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Pashayee-Khamene F, Heidari Z, Asbaghi O, Ashtary-Larky D, Goudarzi K, Forbes SC, Candow DG, Bagheri R, Ghanavati M, Dutheil F. Creatine supplementation protocols with or without training interventions on body composition: a GRADE-assessed systematic review and dose-response meta-analysis. J Int Soc Sports Nutr 2024; 21:2380058. [PMID: 39042054 PMCID: PMC11268231 DOI: 10.1080/15502783.2024.2380058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/02/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Despite the robust evidence demonstrating positive effects from creatine supplementation (primarily when associated with resistance training) on measures of body composition, there is a lack of a comprehensive evaluation regarding the influence of creatine protocol parameters (including dose and form) on body mass and estimates of fat-free and fat mass. METHODS Randomized controlled trials (RCTs) evaluating the effect of creatine supplementation on body composition were included. Electronic databases, including PubMed, Web of Science, and Scopus were searched up to July 2023. Heterogeneity tests were performed. Random effect models were assessed based on the heterogeneity tests, and pooled data were examined to determine the weighted mean difference (WMD) with a 95% confidence interval (CI). RESULTS From 4831 initial records, a total of 143 studies met the inclusion criteria. Creatine supplementation increased body mass (WMD: 0.86 kg; 95% CI: 0.76 to 0.96, I2 = 0%) and fat-free mass (WMD: 0.82 kg; 95% CI: 0.57 to 1.06, I2 = 0%) while reducing body fat percentage (WMD: -0.28 %; 95% CI: -0.47 to -0.09; I2 = 0%). Studies that incorporated a maintenance dose of creatine or performed resistance training in conjunction with supplementation had greater effects on body composition. CONCLUSION Creatine supplementation has a small effect on body mass and estimates of fat-free mass and body fat percentage. These findings were more robust when combined with resistance training.
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Affiliation(s)
| | - Zeinab Heidari
- Ahvaz Jundishapur University of Medical Sciences, Student research committee, Ahvaz, Iran
| | - Omid Asbaghi
- Shahid Beheshti University of Medical Sciences, Cancer Research Center, Tehran, Iran
| | - Damoon Ashtary-Larky
- Ahvaz Jundishapur University of Medical Sciences, Nutrition and Metabolic Diseases Research Center, Ahvaz, Iran
| | - Kian Goudarzi
- Shahid Beheshti University of Medical Sciences, Faculty of Medicine, Tehran, Iran
| | - Scott C Forbes
- Brandon University, Department of Physical Education Studies, Brandon, MB, Canada
| | - Darren G. Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | - Reza Bagheri
- University of Isfahan, Department of Exercise Physiology, Isfahan, Iran
| | - Matin Ghanavati
- Shahid Beheshti University of Medical Sciences, National Nutrition and Food Technology Research Institute, (Faculty of Nutrition Science and Food Technology), Tehran, Iran
| | - Fred Dutheil
- University Hospital of Clermont–Ferrand, Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont–Ferrand, Occupational and Environmental Medicine, Clermont–Ferrand, France
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Clarke H, Kim DH, Meza CA, Ormsbee MJ, Hickner RC. The Evolving Applications of Creatine Supplementation: Could Creatine Improve Vascular Health? Nutrients 2020; 12:nu12092834. [PMID: 32947909 PMCID: PMC7551337 DOI: 10.3390/nu12092834] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/14/2020] [Indexed: 12/19/2022] Open
Abstract
Creatine is a naturally occurring compound, functioning in conjunction with creatine kinase to play a quintessential role in both cellular energy provision and intracellular energy shuttling. An extensive body of literature solidifies the plethora of ergogenic benefits gained following dietary creatine supplementation; however, recent findings have further indicated a potential therapeutic role for creatine in several pathologies such as myopathies, neurodegenerative disorders, metabolic disturbances, chronic kidney disease and inflammatory diseases. Furthermore, creatine has been found to exhibit non-energy-related properties, such as serving as a potential antioxidant and anti-inflammatory. Despite the therapeutic success of creatine supplementation in varying clinical populations, there is scarce information regarding the potential application of creatine for combatting the current leading cause of mortality, cardiovascular disease (CVD). Taking into consideration the broad ergogenic and non-energy-related actions of creatine, we hypothesize that creatine supplementation may be a potential therapeutic strategy for improving vascular health in at-risk populations such as older adults or those with CVD. With an extensive literature search, we have found only four clinical studies that have investigated the direct effect of creatine on vascular health and function. In this review, we aim to give a short background on the pleiotropic applications of creatine, and to then summarize the current literature surrounding creatine and vascular health. Furthermore, we discuss the varying mechanisms by which creatine could benefit vascular health and function, such as the impact of creatine supplementation upon inflammation and oxidative stress.
