Creatine monohydrate enhances strength and body composition in Duchenne muscular dystrophy.
OBJECTIVE
To determine whether creatine monohydrate (CrM) supplementation increases strength and fat-free mass (FFM) in boys with Duchenne muscular dystrophy (DD).


METHODS
Thirty boys with DD (50% were taking corticosteroids) completed a double-blind, randomized, cross-over trial with 4 months of CrM (about 0.10 g/kg/day), 6-week wash-out, and 4 months of placebo. Measurements were completed of pulmonary function, compound manual muscle and handgrip strength, functional tasks, activity of daily living, body composition, serum creatine kinase and gamma-glutamyl transferase activity and creatinine, urinary markers of myofibrillar protein breakdown (3-methylhistidine), DNA oxidative stress (8-hydroxy-2-deoxyguanosine [8-OH-2-dG]), and bone degradation (N-telopeptides).


RESULTS
During the CrM treatment phase, there was an increase in handgrip strength in the dominant hand and FFM (p < 0.05), with a trend toward a loss of global muscle strength (p = 0.056) only for the placebo phase, with no improvements in functional tasks or activities of daily living. Corticosteroid use, but not CrM treatment, was associated with a lower 8-OH-2-dG/creatinine (p < 0.05), and CrM treatment was associated with a reduction in N-telopeptides (p < 0.05).


CONCLUSIONS
Four months of CrM supplementation led to increases in FFM and handgrip strength in the dominant hand and a reduction in a marker of bone breakdown and was well tolerated in children with DD.
Tarnopolsky
M A
MA
Department of Medicine, McMaster University, Hamilton, Ontario, Canada. tarnopol@mcmaster.ca
Mahoney
D J
DJ
Vajsar
J
J
Rodriguez
C
C
Doherty
T J
TJ
Roy
B D
BD
Biggar
D
D
D000080242:8-Hydroxy-2'-Deoxyguanosine; D000293:Adolescent; D001823:Body Composition / Q000187:drug effects*; D002648:Child; D003094:Collagen / Q000652:urine; D024042:Collagen Type I; D003401:Creatine / Q000494:pharmacology / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood / Q000652:urine; D018592:Cross-Over Studies; D003849:Deoxyguanosine / Q000031:analogs & derivatives* / Q000652:urine; D004359:Drug Therapy, Combination; D018737:Hand Strength; D006801:Humans; D008297:Male; D008762:Methylhistidines / Q000097:blood / Q000652:urine; D018482:Muscle, Skeletal / Q000473:pathology*; D020388:Muscular Dystrophy, Duchenne / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D009929:Organ Size / Q000187:drug effects; D010455:Peptides / Q000652:urine; D011241:Prednisone / Q000627:therapeutic use; D011282:Pregnenediones / Q000627:therapeutic use; D012132:Respiratory Muscles / Q000187:drug effects / Q000503:physiopathology; D013147:Spirometry; D016896:Treatment Outcome
D024042:Collagen Type I; D008762:Methylhistidines; D010455:Peptides; D011282:Pregnenediones; C052929:collagen type I trimeric cross-linked peptide; D000080242:8-Hydroxy-2'-Deoxyguanosine; D003094:Collagen; D003404:Creatinine; D003849:Deoxyguanosine; C021988:deflazacort; C028118:3-methylhistidine; D003401:Creatine; D011241:Prednisone