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The effects of coenzyme Q10 supplementation on biomarkers of inflammation and oxidative stress in among coronary artery disease: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Objective

Systemic inflammation and oxidative stress significantly contribute in developing coronary artery disease (CAD). This systematic review and meta-analysis was aimed to determine the effects of coenzyme Q10 (CoQ10) supplementation on biomarkers of inflammation and oxidative stress among patients with CAD.

Methods

The electronic databases including MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Library databases were systematically searched until Oct 2018. The quality assessment and heterogeneity of the selected randomized clinical Trials (RCTs) were examined using the Cochrane Collaboration risk of bias tool, and Q and I2 tests, respectively. Given the presence of heterogeneity, random-effects model or fixed-effect model were used to pool standardized mean differences (SMDs) as summary effect sizes.

Results

A total of 13 clinical RCTs of 912 potential citations were found to be eligible for the current meta-analysis. The pooled findings for biomarkers of inflammation and oxidative stress demonstrated that CoQ10 supplementation significantly increased superoxide dismutase (SOD) (SMD 2.63; 95% CI, 1.17, 4.09, P < 0.001; I2 = 94.5%) and catalase (CAT) levels (SMD 1.00; 95% CI, 0.57, 1.43, P < 0.001; I2 = 24.5%), and significantly reduced malondialdehyde (MDA) (SMD − 4.29; 95% CI − 6.72, − 1.86, P = 0.001; I2 = 97.6%) and diene levels (SMD − 2.40; 95% CI − 3.11, − 1.68, P < 0.001; I2 = 72.6%). We did not observe any significant effect of CoQ10 supplementation on C-reactive protein (CRP) (SMD − 0.62; 95% CI − 1.31, 0.08, P = 0.08; I2 = 87.9%), tumor necrosis factor alpha (TNF-α) (SMD 0.22; 95% CI − 1.07, 1.51, P = 0.73; I2 = 89.7%), interleukin-6 (IL-6) (SMD − 1.63; 95% CI − 3.43, 0.17, P = 0.07; I2 = 95.2%), and glutathione peroxidase (GPx) levels (SMD 0.14; 95% CI − 0.77, 1.04, P = 0.76; I2 = 78.7%).

Conclusions

Overall, this meta-analysis demonstrated CoQ10 supplementation increased SOD and CAT, and decreased MDA and diene levels, but did not affect CRP, TNF-α, IL-6, and GPx levels among patients with CAD.

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References

  • Arroyo A, Kagan VE, Tyurin VA, Burgess JR, de Cabo R, Navas P, Villalba JM (2000) NADH and NADPH-dependent reduction of coenzyme Q at the plasma membrane. Antioxid Redox Signal 2:251–262

    Article  CAS  PubMed  Google Scholar 

  • Aslanabadi N, Safaie N, Asgharzadeh Y, Houshmand F, Ghaffari S, Garjani A, Dousti S, Hamishehkar H, Entezari-Maleki T (2016) The randomized clinical trial of coenzyme Q10 for the prevention of periprocedural myocardial injury following elective percutaneous coronary intervention. Cardiovasc Ther 34:254–260

    Article  CAS  PubMed  Google Scholar 

  • Berman M, Erman A, Ben-Gal T, Dvir D, Georghiou GP, Stamler A, Vered Y, Vidne BA, Aravot D (2004) Coenzyme Q10 in patients with end-stage heart failure awaiting cardiac transplantation: a randomized, placebo-controlled study. Clin Cardiol 27:295–299

    Article  PubMed  Google Scholar 

  • Bocci V, Valacchi G (2013) Free radicals and antioxidants: how to reestablish redox homeostasis in chronic diseases? Curr Med Chem 20:3397–3415

    Article  CAS  PubMed  Google Scholar 

  • Braunwald E (1997) Shattuck lecture—cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities. N Engl J Med 337:1360–1369