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Affiliation(s)
- Holly Clarke
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA; (H.C.); (D.-H.K.); (C.A.M.); (M.J.O.)
| | - Do-Houn Kim
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA; (H.C.); (D.-H.K.); (C.A.M.); (M.J.O.)
| | - Cesar A. Meza
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA; (H.C.); (D.-H.K.); (C.A.M.); (M.J.O.)
| | - Michael J. Ormsbee
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA; (H.C.); (D.-H.K.); (C.A.M.); (M.J.O.)
- Department of Biokenetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Westville 4041, South Africa
- Institute of Sports Sciences and Medicine, Florida State University, 1104 Spirit Way, Tallahassee, FL 32306, USA
| | - Robert C. Hickner
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA; (H.C.); (D.-H.K.); (C.A.M.); (M.J.O.)
- Department of Biokenetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Westville 4041, South Africa
- Institute of Sports Sciences and Medicine, Florida State University, 1104 Spirit Way, Tallahassee, FL 32306, USA
- Correspondence:
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de Guingand DL, Palmer KR, Snow RJ, Davies-Tuck ML, Ellery SJ. Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:E1780. [PMID: 32549301 PMCID: PMC7353222 DOI: 10.3390/nu12061780] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022] Open
Abstract
Creatine Monohydrate (CrM) is a dietary supplement routinely used as an ergogenic aid for sport and training, and as a potential therapeutic aid to augment different disease processes. Despite its increased use in recent years, studies reporting potential adverse outcomes of CrM have been mostly derived from male or mixed sex populations. A systematic search was conducted, which included female participants on CrM, where adverse outcomes were reported, with meta-analysis performed where appropriate. Six hundred and fifty-six studies were identified where creatine supplementation was the primary intervention; fifty-eight were female only studies (9%). Twenty-nine studies monitored for adverse outcomes, with 951 participants. There were no deaths or serious adverse outcomes reported. There were no significant differences in total adverse events, (risk ratio (RR) 1.24 (95% CI 0.51, 2.98)), gastrointestinal events, (RR 1.09 (95% CI 0.53, 2.24)), or weight gain, (mean difference (MD) 1.24 kg pre-intervention, (95% CI -0.34, 2.82)) to 1.37 kg post-intervention (95% CI -0.50, 3.23)), in CrM supplemented females, when stratified by dosing regimen and subject to meta-analysis. No statistically significant difference was reported in measures of renal or hepatic function. In conclusion, mortality and serious adverse events are not associated with CrM supplementation in females. Nor does the use of creatine supplementation increase the risk of total adverse outcomes, weight gain or renal and hepatic complications in females. However, all future studies of creatine supplementation in females should consider surveillance and comprehensive reporting of adverse outcomes to better inform participants and health professionals involved in future trials.
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Affiliation(s)
- Deborah L. de Guingand
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (M.L.D.-T.); (S.J.E.)
| | - Kirsten R. Palmer
- Department of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia;
- Monash Health, Monash Medical Centre, Melbourne 3168, Australia
| | - Rodney J. Snow
- Institute of Physical Activity and Nutrition, Deakin University, Melbourne 3125, Australia;
| | - Miranda L. Davies-Tuck
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (M.L.D.-T.); (S.J.E.)
| | - Stacey J. Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne 3168, Australia; (M.L.D.-T.); (S.J.E.)
- Department of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia;
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de Souza e Silva A, Pertille A, Reis Barbosa CG, Aparecida de Oliveira Silva J, de Jesus DV, Ribeiro AGSV, Baganha RJ, de Oliveira JJ. Effects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis. J Ren Nutr 2019; 29:480-489. [DOI: 10.1053/j.jrn.2019.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/07/2019] [Accepted: 05/19/2019] [Indexed: 12/16/2022] Open
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Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 2017; 14:18. [PMID: 28615996 PMCID: PMC5469049 DOI: 10.1186/s12970-017-0173-z] [Citation(s) in RCA: 335] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 05/30/2017] [Indexed: 12/16/2022] Open
Abstract
Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. Additionally, a number of clinical applications of creatine supplementation have been studied involving neurodegenerative diseases (e.g., muscular dystrophy, Parkinson's, Huntington's disease), diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia, adolescent depression, and pregnancy. These studies provide a large body of evidence that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads. Additionally, researchers have identified a number of potentially beneficial clinical uses of creatine supplementation. These studies show that short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly. Moreover, significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan. The purpose of this review is to provide an update to the current literature regarding the role and safety of creatine supplementation in exercise, sport, and medicine and to update the position stand of International Society of Sports Nutrition (ISSN).
