Effect of Creatine Supplementation on Functional Capacity and Muscle Oxygen Saturation in Patients with Symptomatic Peripheral Arterial Disease: A Pilot Study of a Randomized, Double-Blind Placebo-Controlled Clinical Trial.

Wagner Jorge Ribeiro Domingues,André Alberto Moliterno,Pedro Puech-Leão,Antônio Eduardo Zerati,Gabriel Grizzo Cucato,Pollyana Mayara Nunhes,Nelson Wolosker,Daniel Boari Coelho,Raphael Mendes Ritti-Dias,Ademar Avelar

doi:10.3390/nu13010149

Abstract

The aim of the study was to verify the effects of creatine (Cr) supplementation on functional capacity (walking capacity; primary outcome) and calf muscle oxygen saturation (StO2) (secondary outcome) in symptomatic peripheral arterial disease (PAD) patients. Twenty-nine patients, of both sexes, were randomized (1:1) in a double-blind manner for administration of placebo (PLA, n = 15) or creatine monohydrate (Cr, n = 14). The supplementation protocol consisted of 20 g/day for 1 week divided into four equal doses (loading phase), followed by single daily doses of 5 g in the subsequent 7 weeks (maintenance phase). Functional capacity (total walking distance) was assessed by the 6 min walk test, and calf muscle StO2 was assessed through near infrared spectroscopy. The measurements were collected before and after loading and after the maintenance phase. The level of significance was p < 0.05. No significant differences were found for function capacity (total walking distance (PLA: pre 389 ± 123 m vs. post loading 413 ± 131 m vs. post maintenance 382 ± 99 m; Cr: pre 373 ± 149 m vs. post loading 390 ± 115 m vs. post maintenance 369 ± 115 m, p = 0.170) and the calf muscle StO2 parameters (p > 0.05). Short- and long-term Cr supplementation does not influence functional capacity and calf muscle StO2 parameters in patients with symptomatic PAD.

Highlights

Introduction censeeMDPI, Basel, Switzerland.Walking impairment is the main clinical concern in patients with symptomatic peripheral artery disease (PAD)
Patients were randomly assigned to the experiment in a 1:1 ratio, to blocks of 4–6, considering sex and total walking distance, to receive either placebo or creatine monohydrate supplementation according to a computer-generated treatment sequence in a double-blind design
Secondary outcomes were upper-limb strength, lower-limb strength, and calf muscle StO2 assessed by near-infrared spectroscopy (NIRS)

Summary

Introduction

Walking impairment is the main clinical concern in patients with symptomatic peripheral artery disease (PAD). It is used for energy production [7]. Long-term Cr supplementation increased muscle glycogen content [13,14], leading to an improvement in walking ability in clinical populations [15]. As Cr has the ability to increase the muscle content of both phosphocreatine and glycogen, Cr supplementation could improve walking tolerance in patients with PAD, especially after the onset of claudication pain when anaerobic metabolism becomes predominant. The aim of this study was to analyze the effects of oral

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