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From the Departments of Medicine (Neurology and Rehabilitation) (Drs. Tarnopolsky and Roy, D.J. Mahoney and C. Rodriguez) and Pediatrics (Dr. Tarnopolsky), McMaster University, Hamilton, Department of Pediatrics (Drs. Biggar and Vajsar), Hospital for Sick Children, and Bloorview MacMillan Children’s Center (Dr. Biggar), Toronto, and Departments of Clinical Neurosciences and Rehabilitation Medicine (Dr. Doherty), University of Western Ontario, London, Ontario, Canada.
Address correspondence and reprint requests to Dr. M. Tarnopolsky, Department of Neurology, McMaster University Medical Center, 1200 Main St. W., Rm 4U4, Hamilton, Ontario, Canada L8N 3Z5; e-mail: tarnopol{at}mcmaster.ca
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 
-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.
Received December 11, 2003. Accepted in final form January 24, 2004.
This article has been cited by other articles:
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  A. Safdar, N. J. Yardley, R. Snow, S. Melov, and M. A. Tarnopolsky Global and targeted gene expression and protein content in skeletal muscle of young men following short-term creatine monohydrate supplementation Physiol Genomics, January 17, 2008; 32(2): 219 - 228. [Abstract] [Full Text] [PDF]
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 M. Tarnopolsky, S. Phillips, G. Parise, A. Varbanov, J. DeMuth, P. Stevens, A. Qu, F. Wang, and R. Isfort Gene Expression, Fiber Type, and Strength Are Similar Between Left and Right Legs in Older Adults J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2007; 62(10): 1088 - 1095. [Abstract] [Full Text] [PDF]
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 L. G. Menezes, C. Sobreira, L. Neder, A. L. Rodrigues-Junior, and J. A. Baddini Martinez Creatine supplementation attenuates corticosteroid-induced muscle wasting and impairment of exercise performance in rats J Appl Physiol, February 1, 2007; 102(2): 698 - 703. [Abstract] [Full Text] [PDF]
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 R. R. Alfieri, M. A. Bonelli, A. Cavazzoni, M. Brigotti, C. Fumarola, P. Sestili, P. Mozzoni, G. De Palma, A. Mutti, D. Carnicelli, et al. Creatine as a compatible osmolyte in muscle cells exposed to hypertonic stress J. Physiol., October 15, 2006; 576(2): 391 - 401. [Abstract] [Full Text] [PDF]
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 Other articles noted Evid. Based Med., September 1, 2004; 9(5): e5 - e5. [Full Text] [PDF]
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