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Affiliation(s)
- Richard B. Kreider
- Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843-4243 USA
| | - Douglas S. Kalman
- Nutrition Research Unit, QPS, 6141 Sunset Drive Suite 301, Miami, FL 33143 USA
| | - Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, FL 33328 USA
| | - Tim N. Ziegenfuss
- The Center for Applied Health Sciences, 4302 Allen Road, STE 120, Stow, OH 44224 USA
| | - Robert Wildman
- Post Active Nutrition, 111 Leslie St, Dallas, TX 75208 USA
| | - Rick Collins
- Collins Gann McCloskey & Barry, PLLC, 138 Mineola Blvd., Mineola, NY 11501 USA
| | - Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | | | | | - Hector L. Lopez
- The Center for Applied Health Sciences, 4302 Allen Road, STE 120, Stow, OH 44224 USA
- Supplement Safety Solutions, LLC, Bedford, MA 01730 USA
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Wallimann T, Riek U, Möddel M. Intradialytic creatine supplementation: A scientific rationale for improving the health and quality of life of dialysis patients. Med Hypotheses 2017; 99:1-14. [DOI: 10.1016/j.mehy.2016.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 12/03/2016] [Indexed: 12/19/2022]
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Deminice R, Comparotto H, Jordao AA. Whey protein supplementation increases methionine intake but not homocysteine plasma concentration in rats. Appl Physiol Nutr Metab 2016; 40:46-50. [PMID: 25485892 DOI: 10.1139/apnm-2014-0175] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine the effects of whey protein supplementation on homocysteine (Hcy) metabolism and liver oxidative stress in rats. Twenty-four rats were divided into 3 groups (n = 8) to receive one of the following diets for 4 weeks: control diet (C), whey protein-composed diet (WP), and whey protein-supplemented diet (WPS). The C and WP diets consisted of AIN-93 with 20% casein and 20% whey protein as protein source, respectively. WPS was AIN-93 (20% casein) supplemented by the addition of 20% (w/w) whey protein. Four weeks of ingesting a WPS diet resulted in a significantly higher (P < 0.05) total protein and methionine intakes. Although a significant increase (P < 0.05) in the hepatic S-adenosylmethionine and S-adenosylhomocysteine levels occurred in WPS group compared with C and WP, no significant change was observed in plasma Hcy concentration between groups. Furthermore, the levels of lipid hydroperoxides and advanced oxidation protein products, known liver oxidative stress markers, were increased in the WPS group compared with the C group. In addition, no change in glutathione liver concentration was observed in any of the groups studied. In conclusion, whey protein supplementation increases methionine intake substantially; however, it does not change plasma Hcy concentrations. On the other hand, increased hepatic oxidative stress markers were observed in whey protein supplemented rats were probably due to high protein intake.
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Affiliation(s)
- Rafael Deminice
- a Laboratory of Nutrition and Metabolism, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes 3900, Ribeirao Preto, Sao Paulo, Brazil
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Deminice R, Rosa FT. Creatine supplementation decreased homocysteine plasma levels in rats but not humans: A critical review with meta-analysis. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2016. [DOI: 10.1016/j.jnim.2016.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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9
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Peters BA, Hall MN, Liu X, Parvez F, Siddique AB, Shahriar H, Uddin MN, Islam T, Ilievski V, Graziano JH, Gamble MV. Low-Dose Creatine Supplementation Lowers Plasma Guanidinoacetate, but Not Plasma Homocysteine, in a Double-Blind, Randomized, Placebo-Controlled Trial. J Nutr 2015; 145:2245-52. [PMID: 26311810 PMCID: PMC4580963 DOI: 10.3945/jn.115.216739] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 07/30/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Creatine synthesis from guanidinoacetate consumes ~50% of s-adenosylmethionine (SAM)-derived methyl groups, accounting for an equivalent proportion of s-adenosylhomocysteine (SAH) and total homocysteine (tHcys) synthesis. Dietary creatine inhibits the synthesis of guanidinoacetate, thereby lowering plasma tHcys in rats. OBJECTIVE We tested the hypotheses that creatine supplementation lowers plasma guanidinoacetate, increases blood SAM, lowers blood SAH, and lowers plasma tHcys. METHODS Bangladeshi adults were randomly assigned to receive 1 of 4 treatments for 12 wk: placebo (n = 101), 3 g/d creatine (Cr; n = 101), 400 μg/d folic acid (FA; n = 153), or 3 g/d creatine plus 400 μg/d folic acid (Cr+FA; n = 103). The outcomes of plasma guanidinoacetate and tHcys, as well as whole blood SAM and SAH, were analyzed at baseline and week 12 by HPLC. Treatment effects of creatine supplementation were examined with the use of the group comparisons of Cr vs. placebo and Cr+FA vs. FA. RESULTS Plasma guanidinoacetate declined by 10.6% (95% CI: 4.9, 15.9) in the Cr group while increasing nonsignificantly in the placebo group (3.7%; 95% CI: -0.8, 8.5) (Pgroup difference = 0.0002). Similarly, plasma guanidinoacetate declined by 9.0% (95% CI: 3.4, 14.2) in the Cr+FA group while increasing in the FA group (7.0%; 95% CI: 2.0, 12.2) (Pgroup difference < 0.0001). Plasma tHcys declined by 23.4% (95% CI: 19.5, 27.1) and 21.0% (95% CI: 16.4, 25.2) in the FA and Cr+FA groups, respectively (Pgroup difference = 0.41), with no significant changes in the placebo or Cr groups (Pgroup difference = 0.35). A decrease in guanidinoacetate over time was associated with a decrease in tHcys over time in the Cr+FA group (β = 0.30; 95% CI: 0.17, 0.43; P < 0.0001). CONCLUSIONS Our findings indicate that whereas creatine supplementation downregulates endogenous creatine synthesis, this may not on average lower plasma tHcys in humans. However, tHcys did decrease in those participants who experienced a decline in plasma guanidinoacetate while receiving creatine plus folic acid supplementation. This trial was registered at clinicaltrials.gov as NCT01050556.
