Possible role of ubiquinone in the treatment of massive hypertriglyceridemia resistant to PUFA and fibrates.
OBJECTIVE
To describe the effect of Coenzyme Q10 (CoQ10) (added to either a fibrate, or polyunsaturated fatty acids (PUFA) or association of both) in patients affected by massive hypertriglyceridemia (MHTG) resistant to fibrates and PUFA.


METHODS
Open, sequential, comparative intervention study.


METHODS
Specialised centres for dyslipidemia management.


METHODS
Fifteen subjects (mean age: 45.1+/-12.5 years) affected by MHTG and hyporesponsive to either fibrates, or PUFA, or fibrates-PUFA association, and 15 age-matched subjects regularly responders to PUFA and fenofibrate treatment.


METHODS
Treatment for periods of 6 weeks each with the following consecutive treatments: CoQ10 150 mg/day, PUFA 3000 mg/day, fenofibrate 200 mg/day, PUFA 3000 mg/day+fenofibrate 200 mg/day, PUFA 3000 mg/day+CoQ10 150 mg/day, fenofibrate 200 mg/day+CoQ10 150 mg/day, and finally, fenofibrate 200 mg/day+PUFA 3000 mg/day + CoQ10 150 mg/day.


RESULTS
CoQ10 supplementation did not improve any monitored parameter in the control group except for systolic and diastolic blood pressure, creatinine and Lp(a) plasma levels, both during fenofibrate and/or PUFA treatment. In MHTG group, CoQ10 supplementation significantly improved TG, TC, Lp(a), uric acid and blood pressure during fenofibrate treatment, but only Lp(a) and blood pressure during PUFA treatment. Fenofibrate appeared to have better effect on hsCRP and gamma-GT plasma levels than PUFA. No significant change was observed in any group and under any treatment in regards to homocysteinemia, PAI-1, or t-PA.


CONCLUSIONS
Even though the mechanism of action through which the effects were obtained is yet to be elucidated, adding CoQ10 to fenofibrate could improve the drug's efficacy in MHTG patients not responding to fenofibrate alone.
Cicero
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AF
GC Descovich Atherosclerosis Research Centre, D. Campanacci Clinical Medicine and Applied Biotechonology Department, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. afgcicero@cardionet.it
Derosa
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G
Miconi
A
A
Laghi
L
L
Nascetti
S
S
Gaddi
A
A
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D003067:Coenzymes; D003404:Creatinine / Q000097:blood; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005231:Fatty Acids, Unsaturated / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D011345:Fenofibrate / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use*; D014527:Uric Acid / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
D003067:Coenzymes; D005231:Fatty Acids, Unsaturated; D017270:Lipoprotein(a); D014280:Triglycerides; D014451:Ubiquinone; D014527:Uric Acid; D002784:Cholesterol; D003404:Creatinine; D005723:gamma-Glutamyltransferase; C024989:coenzyme Q10; D011345:Fenofibrate