Is there a place for coenzyme Q in the management of metabolic disorders associated with obesity?

Abstract

Coenzyme Q (CoQ), a lipophilic cofactor of the electron transport chain in the mitochondria, can be synthesized endogenously or provided by food. The aim of this review is to summarize the in vitro cell culture studies, the in vivo animal studies, and the human studies investigating the impact of CoQ supplementation on the occurrence of obesity and related disorders (diabetes, hypertension, lipemia, and atherosclerosis). The antioxidative properties of CoQ have been observed in different experimental models of atherosclerosis, obesity, and diabetes. The recent discovery of the anti-inflammatory effect of CoQ, mostly described in vitro, has generated increased interest in CoQ supplementation, but it needs to be confirmed in vivo in pathological situations. CoQ intervention studies in humans failed to show reproducible effects on body weight, fat mass, or glycemia, but CoQ supplementation does seem to have an antihypertensive effect. The molecular mechanism to explain this effect has only recently been discovered.

Potential role of coenzyme Q₁₀ in health and disease conditions

“…Individuals with type 2 diabetes (T2D) showed lower levels of total CoQ 10 and a decreased ratio of ubiquinol to total CoQ 10 . 4 Hasegawa et al observed changes in antioxidant status in T2D patients who displayed higher amounts of ubiquinone compared with ubiquinol. 40 However, plasma CoQ 10 levels in individuals with type 1 diabetes were increased, suggesting that severity and type could influence CoQ 10 status.…”

“…32,59 Mitochondrial dysfunction, in response to low CoQ 10 and subsequent inefficiency of the respiratory chain, could thus be the end result for patients on long-term statin therapy. 4 The mechanism on how statins cause a decrease in CoQ 10 levels independent of lowering lipid levels still remains unclear.…”

“…It may also be beneficial to prescribe the lowest dosage needed to minimize cholesterol levels as to avoid a decrease in CoQ 10 and induce myopathy. 4 The excellent safety record of CoQ 10 also makes it reasonable for patients to supplement this compound as a safeguard against any negative effects, if any, of statin therapy.…”

The role of nutrition and nutraceutical supplements in the treatment of hypertension

“…Both total dose and frequency of administration may be reduced. (7) Patients administered coenzyme Q10 with enalapril improved the 24 h ABM better than with enalapril monotherapy and also normalized endothelial function [310] ; and (8) Coenzyme Q10 is a lipid phase antioxidant and free radical scavenger, increases eNOS and NO, reduces inflammation and NF-κB and improves endothelial function and vascular elasticity [1,311,312] . Other favorable effects on cardiovascular risk factors include improvement in the serum lipid profile and carbohydrate metabolism with reduced glucose and improved insulin sensitivity, reduced oxidative stress, reduced heart rate, improved myocardial LV function and oxygen delivery and decreased catecholamine levels [1,311,312] .…”

“…Coenzyme Q10 has consistent and significant antihypertensive effects in patients with essential hypertension [1,[308][309][310][311][312][313][314][315][316][317] . The literature is summarized below: (1) Compared to normotensive patients, essential hypertensive patients have a higher incidence (6 fold) of coenzyme Q10 deficiency documented by serum levels [1] ; (2) Doses of 120 to 225 mg/d of coenzyme Q10, depending on the delivery method or the concomitant ingestion with a fatty meal, are necessary to achieve a therapeutic level of 3 ug/mL [1,313,314] .…”