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Affiliation(s)
| | | | - Xinhua Liu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY; and
| | | | - Abu B Siddique
- Columbia University Arsenic Project in Bangladesh, Dhaka, Bangladesh
| | - Hasan Shahriar
- Columbia University Arsenic Project in Bangladesh, Dhaka, Bangladesh
| | | | - Tariqul Islam
- Columbia University Arsenic Project in Bangladesh, Dhaka, Bangladesh
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Deminice R, Rosa FT, da Silva LECM, Jordao AA. Taurine supplementation does not decrease homocysteine levels and liver injury induced by a choline-deficient diet. Life Sci 2014; 105:43-7. [PMID: 24769283 DOI: 10.1016/j.lfs.2014.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 03/20/2014] [Accepted: 04/11/2014] [Indexed: 10/25/2022]
Abstract
AIMS The aim of this study is to examine the effects of taurine supplementation on homocysteine (Hcy) metabolism and liver injury in rats fed a choline-deficient diet. MAIN METHODS Thirty rats were divided into three groups (n=10), to receive one of the following diets for 4 weeks: control diet (C), choline-deficient diet (CDD), or choline-deficient diet supplemented with taurine (CDDT). The CDD and the CDDT consisted of AIN-93 without the recommended choline content of 2.5%, and the CDDT was supplemented by the addition of 2.5% taurine. KEY FINDINGS Four weeks of ingesting a CDD resulted in a significant increase in plasma Hcy (50%) as well as a decrease in liver S-adenosylmethionine (SAM) concentration and S-adenosylmethionine/S-adenosylhomocysteine ratio. No changes were found in plasma methionine and cysteine plasma levels compared to control group. Four weeks of ingesting a CDD also caused a significant (P<0.05) increase in hepatic total fat, hepatic malondialdehyde (MDA), and plasma alanine aminotransferase (ALT) levels. In addition, reduced hepatic glutathione (GSH) levels and reduced/oxidized glutathione ratios (GSH/GSSG) were found in rats fed a CDD compared to controls. Taurine supplementation of the CDD normalized genes involved in the remethylation pathway, BHMT and CHDH, which were impaired by CDD alone. However, taurine supplementation failed to prevent CDD-induced Hcy metabolism disturbances and hepatic injury. Also, taurine added to CDD caused decreased expression of PEMT, CHKa, and CHKb, key genes involved in phosphatidylcholine (PC) synthesis and liver fat accumulation. SIGNIFICANCE Taurine supplementation failed to ameliorate impaired Hcy metabolism and liver injury caused by CDD intake.
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Affiliation(s)
- Rafael Deminice
- Laboratory of Nutrition and Metabolism, Faculty of Medicine of Ribeirao Preto, University of São Paulo, Av. Bandeirantes, 3900, Ribeirao Preto, São Paulo, Brazil; Department of Physical Education, Faculty of Physical Education and Sport, State University of Londrina, Rodovia Celso Garcia Cid, Pr 445 Km 380, Campus Universitário, Londrina, Paraná, Brazil.
