Evidence map›Paper›PMID 40838656›Full record

ArticleEuropean journal of clinical investigation2026

Plasma creatine, estimated intramuscular creatine, transcellular gradient and the risk of mortality: Results from the PREVEND study.

Caecilia S E Doorenbos, Adrian Post, Mariken E Stegmann, Casper F M Franssen, Robin P F Dullaart, Gerjan Navis, Margery A Connelly, Stephan J L Bakker

Abstract read
In one paragraph

Article in European journal of clinical investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Caecilia S E DoorenbosDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0001-8036-520X
Adrian PostDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0001-8645-1627
Mariken E StegmannDepartment of Primary and Long-Term Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Casper F M FranssenDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Robin P F DullaartDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0003-4520-1239
Gerjan NavisDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Margery A ConnellyLabcorp, Morrisville, North Carolina, USA.
Stephan J L BakkerDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Funding

Abbott LaboratoriesAusamDade BehringHartstichting Grant 2001-005Nierstichting Grant E.033Roche
6 · The paper itself

Abstract

backgroundCreatine, an endogenous compound essential for energy metabolism and cellular function, has been associated with numerous beneficial effects in sports and overall health. Here, we investigated relationships between plasma creatine concentration, estimated intramuscular creatine concentration, and all-cause mortality in the general population.

methodsIn a Dutch prospective population-based cohort, plasma creatine concentration, 24-h urinary creatinine excretion and muscle mass (assessed with bio-electrical impedance analysis) were measured in 5127 participants. Total creatine pool size, calculated from 24-h creatinine excretion (assuming a 1.7% daily excretion of the total creatine pool), was divided by muscle mass to estimate intramuscular creatine concentrations. Transcellular gradient was calculated as intramuscular concentration divided by plasma concentration. Hazard ratios for mortality per doubling were assessed using multivariable Cox proportional hazard models, adjusting for common cardiovascular risk factors for mortality.

resultsMedian plasma creatine concentrations were 41 [30-54] μmol/L in females and 28 [21-38] μmol/L in males. Mean intramuscular creatine concentrations were 30 ± 5.0 mmol/kg in females and 27.4 ± 5.0 mmol/kg in males. Median transcellular creatine gradients were 734 [550-1011] in females and 955 [715-1324] in males. Higher intramuscular creatine concentrations were associated with lower mortality in females (HR (95% CI) = .43 (.2; .66)); with a weaker trend in males (HR (95% CI) = .73 (.53; 1.02)). Plasma creatine concentrations were not associated with mortality.

conclusionHigher estimated intramuscular creatine concentrations are strongly associated with lower all-cause mortality in females, with a weaker trend in males. Future research should explore causality, as well as further explore the remarkable sex difference.

Indexed as

CreatineMortalityMuscle, SkeletalAdultAgedCreatinineFemaleHumansMaleMiddle AgedNetherlandsProportional Hazards ModelsProspective StudiesRisk FactorsSex FactorsCreatineCreatininecreatinegeneral populationmortality riskmuscle mass

Identifiers

PMID40838656
PMCPMC12811838

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.