    Article  CAS  PubMed  Google Scholar 

  • Dai YL, Luk TH, Yiu KH, Wang M, Yip PM, Lee SW, Li SW, Tam S, Fong B, Lau CP, Siu CW, Tse HF (2011) Reversal of mitochondrial dysfunction by coenzyme Q10 supplement improves endothelial function in patients with ischaemic left ventricular systolic dysfunction: a randomized controlled trial. Atherosclerosis 216:395–401

    Article  CAS  PubMed  Google Scholar 

  • Davies MJ (2000) The pathophysiology of acute coronary syndromes. Heart 83:361–366

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fan L, Feng Y, Chen GC, Qin LQ, Fu CL, Chen LH (2017) Effects of coenzyme Q10 supplementation on inflammatory markers: a systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 119:128–136

    Article  CAS  PubMed  Google Scholar 

  • Jang S, Lee L, Ryu SM, Lee H, Park J-R, Kim H, Kim D, Jang A, Yang S-R (2017) Effect of coenzyme Q10 via nitric oxide production and growth arrest of human colon cancer HCT116 cells. J Prev Vet Med 41:59–65

    Article  Google Scholar 

  • Lass A, Sohal RS (1998) Electron transport-linked ubiquinone-dependent recycling of alpha-tocopherol inhibits autooxidation of mitochondrial membranes. Arch Biochem Biophys 352:229–236

    Article  CAS  PubMed  Google Scholar 

  • Lee BJ, Huang YC, Chen SJ, Lin PT (2012a) Coenzyme Q10 supplementation reduces oxidative stress and increases antioxidant enzyme activity in patients with coronary artery disease. Nutrition 28:250–255

    Article  CAS  PubMed  Google Scholar 

  • Lee BJ, Huang YC, Chen SJ, Lin PT (2012b) Effects of coenzyme Q10 supplementation on inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, and homocysteine) in patients with coronary artery disease. Nutrition 28:767–772

    Article  CAS  PubMed  Google Scholar 

  • Lee BJ, Lin YC, Huang YC, Ko YW, Hsia S, Lin PT (2012c) The relationship between coenzyme Q10, oxidative stress, and antioxidant enzymes activities and coronary artery disease. Sci World J 2012:792756

    Google Scholar 

  • Lee BJ, Tseng YF, Yen CH, Lin PT (2013) Effects of coenzyme Q10 supplementation (300 mg/day) on antioxidation and anti-inflammation in coronary artery disease patients during statins therapy: a randomized, placebo-controlled trial. Nutr J 12:142

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mirhashemi SM, Najafi V, Raygan F, Asemi Z (2016) The effects of coenzyme Q10 supplementation on cardiometabolic markers in overweight type 2 diabetic patients with stable myocardial infarction: A randomized, double-blind, placebo-controlled trial. ARYA Atheroscler 12:158–165

    PubMed  PubMed Central  Google Scholar 

  • Mortensen SA (2003) Overview on coenzyme Q10 as adjunctive therapy in chronic heart failure. Rationale, design and end-points of "Q-symbio"—a multinational trial. BioFactors 18:79–89

    Article  CAS  PubMed  Google Scholar 

  • Pourmoghaddas M, Rabbani M, Shahabi J, Garakyaraghi M, Khanjani R, Hedayat P (2014) Combination of atorvastatin/coenzyme Q10 as adjunctive treatment in congestive heart failure: A double-blind randomized placebo-controlled clinical trial. ARYA Atheroscler 10:1–5

    PubMed  PubMed Central  Google Scholar 

  • Ridker PM, Rifai N, Pfeffer M, Sacks F, Lepage S, Braunwald E (2000a) Elevation of tumor necrosis factor-alpha and increased risk of recurrent coronary events after myocardial infarction. Circulation 101:2149–2153

    Article  CAS  PubMed  Google Scholar 

  • Ridker PM, Rifai N, Stampfer MJ, Hennekens CH (2000b) Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation 101:1767–1772

    Article  CAS  PubMed  Google Scholar 

  • Schmelzer C, Lindner I, Rimbach G, Niklowitz P, Menke T, Doring F (2008) Functions of coenzyme Q10 in inflammation and gene expression. BioFactors 32:179–183

