CREATINE SUPPLEMENTATION ON SKELTAL MUSCLE MASS AND STRENGTH IN PATIENTS WITH COPD:

Skeletal muscle dysfunction is frequently observed in COPD patients, with loss of skeletal muscle mass and strength, the former being an important predictor of mortality in COPD. Creatine (Cr) supplementation has been shown to increase both muscle strength and endurance and fat-free mass (FFM) in young, healthy adults. However, some benefits have also been demonstrated in healthy older subjects and patient groups (e.g. heart failure), suggesting a potential role for Cr supplementation in COPD. PURPOSE To determine the effects of short-term (14-day) Cr supplementation on body composition, exercise tolerance, muscle strength and endurance in patients with COPD. METHODS 36 patients with advanced COPD were stratified according to FFM and randomly-assigned to Cr (n=18, FEV1=45.4 ± 14.1 % predicted) or placebo (PL) groups (n=18, FEV1=44.0 ± 14.6 % predicted). Before and after Cr (15g/d Cr + 105g/d dextrose) or placebo (130g/d dextrose), measurements were made of lower body muscle strength and endurance (KIN-KOMTM isokinetic-dynamometry; dominant leg); upper body muscle strength and endurance (handgrip dynamometry; dominant and non-dominant hand); shuttle walk test distance; body composition (BOD-PODTM). RESULTS Cr, but not PL, was associated with significant improvement in body mass (1.2 ± 1.1 kg vs 0.2 ± 1.4 kg), FFM (0.8 ± 0.8 kg vs 0.05 ± 0.5 kg), lower body muscle strength (3.1 ± 4.7 N.m vs −0.6 ± 4.5 N.m), and lower body muscle endurance (total work) (157.5 ± 573.8 J vs 1.9 ± 119.7 J) (p < 0.01, between-group differences). No significant differences following supplementation were observed for upper body strength or exercise tolerance (shuttle walk distance). CONCLUSIONS The present findings indicate that short-term creatine supplementation was effective in increasing body mass, fat-free mass, lower body muscle strength and endurance in patients with advanced COPD. It appears likely, therefore, that there may be a potential role for creatine in the treatment of COPD.