| | - Flávia Troncon Rosa
- Laboratory of Nutrition and Metabolism, Faculty of Medicine of Ribeirao Preto, University of São Paulo, Av. Bandeirantes, 3900, Ribeirao Preto, São Paulo, Brazil
| | - Lilian Eslaine Costa Mendes da Silva
- Laboratory of Nutrition and Metabolism, Faculty of Medicine of Ribeirao Preto, University of São Paulo, Av. Bandeirantes, 3900, Ribeirao Preto, São Paulo, Brazil
| | - Alceu Afonso Jordao
- Laboratory of Nutrition and Metabolism, Faculty of Medicine of Ribeirao Preto, University of São Paulo, Av. Bandeirantes, 3900, Ribeirao Preto, São Paulo, Brazil
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Serum creatine, creatinine and total homocysteine concentration-time profiles after a single oral dose of guanidinoacetic acid in humans. J Funct Foods 2014. [DOI: 10.1016/j.jff.2013.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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12
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Deminice R, Rosa FT, Franco GS, da Cunha SFC, de Freitas EC, Jordao AA. Short-term creatine supplementation does not reduce increased homocysteine concentration induced by acute exercise in humans. Eur J Nutr 2013; 53:1355-61. [DOI: 10.1007/s00394-013-0636-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 11/27/2013] [Indexed: 02/02/2023]
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13
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Co-administration of methyl donors along with guanidinoacetic acid reduces the incidence of hyperhomocysteinaemia compared with guanidinoacetic acid administration alone. Br J Nutr 2013; 110:865-70. [PMID: 23351309 DOI: 10.1017/s0007114512005879] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Guanidinoacetic acid (GAA) is the natural biosynthetic precursor of creatine, in a metabolic reaction that requires only a methyl group transfer. The use of GAA as a food additive for restoring creatine load in human tissues is rather unexplored and data on efficacy and safety are limited. In particular, an increase in serum homocysteine after GAA administration can be regarded as critical and should be prevented. The present study evaluated the effects of orally administered GAA with and without methyl group donors on serum and urine creatine concentrations, and the occurrence of adverse events during an intervention in healthy human subjects. A total of twenty male and female volunteers were randomised in a double-blind design to receive either GAA (2.4 g/d) or GAA with methyl donors (2.4 g/d of GAA and 1.6 g/d of betaine HCl, 5 μg/d of vitamin B12, 10 mg/d of vitamin B6 and 600 μg/d of folic acid) by oral administration for 8 weeks. Serum and urine creatine increased significantly from before to after administration in both groups (P< 0.001). The proportion of participants who reported minor adverse events was 33.3 % in the GAA group, and 10.0 % in the GAA with methyl donors group (P= 0.30). Hyperhomocysteinaemia was found in 55.6 % of participants supplemented with GAA, while no participant experienced hyperhomocysteinaemia in the group supplemented with GAA and methyl donors (P= 0.01). In summary, both interventions strongly influenced creatine metabolism, resulting in a significant increase in fasting serum creatine. The concomitant supplementation of methyl donors along with GAA largely precluded the elevation of serum homocysteine caused by GAA administration alone.
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Kolling J, Scherer EBS, Siebert C, Hansen F, Torres FV, Scaini G, Ferreira G, de Andrade RB, Gonçalves CAS, Streck EL, Wannmacher CMD, Wyse ATS. Homocysteine induces energy imbalance in rat skeletal muscle: is creatine a protector? Cell Biochem Funct 2012; 31:575-84. [PMID: 23225327 DOI: 10.1002/cbf.2938] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 10/23/2012] [Accepted: 11/15/2012] [Indexed: 12/22/2022]
Abstract
Homocystinuria is a neurometabolic disease caused by a severe deficiency of cystathionine beta-synthase activity, resulting in severe hyperhomocysteinemia. Affected patients present several symptoms including a variable degree of motor dysfunction. In this study, we investigated the effect of chronic hyperhomocysteinemia on the cell viability of the mitochondrion, as well as on some parameters of energy metabolism, such as glucose oxidation and activities of pyruvate kinase, citrate synthase, isocitrate dehydrogenase, malate dehydrogenase, respiratory chain complexes and creatine kinase in gastrocnemius rat skeletal muscle. We also evaluated the effect of creatine on biochemical alterations elicited by hyperhomocysteinemia. Wistar rats received daily subcutaneous injections of homocysteine (0.3-0.6 µmol/g body weight) and/or creatine (50 mg/kg body weight) from the 6th to the 28th days of age. The animals were decapitated 12 h after the last injection. Homocysteine decreased the cell viability of the mitochondrion and the activities of pyruvate kinase and creatine kinase. Succinate dehydrogenase was increased other evaluated parameters were not changed by this amino acid. Creatine, when combined with homocysteine, prevented or caused a synergistic effect on some changes provoked by this amino acid. Creatine per se or creatine plus homocysteine altered glucose oxidation. These findings provide insights into the mechanisms by which homocysteine exerts its effects on skeletal muscle function, more studies are needed to elucidate them. Although creatine prevents some alterations caused by homocysteine, it should be used with caution, mainly in healthy individuals because it could change the homeostasis of normal physiological functions.
