title":"J. Strength. Cond. Res."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Kang, Y., Dillon, K.N., Martinez, M.A., Maharaj, A., Fischer, S.M., and Figueroa, A. (2024). L-Citrulline Supplementation Improves Arterial Blood Flow and Muscle Oxygenation during Handgrip Exercise in Hypertensive Postmenopausal Women. Nutrients, 16.","DOI":"10.3390\/nu16121935"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1249\/01.mss.0000210197.02576.da","article-title":"L-citrulline reduces time to exhaustion and insulin response to a graded exercise test","volume":"38","author":"Hickner","year":"2006","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1007\/s00726-015-1932-2","article-title":"Citrulline and nitrogen homeostasis: An overview","volume":"47","author":"Breuillard","year":"2015","journal-title":"Amino Acids"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Figueroa, A., Dillon, K.N., Levitt, D.E., and Kang, Y. (2025). Citrulline Supplementation Improves Microvascular Function and Muscle Strength in Middle-Aged and Older Adults with Type 2 Diabetes. Nutrients, 17.","DOI":"10.3390\/nu17172790"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1152\/japplphysiol.00192.2014","article-title":"l-Citrulline supplementation improves O2 uptake kinetics and high-intensity exercise performance in humans","volume":"119","author":"Bailey","year":"2015","journal-title":"J. Appl. Physiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1249\/JES.0000000000000223","article-title":"L-Citrulline Supports Vascular and Muscular Benefits of Exercise Training in Older Adults","volume":"48","author":"Figueroa","year":"2020","journal-title":"Exerc. Sport. Sci. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"612","DOI":"10.5603\/CJ.2012.0113","article-title":"Improvement of ventricular function in systolic heart failure patients with oral L-citrulline supplementation","volume":"19","year":"2012","journal-title":"Cardiol. J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2434","DOI":"10.1161\/01.CIR.102.19.2434","article-title":"Endothelins and endothelin receptor antagonists: Therapeutic considerations for a novel class of cardiovascular drugs","volume":"102","author":"Barton","year":"2000","journal-title":"Circulation"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.freeradbiomed.2005.08.025","article-title":"Plasma nitrite concentrations reflect the degree of endothelial dysfunction in humans","volume":"40","author":"Kleinbongard","year":"2006","journal-title":"Free Radic. Biol. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1111\/jhn.12792","article-title":"Oxidative stress and nitrate\/nitrite (NOx) status following citrulline supplementation in type 2 diabetes: A randomised, double-blind, placebo-controlled trial","volume":"34","author":"Azizi","year":"2021","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_59","first-page":"1557","article-title":"Intention to treat and follow up are important in assessing validity of a randomized clinical trial","volume":"132","author":"Capurro","year":"2004","journal-title":"Rev. Med. 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