Coenzyme Q10: is there a clinical role and a case for measurement?
Coenzyme Q(10) (CoQ(10)) is an essential cofactor in the mitochondrial electron transport pathway, and is also a lipid-soluble antioxidant. It is endogenously synthesised via the mevalonate pathway, and some is obtained from the diet. CoQ(10) supplements are available over the counter from health food shops and pharmacies. CoQ(10) deficiency has been implicated in several clinical disorders, including but not confined to heart failure, hypertension, Parkinson's disease and malignancy. Statin, 3-hydroxy-3- methyl-glutaryl (HMG)-CoA reductase inhibitor therapy inhibits conversion of HMG-CoA to mevalonate and lowers plasma CoQ(10) concentrations. The case for measurement of plasma CoQ(10) is based on the relationship between levels and outcomes, as in chronic heart failure, where it may identify individuals most likely to benefit from supplementation therapy. During CoQ(10) supplementation plasma CoQ(10) levels should be monitored to ensure efficacy, given that there is variable bioavailability between commercial formulations, and known inter-individual variation in CoQ(10) absorption. Knowledge of biological variation and reference change values is important to determine whether a significant change in plasma CoQ(10) has occurred, whether a reduction for example following statin therapy or an increase following supplementation. Emerging evidence will determine whether CoQ(10) does indeed have an important clinical role and in particular, whether there is a case for measurement.
Molyneux
Sarah L
SL
Clinical Biochemistry Unit, Canterbury Health Laboratories, Christchurch, New Zealand. sarah.molyneux@cdhb.govt.nz
Young
Joanna M
JM
Florkowski
Christopher M
CM
Lever
Michael
M
George
Peter M
PM
J Am Coll Cardiol. 2003 Dec 3;42(11):1933-40
14662255
J Lipid Res. 1996 Jan;37(1):67-75
8820103
J Chromatogr. 1988 Mar 4;425(1):87-97
3360880
J Chromatogr. 1985 Jul 12;342(1):35-46
4044758
JAMA. 2003 Apr 2;289(13):1681-90
12672737
Ann Intern Med. 2000 Apr 18;132(8):636-40
10766682
Arch Biochem Biophys. 1998 Apr 15;352(2):229-36
9587410
Ann Intern Med. 2002 Oct 1;137(7):581-5
12353945
Physiol Res. 1996;45(1):39-45
8884922
Exp Neurol. 2004 Aug;188(2):491-4
15246848
Proc Natl Acad Sci U S A. 1989 Apr;86(7):2379-82
2928337
J Chromatogr. 1992 Feb 28;593(1-2):217-26
1639907
Scand J Clin Lab Invest. 1999 Oct;59(6):457-66
10612557
Eur Heart J. 1992 Nov;13(11):1528-33
1464342
Atherosclerosis. 2008 Feb;196(2):966-9
18164307
Proc Natl Acad Sci U S A. 1985 Feb;82(3):901-4
3856239
Clin Biochem. 2007 Jun;40(9-10):623-8
17425952
Biofactors. 1999;9(2-4):285-9
10416042
J Am Coll Cardiol. 1999 May;33(6):1549-52
10334422
Proc Natl Acad Sci U S A. 1991 Mar 1;88(5):1646-50
2000375
Biofactors. 2003;18(1-4):79-89
14695923
J Clin Invest. 2007 Mar;117(3):765-72
17332895
J Card Fail. 2006 Aug;12(6):464-72
16911914
Clin Pharmacol Ther. 1995 Jan;57(1):62-6
7828383
Int J Clin Lab Res. 1994;24(3):171-6
7819598
Clin Chem. 1990 Feb;36(2):265-70
2302771
BMJ. 2006 Jun 3;332(7553):1330-2
16740566
Clin Chim Acta. 2002 Dec;326(1-2):155-61
12417107
Clin Chim Acta. 2003 Jun;332(1-2):123-32
12763289
J Neurol Sci. 2004 Aug 30;223(2):161-6
15337618
Arch Neurol. 2003 Aug;60(8):1170-2; author reply 1172-3
12925381
Diabetes Care. 1992 Mar;15(3):318-68
1532777
Biochem Biophys Res Commun. 1997 May 19;234(2):296-9
9177262
Eur J Clin Nutr. 2002 Nov;56(11):1137-42
12428181
Diabetologia. 2002 Mar;45(3):420-6
11914748
Int J Vitam Nutr Res. 1997;67(2):123-9
9129255
J Am Acad Dermatol. 2006 Feb;54(2):234-41
16443053
Biochem Biophys Res Commun. 1993 May 28;193(1):88-92
8503942
Mol Aspects Med. 1994;15 Suppl:S265-72
7752851
Atherosclerosis. 1998 Nov;141(1):17-30
9863535
Free Radic Biol Med. 1999 Nov;27(9-10):1027-32
