Does creatine affect lipid profile? a systematic review and meta-analysis of randomized placebo-controlled trials

Creatine, recognized for its regulatory functions in various metabolic tissues, has aroused interest regarding its systemic effects. This study aimed to evaluate the impact of creatine supplementation on blood lipid profile parameters.

A systematic review with meta-analysis was conducted following the PRISMA guidelines (CRD420251025690). Searches were conducted in EMBASE, Lilacs, CINAHL, MEDLINE/PubMed, Cochrane, Scopus, and Web of Science databases up to June 2025. Randomized clinical trials involving adults receiving oral creatine supplementation versus placebo were included. The outcomes analyzed included triglycerides, total cholesterol, low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-c). Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was assessed using the GRADE system.

We selected 8 RCTs. Pooled analyses demonstrated no statistically significant effects of creatine supplementation on total cholesterol (MD: 2.9 mg/dL; 95% CI: -7.44 to 13.24; I² = 46%), LDL-C cholesterol (MD: 4.08 mg/dL; 95% CI: -2.55 to 10.70; I² = 8%), HDL-C (MD: -0.68 mg/dL; 95% CI: -3.94 to 2.59; I² = 0%), or triglycerides (MD: 7.95 mg/dL; 95% CI: -13.73 to 29.63; I² = 55%). The certainty of evidence was classified as very low for total cholesterol and triglycerides and low for LDL-C and HDL-C. Methodological limitations were identified in the randomization and reporting of results processes.

Creatine supplementation did not demonstrate clinically relevant effects on lipid profiles. Future studies with greater methodological rigor and larger samples are recommended for definitive confirmation of these findings.