Effects of nutraceutical diet integration, with coenzyme Q10 (Q-Ter multicomposite) and creatine, on dyspnea, exercise tolerance, and quality of life in COPD patients with chronic respiratory failure

Abstract

BackgroundThe protein-calorie malnutrition, resulting in muscle mass loss, frequently occurs in severe COPD patients with chronic respiratory failure (CRF), causing dyspnea, reduced exercise tolerance and impaired quality of life.The cause of this occurrence is an intake-output energy imbalance. A documented deficit of phosphocreatine and reduced mithocondrial energy production can contribute to this imbalance.Aim of this study is to verify whether a dietary supplementation with creatine and coenzyme Q10, important mitochondrial function factors, is able to influence this mechanism leading to a dyspnea reduction and improving exercise tolerance and quality of life.Methods55 COPD patients with chronic respiratory failure (in long term O2 therapy), in stable phase of the disease and without severe comorbidities were assigned (double-blind, randomized) to: group A (30 patients) with daily dietary supplementation with Creatine 340 mg + 320 mg Coenzyme Q-Ter (Eufortyn®, Scharper Therapeutics Srl) for 2 months whereas Group B (25 patients) received placebo.All patients continued the same diet, rehabilitation and therapy during the study. At recruitment (T0) and after 2 months (T1), patients were submitted to medical history, anthropometry (BMI), bioelectrical impedance, arterial blood gas analysis, evaluation of dyspnea (VAS, Borg, BDI, MRC) and functional independence (ADL), 6-minute walk test (6MWT) and quality of life questionnaire (SGRQ). At 6 months and 1 year, a telephone follow up was conducted on exacerbations number.ResultsNo significant difference was detected at baseline (T0) in the 2 groups. After 2 months of therapy (T1) the FFMI increased in the daily dietary supplementation group (+ 3.7 %) and decreased in the placebo group (- 0.6 %), resulting in a statistically significant (p < 0.001) treatment difference. Statistically significant treatment differences, favouring daily dietary supplementation group, were also seen for the 6MWT comparison. Group A patients also showed significant: 1) improvement in the degree of dyspnea (VAS: p < 0.05; Borg: p < 0.05; MRC: p < 0.001; BDI1: p < 0.05; BDI3: p < 0.03), and independence level in activities of daily living (p < 0.03); 2) improvement in quality of life in activity section (- 6.63 pt) and in total score (- 5.43 pt); 3) exacerbation number decrease (p < 0.02). No significant differences were found (end of study vs baseline) in group B.ConclusionsThe nutraceutical diet integration with Q-Ter and creatine, in COPD patients with CRF in O2TLT induced an increasing lean body mass and exercise tolerance, reducing dyspnea, quality of life and exacerbations. These results provide a first demonstration that acting on protein synthesis and muscular efficiency can significantly modify the systemic consequences of the disease.

Effects of a therapeutic lifestyle change diet and supplementation with Q10 plus L-carnitine on quality of life in patients with myocardial infarction: A randomized clinical trial

“…15 Previous studies have reported L-carnitine 16 and Q10 15-17 as potent antioxidants, each having a positive effect on QoL. L-carnitine plays an important role in energy production in the myocardium and inhibits fatty acid ester reposition that occurs during ischemic events.…”

Effect of Hospital Use of Oral Nutritional Supplementation on Length of Stay, Hospital Cost, and 30-Day Readmissions Among Medicare Patients With COPD

“…Nutritional defi ciency and negative energy balance are common among patients hospitalized with COPD, particularly during acute exacerbations, [17][18][19] and have been associated with poor prognoses. [20][21][22] Not surprisingly, growing evidence suggests that nutritional interventions such as vitamin D repletion, 23,24 dietary fi ber, 25,26 and oral nutritional supplementation (ONS) [27][28][29] are associated with improved outcomes for patients with COPD on a variety of dimensions. In particular, ONS use is associated with improvements in weight gain, lean body mass, muscle strength, 6-min walking distance, and ability to exercise in patients with COPD.…”

May nutrients and dietary supplements influence the gut-lung microbiota axis in chronic obstructive pulmonary disease and exacerbations?

“…Notably, confirmations come from biopsies of the muscles, which showed alterations in the number and function of mitochondria [82,83]. Also, it is reported that in chronic diseases, such as COPD, there could be a deficit of elements such as coenzyme Q10 or ubiquinone that are essential for the production of ATP and energy by mitochondrion promotion [84][85][86].…”

“…A nutraceutical can be defined as a dietary fortified supplement that may provide health benefits in addition to its basic nutritional value [84], delivered for therapeutic purposes in a higher concentration than what is available from a normal diet. Several studies have been addressed to modulate muscle protein synthesis and energy state in COPD patients.…”