Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors.
Coenzyme Q10 (ubiquinone) the essential mitochondrial redox-component and endogenous antioxidant, packaged into the LDL + VLDL fractions of cholesterol, has been suggested as an important anti-risk factor for the development of atherosclerosis as explained by the oxidative theory. Forty-five hypercholesterolemic patients were randomized in a double-blind trial in order to be treated with increasing dosages of either lovastatin (20-80 mg/day) or pravastatin (10-40 mg/day) over a period of 18 weeks. Serum levels of coenzyme Q10 were measured parallel to the levels of cholesterol at baseline on placebo and diet and during active treatment. A dose-related significant decline of the total serum level of coenzyme Q10 was found in the pravastatin group from 1.27 +/- 0.34 at baseline to 1.02 +/- 0.31 mmol/l at the end of the study period (mean +/- S.D.), P < 0.01. After lovastatin therapy the decrease was significant as well and more pronounced, from 1.18 +/- 0.36 to 0.84 +/- 0.17 mmol/l, P < 0.001. Although HMG-CoA reductase inhibitors are safe and effective within a limited time horizon, continued vigilance of a possible adverse consequence from coenzyme Q10 lowering seems important during long-term therapy.
Mortensen
S A
SA
Department of Medicine B, National University Hospital, Rigshospitalet, Copenhagen, Denmark.
Leth
A
A
Agner
E
E
Rohde
M
M
D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000032:analysis*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood / Q000737:chemistry; D015243:Cholesterol, VLDL / Q000097:blood; D003067:Coenzymes; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008148:Lovastatin / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D017035:Pravastatin / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D012307:Risk Factors; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000097:blood
D000975:Antioxidants; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D003067:Coenzymes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014451:Ubiquinone; D002784:Cholesterol; D008148:Lovastatin; C024989:coenzyme Q10; D017035:Pravastatin