10569635
Atherosclerosis. 2005 Mar;179(1):201-6
15721028
QJM. 2004 Aug;97(8):537-48
15256611
Ann Neurol. 1989 Dec;26(6):719-23
2557792
Mol Aspects Med. 1994;15 Suppl:s155-63
7752827
Mol Aspects Med. 1994;15 Suppl:s207-12
7752832
Biofactors. 2004;20(3):173-81
15665387
N Engl J Med. 2007 Nov 29;357(22):2248-61
17984166
J Neurochem. 1990 Dec;55(6):2142-5
2121905
Clin Chem. 2005 Feb;51(2):455-7
15681564
Proc Natl Acad Sci U S A. 1990 Nov;87(22):8931-4
2247468
Biochem Biophys Res Commun. 1995 Jul 6;212(1):172-7
7612003
Ann Neurol. 1997 Aug;42(2):261-4
9266740
Pharmacogenet Genomics. 2007 Sep;17(9):695-707
17700359
Asia Pac J Clin Nutr. 1998 Mar;7(1):37-40
24394896
Am J Cardiol. 2004 Nov 15;94(10):1306-10
15541254
Clin Chem. 2007 Apr;53(4):802-3
17405953
J Biol Chem. 2004 Sep 3;279(36):37575-87
15220329
J Hum Hypertens. 1999 Mar;13(3):203-8
10204818
Methods Enzymol. 1984;105:147-55
6727663
Neurology. 1997 May;48(5):1238-43
9153450
N Engl J Med. 1998 Oct 8;339(15):1044-53
9761807
Free Radic Biol Med. 1997;22(7):1195-202
9098093
Clin Chem. 2005 Dec;51(12):2380-2
16306103
Biol Pharm Bull. 1994 Aug;17(8):997-1002
7820130
Clin Pharmacol Ther. 2005 Jul;78(1):60-8
16003294
Clin Chim Acta. 2004 Sep;347(1-2):139-44
15313151
Methods Enzymol. 2004;378:146-51
15038964
Proc Natl Acad Sci U S A. 1985 Jun;82(12):4240-4
3858877
Arch Neurol. 2007 Jul;64(7):938-44
17502459
Free Radic Biol Med. 2006 Apr 15;40(8):1293-302
16631519
Int J Vitam Nutr Res. 2003 May;73(3):207-14
12847998
Anal Biochem. 2002 Jun 1;305(1):49-54
12018945
J Am Coll Nutr. 2001 Dec;20(6):591-8
11771674
Int J Cardiol. 2006 Sep 20;112(2):234-42
16846656
Br J Clin Pharmacol. 1996 Sep;42(3):333-7
8877024
Clin Chim Acta. 1997 Jul 4;263(1):67-77
9247729
N Z Med J. 1991 Nov 27;104(924):493-5
1745460
Lancet. 1998 Aug;352 Suppl 1:SI19-28
9736476
Anal Biochem. 1997 Jul 15;250(1):66-73
9234900
Mitochondrion. 2007 Jun;7 Suppl:S89-93
17485249
Free Radic Res. 2002 Apr;36(4):389-97
12069102
Eur J Clin Pharmacol. 1994;46(4):313-7
7957515
Heart Lung Circ. 2003;12(3):135-41
18705154
Clin Chim Acta. 2004 Nov;349(1-2):121-7
15469864
Arch Neurol. 2005 Nov;62(11):1709-12
16286544
Clin Chim Acta. 2004 Mar;341(1-2):173-84
14967174
Lipids Health Dis. 2007 Mar 21;6:7
17376224
J Biol Chem. 1966 Oct 10;241(19):4353-6
5922959
J Clin Pharmacol. 1993 Mar;33(3):226-9
8463436
J Clin Invest. 2007 Mar;117(3):587-9
17332886
Muscle Nerve. 2006 Aug;34(2):153-62
16671104
Science. 1983 Feb 25;219(4587):979-80
6823561
Atherosclerosis. 2003 May;168(1):169-79
12732401
Anal Biochem. 1995 Dec 10;232(2):210-6
8747477
Biochim Biophys Acta. 1992 Jun 26;1126(3):247-54
1637852
Clin Chim Acta. 2005 Aug;358(1-2):198-200
15953597
Mol Aspects Med. 1994;15 Suppl:s273-80
7752839
Biochim Biophys Acta. 1957 Jul;25(1):220-1
13445756
Am J Cardiol. 2007 May 15;99(10):1409-12
17493470
Atherosclerosis. 1997 Feb 28;129(1):119-26
9069526
FEBS Lett. 1999 Jan 25;443(2):163-6
9989597
Lancet. 2000 Jul 29;356(9227):391-5
10972372
Arch Neurol. 2002 Oct;59(10):1541-50
12374491
J Neurol Sci. 1998;156(1):41-6
9559985
Neurosci Lett. 2003 May 8;341(3):201-4
12697283
Neurology. 2001 Aug 14;57(3):515-8
11502923
Ann Nutr Metab. 2003;47(1):16-21
12624483
Am J Cardiol. 1996 Apr 15;77(10):851-4
8623738
Am J Cardiol. 2007 Nov 1;100(9):1400-3
17950797
J Clin Pathol. 1993 Nov;46(11):1055-7
8254097
Biofactors. 2003;18(1-4):185-93
14695934
J Card Fail. 1995 Mar;1(2):101-7
9420639
Clin Chem. 2001 Feb;47(2):256-65
11159774
Lancet. 2007 Nov 24;370(9601):1781-90
17559928
J Chromatogr B Biomed Sci Appl. 1999 Apr 16;726(1-2):297-302
10348199
J Hum Hypertens. 2007 Apr;21(4):297-306
17287847
Mitochondrion. 2007 Jun;7 Suppl:S146-53
17485247
N Z Med J. 2004 Oct 08;117(1203):U1108
15477929
Mol Aspects Med. 1997;18 Suppl:S159-68
9266518