    Article  CAS  PubMed  Google Scholar 

  • Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW, McKillop JH, Packard CJ (2004) Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. 1995. Atheroscler Suppl 5:91–97

    Article  CAS  PubMed  Google Scholar 

  • Singh RB, Niaz MA (1999) Serum concentration of lipoprotein(a) decreases on treatment with hydrosoluble coenzyme Q10 in patients with coronary artery disease: discovery of a new role. Int J Cardiol 68:23–29

    Article  CAS  PubMed  Google Scholar 

  • Singh RB, Wander GS, Rastogi A, Shukla PK, Mittal A, Sharma JP, Mehrotra SK, Kapoor R, Chopra RK (1998) Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drugs Ther 12:347–353

    Article  CAS  PubMed  Google Scholar 

  • Singh RB, Kartikey K, Charu AS, Niaz MA, Schaffer S (2003a) Effect of taurine and coenzyme Q10 in patients with acute myocardial infarction. Adv Exp Med Biol 526:41–48

    Article  CAS  PubMed  Google Scholar 

  • Singh RB, Neki NS, Kartikey K, Pella D, Kumar A, Niaz MA, Thakur AS (2003b) Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction. Mol Cell Biochem 246:75–82

    Article  CAS  PubMed  Google Scholar 

  • Singh U, Devaraj S, Jialal I (2007) Coenzyme Q10 supplementation and heart failure. Nutr Rev 65:286–293

    Article  PubMed  Google Scholar 

  • Stoyanovsky DA, Osipov AN, Quinn PJ, Kagan VE (1995) Ubiquinone-dependent recycling of vitamin E radicals by superoxide. Arch Biochem Biophys 323:343–351

    Article  CAS  PubMed  Google Scholar 

  • Tiano L, Belardinelli R, Carnevali P, Principi F, Seddaiu G, Littarru GP (2007) Effect of coenzyme Q10 administration on endothelial function and extracellular superoxide dismutase in patients with ischaemic heart disease: a double-blind, randomized controlled study. Eur Heart J 28:2249–2255

    Article  CAS  PubMed  Google Scholar 

  • Weissberg PL (2000) Atherogenesis: current understanding of the causes of atheroma. Indian Heart J 52:467–472

    CAS  PubMed  Google Scholar 

  • Wilson PW (2008) Evidence of systemic inflammation and estimation of coronary artery disease risk: a population perspective. Am J Med 121:S15–20

    Article  PubMed  Google Scholar 

  • Witte KK, Nikitin NP, Parker AC, von Haehling S, Volk HD, Anker SD, Clark AL, Cleland JG (2005) The effect of micronutrient supplementation on quality-of-life and left ventricular function in elderly patients with chronic heart failure. Eur Heart J 26:2238–2244

    Article  CAS  PubMed  Google Scholar 

  • Zhai J, Bo Y, Lu Y, Liu C, Zhang L (2017) Effects of coenzyme Q10 on markers of inflammation: a systematic review and meta-analysis. PLoS ONE 12:e0170172. https://doi.org/10.1371/journal.pone.0170172

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zhang YP, Eber A, Yuan Y, Yang Z, Rodriguez Y, Levitt RC, Takacs P, Candiotti KA (2013) Prophylactic and antinociceptive effects of coenzyme Q10 on diabetic neuropathic pain in a mouse model of type 1 diabetes. Anesthesiology 118:945–954

    Article  CAS  PubMed  Google Scholar 

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Funding

The research grant provided by Research Deputy of Shiraz University of Medical Sciences (SUMS).

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ZA, MA and RT contributed in conception, design, statistical analysis and drafting of the manuscript. M-VJ, FK, MS and S-TH contributed in conception, data collection and manuscript drafting.

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Correspondence to Zatollah Asemi.

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Jorat, M.V., Tabrizi, R., Kolahdooz, F. et al. The effects of coenzyme Q10 supplementation on biomarkers of inflammation and oxidative stress in among coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. Inflammopharmacol 27, 233–248 (2019). https://doi.org/10.1007/s10787-019-00572-x

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