Kreatin zur Behandlung von Muskelkrankheiten? - Pro und Kontra

Zusammenfassung

Schon seit etwa 10 Jahren zur Leistungssteigerung bei Athleten erfolgreich eingesetzt, wird Kreatin seit einigen Jahren auch bei Patienten mit verschiedenen Muskelerkrankungen verwendet. Dies gründet sich auf der Beobachtung, dass bei einer Reihe von Muskelerkrankungen (mitochondriale Myopathien, Dystrophien, Myositiden) erniedrigte Konzentrationen an Kreatin sowie eine reduzierte Zahl an plasmazellulären Kreatintransportern festgestellt wurden. Die überwiegende Mehrzahl der klinischen Studien an Patienten mit verschiedenen Krankheitsbildern zeigte unspezifische, vom jeweiligen Krankheitsbild unabhängige, Steigerungen der isometrischen Kraftentfaltung um ca. 15 %. Zwei Studien konnten keine positiven Effekte einer Kreatinsupplementierung nachweisen. Auch bei den positiven Studien ist jedoch fraglich, ob die Parameter, die eine Verbesserung zeigten, für das Alltagsleben der Patienten wirklich relevant sind. Signifikante Nebenwirkungen einer Kreatinsupplementierung fanden sich in keiner Studie. - Angesichts fehlender spezifischer Therapiemöglichkeiten bei vielen Myopathien halten wir einen probatorischen Einsatz von Kreatin für sinnvoll.

Abstract

Since 1992, creatine has been used successfully by athletes to improve their physical performance. Following this, and based on the observation that the intracellular concentration of creatine and the number of plasmacellular creatine transporters are reduced in various muscle diseases (mitochondrial myopathies, dystrophies, myositis), creatine has been administered to patients with a variety of muscle disorders in the last few years. The majority of the clinical studies performed in patients with various muscle disorders showed non-specific increases (about 15 %) of isometric strength which were independent of the type of disorder. Two studies could not demonstrate any positive effects of creatine supplementation. Even the positive studies give rise to doubt about the practical relevance for everyday life of the parameters which showed an improvement. There were no significant side effects of creatine supplementation in any of the studies. - In view of the lack of specific therapeutic options in many myopathies we recommend to use creatine in such patients on a trial basis.

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