Dose-Response Effect of Coenzyme Q10 Supplementation on Blood Pressure among Patients with Cardiometabolic Disorders: A Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials

Trends in Coenzyme Q10 Supplement Use and Associations With All-Cause and Cardiovascular Mortality: A Population-Based Cohort Study

Coenzyme Q10 (CoQ10) is a fat-soluble nutrient, which has antioxidant and anti-inflammatory properties. However, there is insufficient evidence on its daily use and the association with mortality. We aimed to evaluate the trends of CoQ10 supplement use among US noninstitutionalized adults and explore its associations with all-cause and CVD mortality. A prospective cohort study used data from the National Health and Nutrition Examination Survey (1999-2018). The association of CoQ10 supplementation with mortality was assessed with Cox proportional hazard models. The overall reported prevalence of CoQ10 supplement use increased from 1.2% (95% CI 0.7%-1.8%) in 1999-2000 to 4.6% (95% CI 3.4%-6.1%) in 2017-2018 (linear p  =  0.002). During an average of 9.8 years of follow-up, 5237 deaths were identified, including 1428 deaths due to CVD. In the multivariable model, CoQ10 supplement use was not associated with all-cause mortality (HR 1.00, 95% CI 0.77-1.30, p = 0.996) and CVD mortality (HR 1.30, 95% CI 0.89-1.90, p = 0.170). Subgroup analyses suggested that the use of CoQ10 supplements was associated with a higher all-cause mortality in obese participants (HR 1.45, 95% CI 1.01-2.08, p for interaction = 0.013). Although the prevalence of CoQ10 supplement use experienced continuous growth from 1999 to 2018 in the general adults of NHANES, CoQ10 supplementation was not associated with all-cause and CVD mortality.

Current Approaches and Innovations in Managing Preeclampsia: Highlighting Maternal Health Disparities

Preeclampsia (PE) is a major cause of maternal mortality and morbidity, affecting 3-6% of pregnancies worldwide and ranking among the top six causes of maternal deaths in the U.S. PE typically develops after 20 weeks of gestation and is characterized by new-onset hypertension and/or end-organ dysfunction, with or without proteinuria. Current management strategies for PE emphasize early diagnosis, blood pressure control, and timely delivery. For prevention, low-dose aspirin (81 mg/day) is recommended for high-risk women between 12 and 28 weeks of gestation. Magnesium sulfate is also advised to prevent seizures in preeclamptic women at risk of eclampsia. Emerging management approaches include antiangiogenic therapies, hypoxia-inducible factor suppression, statins, and supplementation with CoQ10, nitric oxide, and hydrogen sulfide donors. Black women are at particularly high risk for PE, potentially due to higher rates of hypertension and cholesterol, compounded by healthcare disparities and possible genetic factors, such as the APOL1 gene. This review explores current and emerging strategies for managing PE and addresses the underlying causes of health disparities, offering potential solutions to improve outcomes.

Can Coenzyme Q10 Supplementation Reduce Cardiovascular Disease Risk Factors? A Protocol for a GRADE-Assessed Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials

Background and Aims

Cardiovascular diseases (CVDs), encompassing a variety of conditions affecting the heart and blood vessels, remain a significant global public health challenge. Among various therapeutic options, Coenzyme Q10 (CoQ10) has garnered attention due to its potential benefits for cardiovascular health. CoQ10 is a naturally occurring antioxidant that plays a crucial role in cellular energy production and has long been used therapeutically. This study aims to summarize and systematically analyze the scientific literature on glycemic profile, lipid profile, anthropometric measures, blood pressure, inflammatory factors, liver function tests, oxidative stress parameters and adipokines associated with CoQ10 supplementation to provide a basis for clinical treatment.

Methods

A systematic electronic search will be conducted to identify articles published from inception to July 2024 across databases including PubMed, Scopus, Web of Science, CENTRAL, and EMBASE. The search will focus on randomized controlled trials (RCTs) involving both healthy and unhealthy participants. Two independent reviewers will evaluate articles, extract data, and assess study quality using the Cochrane risk of bias tool. Discrepancies will be resolved through consultation with a third reviewer. If a sufficient number of eligible studies are identified, a meta-analysis will be performed on the selected outcomes.

Results

The results will provide a comprehensive synthesis of the effects of CoQ10 supplementation on cardiovascular disease risk factors, including glycemic profile, lipid profile, anthropometric measures, blood pressure, inflammatory factors, liver function tests, oxidative stress parameters, and adipokines.

