Effect of atorvastatin withdrawal on circulating coenzyme Q10 concentration in patients with hypercholesterolemia.
Statin therapy can reduce the biosynthesis of both cholesterol and coenzyme Q10 by blocking the common upstream mevalonate pathway. Coenzyme Q10 depletion has been speculated to play a potential role in statin-related adverse events, and withdrawal of statin is the choice in patients developing myotoxicity or liver toxicity. However, the effect of statin withdrawal on circulating levels of coenzyme Q10 remains unknown. Twenty-six patients with hypercholesterolemia received atorvastatin at 10 mg/day for 3 months. Serum lipid profiles and coenzyme Q10 were assessed before and immediately after 3 months and were also measured 2 and 3 days after the last day on the statin. After 3 months' atorvastatin therapy, serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and coenzyme Q10 (0.43 +/- 0.23 to 0.16 +/- 0.10 microg/mL) were all significantly reduced (all p<0.001). On day 2 after the last atorvastatin, the coenzyme Q10 level was significantly elevated (0.37 +/- 0.16 microg/mL) and maintained the same levels on day 3 (0.39 +/- 0.18 microg/mL) compared with those on month 3 (both p< 0.001), while TC and LDL-C did not significantly change within the same 3 days. These results suggest that statin inhibition of coenzyme Q10 synthesis is less strict than inhibition of cholesterol biosynthesis.
Chu
Chih-Sheng
CS
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kou
Hwang-Shang
HS
Lee
Chun-Jing
CJ
Lee
Kun-Tai
KT
Chen
Su-Hwei
SH
Voon
Wen-Chol
WC
Sheu
Sheng-Hsiung
SH
Lai
Wen-Ter
WT
D000069059:Atorvastatin; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003067:Coenzymes / Q000097:blood; D005260:Female; D006538:Heptanoic Acids / Q000009:adverse effects*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome; D014280:Triglycerides / Q000097:blood; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003067:Coenzymes; D006538:Heptanoic Acids; D011758:Pyrroles; D014280:Triglycerides; D014451:Ubiquinone; D002784:Cholesterol; D000069059:Atorvastatin; C024989:coenzyme Q10