Applied nutritional investigationCoenzyme Q10 supplementation reduces oxidative stress and increases antioxidant enzyme activity in patients with coronary artery disease
Introduction
Coenzyme Q10 (also called ubiquinone) is a lipid-soluble benzoquinone with 10 isoprenyl units in the side chain and is a key component of the mitochondrial respiratory chain for adenosine triphosphate synthesis [1], [2]. Coenzyme Q10 is recognized as an intracellular antioxidant that protects membrane phospholipids, mitochondrial membrane protein, and low-density lipoprotein from free radical-induced oxidative damage [3], [4]. Coenzyme Q10 can be synthesized in tissue from farnesyl diphosphate and tyrosine and can be obtained from the consumption of meat, poultry, fish, vegetables and fruits; however, total absorption of coenzyme Q10 from food is thought to be lower than 10% [5], [6].
Cardiovascular disease is the leading cause of death worldwide [7]. Many previous studies [8], [9], [10] have documented a deficiency of coenzyme Q10 in patients with cardiovascular disease and the benefits of treating these patients with coenzyme Q10 supplementation [11], [12], [13], [14], [15]. Additional studies [16], [17], [18], [19] have reported remarkable clinical benefits such as improved tolerance of work in patients with stable angina pectoris after administration of coenzyme Q10 at doses of 30 to 150 mg/d for a short period (1 or 4 wk). A recent study [20] has indicated a relation between low plasma coenzyme Q10 concentration and coronary artery disease (CAD), which may contribute to the higher susceptibility of some individuals to cardiovascular disease, especially Asian Indians and Chinese [21]. A double-blind, randomized, controlled study conducted by Tiano et al. [22] treated 35 patients with ischemic heart disease using coenzyme Q10 at a dose of 100 mg three times daily (300 mg/d) for 1 mo. The results showed a significant increase in the activity of endothelium-bound extracellular superoxide dismutase (SOD) and endothelium-dependent relaxation. Singh et al. [23], [24] suggested that coenzyme Q10 supplements (120 mg/d) administered within 3 d of the onset of symptoms may provide antioxidant protection in patients with myocardial infarction. However, in some clinical trials, coenzyme Q10 supplements produced only a slight improvement or none at all in patients with CAD [25], [26], [27]. The department of health (DOH) in Taiwan recommends a daily intake of no more than 30 mg of coenzyme Q10 for healthy adults but does not provide any information on the use of coenzyme Q10 to prevent CAD. Therefore, in this study we investigated the effect of coenzyme Q10 supplementation (60 and 150 mg/d) on oxidative stress and antioxidant enzyme activity in patients with CAD.
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Subjects
This study was designed as a randomized, parallel, placebo-controlled study. Patients with CAD were recruited from the cardiology clinic of Taichung Veterans General Hospital, which is a teaching hospital in central Taiwan. Patients identified by cardiac catheterization as having at least 50% stenosis of one major coronary artery or receiving percutaneous transluminal coronary angioplasty were enrolled in this study. Subjects with diabetes or liver or renal diseases were excluded to minimize
Results
Forty-three subjects with CAD completed the study. There were no significant differences among groups in age, body mass index, blood pressure, anthropometric measurements, hematologic entities (i.e., serum urea nitrogen, serum creatinine, lipid profiles, high-sensitivity C-reactive protein), plasma homocysteine concentration, the frequency of smoking, and the nutrient composition at baseline (Table 1).
Figure 2 shows the effect of coenzyme Q10 supplementation on lipid peroxidation and
Discussion
The results showed that subjects supplied with coenzyme Q10 at a dose of 150 mg had their MDA levels lowered by approximately 28% at week 4 and MDA levels were significantly lower in the Q10-150 group than in the placebo group at week 8 (P = 0.03). Based on our results, it seems clear that coenzyme Q10 has a protective effect against CAD, which may be ascribed to its antioxidant function. Coenzyme Q10 can provide rapid protective effects against lipid peroxides (MDA), which is an indicator of
Acknowledgments
The authors express their sincere appreciation to the subjects for their participation and to Dr. Hsia who kindly provided the coenzyme Q10 supplements for this trial. They thank the nurses at Taichung Veterans General Hospital and Ms. Hsu-Hui Chen for providing expert assistance in blood sample collection and data analysis.
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This study was supported by grant NSC 97-2320-B-040-034-MY2 from the National Science Council, Taiwan.