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Affiliation(s)
- Janaína Kolling
- Laboratório de Neuroproteção e Doenças Neurometabólicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Laboratório de Erros Inatos do Metabolismo, Departamento de Bioquímica, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Abstract
OBJECTIVE To evaluate the effects of creatine monohydrate (CMH) supplementation on global DNA methylation and disease-specific clinical symptoms in female patients with Rett syndrome (RTT). METHODS Double-blind, randomized, placebo-controlled crossover trial of female patients with RTT. Participants received 200 mg/kg of either CMH or placebo daily for 6 months and switched following a 4-week washout period. Primary endpoints were change in global DNA methylation and in a RTT-specific symptom score as defined by medical history and clinical evaluation with Rett Syndrome Motor and Behavioral Assessment. Secondary endpoints were changes in biochemical markers of methionine metabolism. RESULTS Eighteen female patients aged 3 to 25 years with clinically diagnosed typical RTT and MECP2 mutation at clinical Stages III or IV were studied. CMH supplementation resulted in a statistically significant increase of global methylation by 0.11 (95% confidence interval 0.03-0.19, p = .009) compared with placebo. Total and subscores of Rett Syndrome Motor and Behavioral Assessment tended to improve but without statistical significance. CONCLUSION CMH supplementation increases global DNA methylation statistically significantly. Scores were lower for creatine than for placebo reflecting clinical improvement but not reaching statistical significance. Biochemical variables of methionine-homocysteine remethylation are unaffected. Multicenter studies are urgently warranted to evaluate the long-term effects of CMH supplementation in an optimally homogenous RTT population over a prolonged period.
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Deminice R, Vannucchi H, Simões-Ambrosio LM, Jordao AA. Creatine supplementation reduces increased homocysteine concentration induced by acute exercise in rats. Eur J Appl Physiol 2011; 111:2663-70. [PMID: 21394640 DOI: 10.1007/s00421-011-1891-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Accepted: 02/21/2011] [Indexed: 12/22/2022]
Abstract
The aim of this study was to evaluate the effect of creatine supplementation on homocysteine (Hcy) metabolism after acute aerobic and anaerobic exercise. A total of 112 Wistar rats were divided into four groups: aerobic exercise (A), aerobic exercise plus creatine supplementation (ACr), anaerobic exercise (An), and anaerobic exercise plus creatine-supplemented (AnCr). Creatine supplementation consisted of the addition of 2% creatine monohydrate to the diet. After 28 days, the rats performed an acute moderate aerobic exercise bout (1 h swimming with 4% of total body weight load) or an acute intense anaerobic exercise bout (6 × 30-s vertical jumps into the water with a 30-s rest between jumps, with 50% of total body weight load). The animals were killed before (pre) and at 0, 2, and 6 h (n = 8) after acute exercise. Plasma Hcy concentration increased significantly (P < 0.05) up to 2 h after anaerobic exercise (An group: pre 8.7 ± 1.2, 0 h 13.2 ± 2.3, 2 h 13.5 ± 4.2, and 6 h 12.1 ± 2.2, μmol/l). The same did not occur in acute aerobic exercised animals. Nevertheless, creatine supplementation significant decreased (P < 0.05) homocysteine concentration independent of exercise intensity (AnCr group: pre 17%, 0 h 80%, 2 h 107%, and 6 h 48%; ACr group: pre 17%, 0 h 19%, 2 h 28%, and 6 h 27%). Increased S-adenosylhomocysteine was also found in the An group. In conclusion, acute intense anaerobic exercise increased plasma Hcy concentration. On the other hand, creatine supplementation decreased plasma Hcy independent of exercise intensity.
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Affiliation(s)
- Rafael Deminice
- Laboratory of Nutrition and Metabolism, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Av. Bandeirantes 3900, SP, Ribeirao Preto, Brazil.
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Jahangir E, Vita JA, Handy D, Holbrook M, Palmisano J, Beal R, Loscalzo J, Eberhardt RT. The effect of L-arginine and creatine on vascular function and homocysteine metabolism. Vasc Med 2009; 14:239-48. [PMID: 19651674 DOI: 10.1177/1358863x08100834] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Studies with L-arginine supplementation have shown inconsistent effects on endothelial function. The generation of guanidinoacetate (GAA) from L-arginine with subsequent formation of creatine and homocysteine and consumption of methionine may reduce the pool of L-arginine available for nitric oxide generation. Experimental studies suggest that creatine supplementation might block this pathway. We sought to determine the effects of L-arginine, creatine, or the combination on endothelium-dependent vasodilation and homocysteine metabolism in patients with coronary artery disease. Patients with coronary artery disease were randomized to L-arginine (9 g/day), creatine (21 g/day), L-arginine plus creatine, or placebo for 4 days (n = 26-29/group). Brachial artery flow-mediated dilation and plasma levels of L-arginine, creatine, homocysteine, methionine, and GAA were measured at baseline and follow-up. L-arginine and creatine supplementation had no effects on vascular function. L-arginine alone increased GAA (p < 0.01) and the ratio of homocysteine to methionine (p < 0.01), suggesting increased methylation demand. The combination of creatinine and L-arginine did not suppress GAA production or prevent the increase in homocysteine-to-methionine ratio. Unexpectedly, creatine supplementation (alone or in combination with L-arginine) was associated with an 11-20% increase in homocysteine concentration (p < 0.05), which was not attributable to worsened renal function, providing evidence against an effect of creatine on decreasing methylation demand. In conclusion, the present study provides no evidence that L-arginine supplementation improves endothelial function and suggests that l-arginine may increase methylation demand. Creatine supplementation failed to alter the actions of L-arginine on vascular function or suppress methylation demand. The unexpected increase in homocysteine levels following creatine supplementation could have adverse effects and merits further study, since creatine is a commonly used dietary supplement.
