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7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV13–16 November 2005, Dublin, Ireland |
Creatine supplementation fails to augment the benefits derived from resistance exercise training in patients with HIV infection
GK Sakkas1,2, K Mulligan1, ML DeSilva1, J Doyle1, H Khatami1, J Kent-Braun3 and M Schambelan1
1University of California, San Francisco, CA, USA; 2University of Thessaly, Greece; 3University of Massachusetts, Amherst, MA, USA
Antiviral Therapy 2005; Supplement 3:L6 (abstract no. 6)
OBJECTIVES: Creatine monohydrate is widely used to enhance the response to exercise training, purportedly by increasing intracellular phosphocreatine (PCr), which is a major energy source during short-term, high-intensity exercise. The aim of the present study was to determine whether creatine supplementation augments the benefits derived from resistance exercise training (RT) and improves mitochondrial energy metabolism in patients with HIV infection.
METHODS: Forty HIV-positive men were randomized in 1:1 fashion to receive creatine monohydrate or placebo. Subjects received a loading dose of 20 g/day for 5 days, followed by a maintenance dose of 4.8 g/day or matching placebo, in repeated 6-week cycles. After the first 2 weeks, all subjects underwent a 12-week program of supervised progressive RT three times weekly. The primary outcome was change in muscle strength (1 repetition maximum [1RM] in 8 muscle groups and maximum voluntary contraction [MVC] of the tibialis anterior during dorsiflexion). Secondary outcomes included changes in body composition (DEXA), muscle cross-sectional area (CSA) of the thigh and calf (MRI), intracellular muscle metabolites (PCr, inorganic phosphate, pH at rest and following exercise, and PCr recovery after exercise [in vivo 31P-MRS]) and resistance to fatigue.
RESULTS: Thirty three subjects (17 creatine, 16 placebo) completed the 14-week study. Lean body mass (LBM) increased significantly in both groups and, by week 14, the increase was greater in the creatine group (+2.3 ±1.4 [SD] vs +0.9 ±1.4 kg, P=0.01). Thigh muscle CSA also increased in both groups, but the difference between groups was not statistically significant (+12.2 ±7.8 vs +9.3 ±8.1 cm2, P=0.34). Strength increased robustly in all muscle groups (average increase 44 ±18 vs 42 ±15% in creatine and placebo, respectively) but this increase in strength was not augmented by creatine supplementation. Likewise, there were no differences between groups in changes in intracellular metabolites in response to both single and repeated MVCs or in resistance to fatigue.
CONCLUSIONS: Resistance exercise training improved muscle size and strength in HIV-infected men. Although creatine supplementation increased LBM, it failed to augment the increase in strength derived from resistance exercise training.
ACKNOWLEDGMENTS: NIH (AT 00491); General Clinical Research Center at San Francisco General Hospital (RR- 00083).
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2005-11-13
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