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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Dr. med. Jochen Schaefer
Neurologische Uniklinik (Haus 27) · Uniklinikum C. G. Carus der TU Dresden
Fetscherstraße 74
01307 Dresden
Email: schaefer@rcs.urz.tu-dresden.de