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Affiliation(s)
- Eiman Jahangir
- Boston University School of Medicine, Boston, MA 02118, USA
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18
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Baguet A, Reyngoudt H, Pottier A, Everaert I, Callens S, Achten E, Derave W. Carnosine loading and washout in human skeletal muscles. J Appl Physiol (1985) 2009; 106:837-42. [DOI: 10.1152/japplphysiol.91357.2008] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Carnosine (β-alanyl-l-histidine) is present in high concentrations in human skeletal muscles. The oral ingestion of β-alanine, the rate-limiting precursor in carnosine synthesis, has been shown to elevate the muscle carnosine content both in trained and untrained humans. Little human data exist about the dynamics of the muscle carnosine content, its metabolic regulation, and its dependence on muscle fiber type. The present study aimed to investigate in three skeletal muscle types the supplementation-induced amplitude of carnosine synthesis and its subsequent elimination on cessation of supplementation (washout). Fifteen untrained males participated in a placebo-controlled double-blind study. They were supplemented for 5–6 wk with either 4.8 g/day β-alanine or placebo. Muscle carnosine was quantified in soleus, tibialis anterior, and medial head of the gastrocnemius by proton magnetic resonance spectroscopy (MRS), before and after supplementation and 3 and 9 wk into washout. The β-alanine supplementation significantly increased the carnosine content in soleus by 39%, in tibialis by 27%, and in gastrocnemius by 23% and declined postsupplementation at a rate of 2–4%/wk. Average muscle carnosine remained increased compared with baseline at 3 wk of washout (only one-third of the supplementation-induced increase had disappeared) and returned to baseline values within 9 wk at group level. Following subdivision into high responders (+55%) and low responders (+15%), washout period was 15 and 6 wk, respectively. In the placebo group, carnosine remained relatively constant with variation coefficients of 9–15% over a 3-mo period. It can be concluded that carnosine is a stable compound in human skeletal muscle, confirming the absence of carnosinase in myocytes. The present study shows that washout periods for crossover designs in supplementation studies for muscle metabolites may sometimes require months rather than weeks.
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Abstract
Hyperhomocysteinaemia is an independent risk factor for CVD. Recent data show a relationship between homocysteine (Hcy) and free radical formation. Since creatine synthesis is responsible for most of the methyl group transfers that result in Hcy formation, creatine supplementation might inhibit Hcy production and reduce free radical formation. The present study investigated the effects of creatine supplementation on Hcy levels and lipid peroxidation biomarkers. Thirty rats were divided into three groups: control group; diet with creatine group (DCr; 2 % creatine in the diet for 28 d); creatine overload plus diet with creatine group (CrO + D; 5 g creatine/kg by oral administration for 5 d+2 % in the diet for 23 d). Plasma Hcy was significantly lower (P < 0.05) in DCr (7.5 (sd 1.2) micromol/l) and CrO + D (7.2 (sd 1.7) micromol/l) groups compared with the control group (12.4 (sd 2.2) micromol/l). Both plasma thiobarbituric acid-reactive species (TBARS) (control, 10 (sd 3.4); DCr, 4.9 (sd 0.7); CrO + D, 2.4 (sd 1) micromol/l) and plasma total glutathione (control, 4.3 (sd 1.9); DCr, 2.5 (sd 0.8); CrO + D, 1.8 (sd 0.5) micromol/l) were lower in the groups that received creatine (P < 0.05). In addition, Hcy showed significant negative correlation (P < 0.05) with plasma creatine (r - 0.61) and positive correlation with plasma TBARS (r 0.74). Plasma creatine was negatively correlated with plasma TBARS (r - 0.75) and total peroxide (r - 0.40). We conclude that creatine supplementation reduces plasma Hcy levels and lipid peroxidation biomarkers, suggesting a protective role against oxidative damage. Modulating Hcy formation may, however, influence glutathione synthesis and thereby affect the redox state of the cells.
