title: Creatine monohydrate supplementation does not increase muscle strength, lean body mass, or muscle phosphocreatine in patients with myotonic dystrophy type 1.
abstract: Creatine monohydrate (CrM) supplementation may increase strength in some types of muscular dystrophy. A recent study in myotonic muscular dystrophy type 1 (DM1) did not find a significant treatment effect, but measurements of muscle phosphocreatine (PCr) were not performed. We completed a randomized, double-blind, cross-over trial using 34 genetically confirmed adult DM1 patients without significant cognitive impairment. Participants received CrM (5 g, approximately 0.074 g/kg daily) and a placebo for each 4-month phase with a 6-week wash-out. Spirometry, manual muscle testing, quantitative isometric strength testing of handgrip, foot dorsiflexion, and knee extension, handgrip and foot dorsiflexion endurance, functional tasks, activity of daily living scales, body composition (total, bone, and fat-free mass), serum creatine kinase activity, serum creatinine concentration and clearance, and liver function tests were completed before and after each intervention, and muscle PCr/beta-adenosine triphosphate (ATP) ratios of the forearm flexor muscles were completed at the end of each phase. CrM supplementation did not increase any of the outcome measurements except for plasma creatinine concentration (but not creatinine clearance). Thus, CrM supplementation at 5 g daily does not have any effects on muscle strength, body composition, or activities of daily living in patients with DM1, perhaps because of a failure of the supplementation to increase muscle PCr/beta-ATP content.
authors.affiliation: Department of Medicine (Neurology and Rehabilitation), McMaster University, Hamilton, Canada. tarnopol@mcmaster.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Tarnopolsky
authors.forename: Douglas
authors.initials: D
authors.lastname: Mahoney
authors.forename: Terry
authors.initials: T
authors.lastname: Thompson
authors.forename: Heather
authors.initials: H
authors.lastname: Naylor
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Doherty
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D015992:Body Mass Index; D003401:Creatine / Q000097:blood / Q000627:therapeutic use* / Q000652:urine; D018592:Cross-Over Studies; D017079:Exercise Tolerance / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009124:Muscle Proteins / Q000097:blood / Q000652:urine; D018908:Muscle Weakness / Q000188:drug therapy* / Q000209:etiology; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D009223:Myotonic Dystrophy / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D010725:Phosphocreatine / Q000378:metabolism*; D012129:Respiratory Function Tests; D017211:Treatment Failure
chemical_list: D009124:Muscle Proteins; D010725:Phosphocreatine; D003401:Creatine