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.

Nutritional therapy improves function and complements corticosteroid intervention in mdx mice

“…46 Several studies have demonstrated the benefit from creatine monohydrate supplementation in mdx mice 15,26,36 and in patients with DMD. 25,47,52 Although increasing muscle creatine levels may be the mechanism behind a therapeutic effect, some studies have not measured muscle phosphocreatine and total creatine levels.…”

Évaluation de la capacité fonctionnelle chez des patients atteints de la dystrophie myotonique de type 1 /

“…Les prélèvements sanguins effectués dans le but de mesurer ce paramètre sont très courants dans le suivi de ce type de maladie, notamment dans les différents types de dystrophies (Vassella et al, 1965;Goto et al, 1967;Rossi et al, 1990;Tarnopolsky et al, 2004). Lors d'une blessure ou d'une contraction contre résistance, des lésions microscopiques peuvent survenir et ces lésions provoquent l'élévation du taux plasmatique de CK.…”

Myotonic Dystrophy: Therapeutic Strategies for the Future

“…Randomized trials of testosterone and creatine failed to improve muscle strength in DM patients. [20][21][22][23] A pilot study reported that dehydroepiandrosterone (DHEA) improved strength in 11 DM patients, 24 and a phase II/III trial testing two doses of oral DHEA in DM patients has been completed (NCT00167609 at http://www. clinicaltrials.gov), although final results of this study had not been published as of June 2008.…”