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Huang YC, Kuo YW, Lee TH, Lee M, Hsiao MC, Wang CL, Lee JD. Hypoalbuminemia and not hyperhomocysteinemia as a risk factor for dementia in hemodialysis patients. J Ren Nutr 2008; 18:347-54. [PMID: 18558299 DOI: 10.1053/j.jrn.2007.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The most common causes of morbidity and mortality in uremic patients are cardiovascular disease and central nervous system dysfunction. However, the exact causes of dementia in uremic patients remain unclear. This study attempted to determine which risk factors are associated with dementia in hemodialysis patients. METHODS In total, 147 chronic uremic patients receiving regular hemodialysis treatment were recruited. Data for risk factors regarding cardiovascular disease and dementia, such as hypertension, diabetes mellitus, smoking, age, illiteracy, serum levels of albumin, cholesterol, triglycerides, and homocysteine, and liver function, were recorded. The Mini-Mental Status examination was used to assess mental function, and the Hachinski ischemic scale was applied to differentiate among dementia types. The diagnosis of dementia was based on criteria from the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. RESULTS Twenty-six patients were diagnosed as manifesting dementia. Of all patients with dementia, 21 had a Hachinski score of 0 to 4, and 5 had a score of 7 to 10. In a multiple logistic regression analysis, low serum albumin and illiteracy were significantly associated with dementia. However, no difference existed between the two groups in terms of homocysteine levels. CONCLUSIONS This study demonstrated that uremic patients were prone to nonvascular dementia. We conclude that hypoalbuminemia and not hyperhomocysteinemia is a risk factor for dementia in hemodialysis patients.
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Affiliation(s)
- Ying-Chih Huang
- Department of Neurology, Chang Gung Memorial Hospital, Chang Gung Institute of Technology, Chiayi, Taiwan
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21
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Boehm O, Zur B, Koch A, Tran N, Freyenhagen R, Hartmann M, Zacharowski K. Clinical chemistry reference database for Wistar rats and C57/BL6 mice. Biol Chem 2007; 388:547-54. [PMID: 17516851 DOI: 10.1515/bc.2007.061] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Clinical chemistry data are decisive for evaluating altered organ function or damage in experimental animals. Few publications provide reliable clinical chemistry reference intervals, and analytical methods are often not described. Here, we investigated common clinical chemistry values in adult male and female Wistar rats and C57/BL6 mice (n=30/group). Blood samples were taken and analysed for electrolytes, substrates, metabolites and enzymes. In addition, we investigated cystatin C, an important marker of glomerular dysfunction. All data were obtained using commercially available kits frequently employed in most clinical chemistry laboratories and compared with data from other studies, as well as with human data. Significant gender-specific differences were observed in rats (electrolytes, retention parameters and transaminases) and in mice (cholesterol, glucose). High variability was noted for sodium, potassium, glucose, creatine kinase, lactate dehydrogenase and transaminase levels. Both rodent species showed markedly higher alpha-amylase activity than humans. This report demonstrates significant differences between genders for many analytes in rats and for fewer parameters in mice. Some reference values displayed major discrepancies between rodents and humans.
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Affiliation(s)
- Olaf Boehm
- Department of Anaesthesiology, Heinrich Heine University Medical School, Düsseldorf, Germany
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van Guldener C, Stam F, Stehouwer CDA. Hyperhomocysteinaemia in chronic kidney disease: focus on transmethylation. Clin Chem Lab Med 2005; 43:1026-31. [PMID: 16197293 DOI: 10.1515/cclm.2005.180] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractHyperhomocysteinaemia almost invariably occurs in patients with end-stage renal disease (ESRD), but there is debate whether, within the group of ESRD patients, higher or lower plasma homocysteine concentrations are related to an increased risk of vascular disease. Homocysteine is thought to be vasculotoxic in high concentrations, but it may also lead to elevated levels of its precursor, S-adenosylhomocysteine (AdoHcy), which is a potent inhibitor of the transmethylation pathway, in which S-adenosylmethionine (AdoMet) donates its methyl group to a variety of acceptors. Impairment of this transmethylation pathway in ESRD patients has been suggested by high AdoHcy levels, decreased AdoMet/AdoHcy ratios, decreased protein repair requiring methyltransferases, and by DNA hypomethylation. Stable isotope techniques using labelled methionine have indeed demonstrated a decreased whole body transmethylation flux in ESRD patients. These studies have also shown that folic acid treatment is capable of restoring transmethylation rates to normal values. The remaining hyperhomocysteinaemia after folic acid treatment in ESRD is probably due to a persistent impairment of homocysteine clearance through transsulphuration. DNA hypomethylation with its concurrent alterations in gene expression is largely improved by folate treatment. The adverse effects of hyperhomocysteinaemia in ESRD may thus be related to impaired transmethylation. Normalisation of plasma homocysteine does not seem to be required to restore transmethylation to normal levels in ESRD patients.
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Affiliation(s)
- Coen van Guldener
- Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands.
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Taes YEC, De Vriese AS. Analytical and biochemical aspects associated with supraphysiological creatine intake. Clin Chim Acta 2005; 351:217-9. [PMID: 15563893 DOI: 10.1016/j.cccn.2004.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Revised: 09/23/2004] [Accepted: 09/23/2004] [Indexed: 10/26/2022]
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