Conclusion

This protocol outlines a comprehensive approach to systematically review and perform a dose-response meta-analysis on the effects of CoQ10 supplementation on CVD risk factors. The study will employ rigorous methodologies, including independent evaluation and GRADE assessment, to ensure high-quality evidence synthesis from RCTs.

Renoprotective effects of coenzyme Q10 supplementation in patients with chronic kidney disease: a protocol for a systematic review

INTRODUCTION

Coenzyme Q10 (CoQ10) is a fat-soluble vitamin-like quinone. The plasma levels of CoQ10 are reduced in patients with chronic kidney disease (CKD). CoQ10 supplementation can improve mitochondrial function and decrease oxidative stress in these patients. This systematic review will assess the renoprotective effects of CoQ10 supplementation in patients with CKD.

METHODS AND ANALYSIS

We will include the following studies: (1) randomised-controlled trials, (2) participants with CKD and (3) participants treated with CoQ10 as an intervention. The systematic review protocol was prepared in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and International Clinical Trials Register databases will be searched for articles without language restrictions in December 2024. The authors will be divided into two groups. Two independent authors will screen the titles and abstracts of all reports extracted via an electronic search. After the initial screening, the authors will independently review the full-text articles and perform a directed content analysis of the extracted data. For outcomes measured using continuous scales of measurement, we will adopt standardised mean differences as the effect measures. We will pool the data using the random-effects model.

ETHICS AND DISSEMINATION

No human participants will be involved in the study. On completion of the analysis, the manuscript will be prepared for publication in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42021241085.

Exploring the Renoprotective Potential of Bioactive Nutraceuticals in Chronic Kidney Disease Progression: A Narrative Review

Chronic kidney disease (CKD) is a condition that is characterized by progressive loss of kidney function over time. A substantial increase in the burden of CKD is evident globally, attributed to multifactorial conditions like an expanding aging population, rising diabetes and hypertension rates, and more significant exposures to risk factors associated with the environment and lifestyle. Nutraceuticals are substances that are usually considered a food or an active part of a food that provides medical or health benefits, including the prevention and treatment of a disease. The aim is to review the positive role of nutraceuticals in managing CKD. A narrative review is generated, extracting the papers from databases like Web of Science, Scopus, ScienceDirect, ResearchGate, and PubMed. Animal and human trials focusing on the effect of different nutraceuticals on the initial stage of kidney disease, i.e., stages 1, 2, and 3 of CKD, were included. The review's outcome is understanding the effectiveness of nutraceuticals that have shown positive results in CKD conditions. Active compounds include ubiquinone, curcumin, nitrates, nitrites, lycopene, and resveratrol. These bioactive components are also beneficial for other comorbid conditions like diabetes, hypertension, and cardiovascular conditions that have an eminent adverse effect on CKD. Lycopene, coenzyme Q10 (CoQ10), resveratrol, curcumin, and flavonoids have positively impacted CKD complications. Nutraceuticals hold great promise for individuals with CKD in the coming years, offering diverse potential benefits. These include delivering vital antioxidant and anti-inflammatory support to alleviate oxidative stress and inflammation, helping to regulate blood pressure and lipid levels for improved cardiovascular health, promoting optimal renal function to sustain kidney health, assisting in maintaining electrolyte balance, warding off complications, influencing gut microbiota for enhanced digestive well-being, and ultimately elevating the overall quality of life, for those managing CKD.

The Role of Antioxidants in the Therapy of Cardiovascular Diseases-A Literature Review

Antioxidants are endogenous and exogenous substances with the ability to inhibit oxidation processes by interacting with reactive oxygen species (ROS). ROS, in turn, are small, highly reactive substances capable of oxidizing a wide range of molecules in the human body, including nucleic acids, proteins, lipids, carbohydrates, and even small inorganic compounds. The overproduction of ROS leads to oxidative stress, which constitutes a significant factor contributing to the development of disease, not only markedly diminishing the quality of life but also representing the most common cause of death in developed countries, namely, cardiovascular disease (CVD). The aim of this review is to demonstrate the effect of selected antioxidants, such as coenzyme Q10 (CoQ10), flavonoids, carotenoids, and resveratrol, as well as to introduce new antioxidant therapies utilizing miRNA and nanoparticles, in reducing the incidence and progression of CVD. In addition, new antioxidant therapies in the context of the aforementioned diseases will be considered. This review emphasizes the pleiotropic effects and benefits stemming from the presence of the mentioned substances in the organism, leading to an overall reduction in cardiovascular risk, including coronary heart disease, dyslipidaemia, hypertension, atherosclerosis, and myocardial hypertrophy.

