The impact of creatine supplementation associated with resistance training on muscular strength and lean tissue mass in the aged: a systematic review and meta-analysis.

抄録

BACKGROUND: Sarcopenia is an age-related decline in muscle strength and mass, which significantly impacts the quality of life for older adults. Resistance training (RT) is well established as an effective intervention for sarcopenia. Some studies suggest that additional benefits may be obtained when RT is combined with creatine supplement (Cr). However, critical confounding factors, such as age and intervention duration, have not been systematically controlled in previous investigations. This systematic review and meta-analysis aims to quantify the efficacy of Cr + RT on appendicular muscle strength and lean tissue mass in older adults, with a particular emphasis on temporal effect modification through duration-stratified subgroup analyses. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) through searches across eight databases. Eligible studies involved aged individuals undergoing resistance training (2–3 sessions/week) with Cr or placebo (PL) for 8-104 weeks. After screening, 8 RCTs (n = 482 participants) were included, assessing outcomes of lean tissue mass, chest press, and leg press strength. RESULTS: Compared to PL + RT, Cr + RT significantly improved lower limb strength (SMD = 0.29 [95% CI 0.00-0.57]; p = 0.05) and lean tissue mass (SMD = 0.27 [95% CI 0.02–0.53]; p = 0.03), but did not show significant improvements in upper extremity muscle strength. Subgroup analysis revealed intervention duration effects: interventions lasting ≤ 32 weeks (5 studies) showed better upper limb strength gains (SMD = 0.45 [95% CI 0.14–0.77]; p = 0.005) and increases in lean tissue mass (SMD = 0.57 [95% CI 0.19–0.96]; p = 0.004). CONCLUSIONS: Cr + RT can significantly increase muscle strength and lean tissue mass in older adults, particularly in interventions lasting up to 32 weeks. These time-dependent effects highlight the importance of intervention duration in nutritional ergogenic strategies for sarcopenia management.  TRIAL REGISTRATION: This systematic review has the registration number CRD420251018405 on PROSPERO.