Associations between Long-Term Dietary Coenzyme Q10 Intake and New-Onset Hypertension in Adults: Insights from a Nationwide Prospective Cohort Study

Coenzyme Q10 (CoQ10) supplementation appears to be associated with a lower blood pressure. Nevertheless, it remains unclear whether food-sourced CoQ10 will affect new-onset hypertension in general adults. This study investigated the relationship between dietary CoQ10 intake and new-onset hypertension among the general population. Participants without hypertension at baseline from the China Health and Nutrition Survey (CHNS) prospective cohort study were included (n = 11,428). Dietary CoQ10 intake was collected by validated dietary recalls and the food weighing method. Linear and non-linear relationships between dietary CoQ10 intake and new-onset hypertension were analyzed using multivariable Cox proportional hazards models and restricted cubic splines. During follow-up (median: 6 years), 4006 new-onset hypertension cases were documented. Compared with non-consumers, the hazard ratio (HR) and 95% confidence interval (CI) from quintile 2 to 4 total dietary CoQ10 were 0.83 (0.76, 0.91), 0.86 (0.78, 0.94) and 1.01 (0.92, 1.11); total plant-derived CoQ10 were 0.80 (0.73, 0.88), 1.00 (0.91, 1.09) and 1.10 (1.00, 1.20); and animal-derived CoQ10 were 0.65 (0.59, 0.71), 0.58 (0.53, 0.64) and 0.68 (0.62, 0.75). The lowest risk was found at moderate intake, with a non-linear relationship (P nonlinearity < 0.05). Furthermore, the overall inverse association was stronger among individuals without alcohol consumption or eating a low-fat diet. Moderate long-term dietary CoQ10 intake might be protective against new-onset hypertension. However, it follows a non-linear relationship and excessive intake may increase the risk of new-onset hypertension in the Chinese population.

Recommendations for nutritional supplements for dry eye disease: current advances

Dry eye disease (DED) represents a prevalent ocular surface disease. The development of effective nutritional management strategies for DED is crucial due to its association with various factors such as inflammation, oxidative stress, deficiencies in polyunsaturated fatty acids (PUFAs), imbalanced PUFA ratios, and vitamin insufficiencies. Extensive research has explored the impact of oral nutritional supplements, varying in composition and dosage, on the symptoms of DED. The main components of these supplements include fish oils (Omega-3 fatty acids), vitamins, trace elements, and phytochemical extracts. Beyond these well-known nutrients, it is necessary to explore whether novel nutrients might contribute to more effective DED management. This review provides a comprehensive update on the therapeutic potential of nutrients and presents new perspectives for combination supplements in DED treatment.

The Association between the Diversity of Coenzyme Q10 Intake from Dietary Sources and the Risk of New-Onset Hypertension: A Nationwide Cohort Study

Coenzyme Q10 (CoQ10) is a food active component with blood-pressure-improving properties. However, the association between the variety and quantity of different sources of dietary CoQ10 and new-onset hypertension remains uncertain. We aimed to investigate the associations between the diversity and quantity of CoQ10 intake from eight major food sources and new-onset hypertension risk. A total of 11,489 participants were included. Dietary intake was evaluated via three consecutive 24 h recalls and household food inventory. The diversity score of CoQ10 sources was calculated by the sum of food groups consumed in the ideal range. Cox proportional hazard models were used for evaluating their associations with hypertension. Model performance was assessed by ROC analyses and 200-times ten-fold cross-validation. The relationships between CoQ10 and hypertension were U-shaped for meat, egg, vegetable, and fruit sources, inverse J-shaped for fish, and nut sources, and L-shaped for dairy products sources (all p-values < 0.001). A higher diversity score was associated with lower hypertension risk (HR (95% CI): 0.66 (0.64, 0.69)). The mean areas under the ROC curves for 6, 12 and 18 years were 0.81, 0.80 and 0.78, respectively. There is a negative correlation between the diversity of CoQ10 with moderate intake from different sources and new-onset hypertension. One diversity score based on CoQ10 was developed.

Evidence on the use of alternative substances and therapies in hypertension

OBJECTIVE

Review of some of the best-known biological and non-biological complementary/alternative therapies/medicines (CAM) and their relationship with blood pressure (BP) and hypertension (HT).

SEARCH STRATEGY

Narrative review assessing a recent series of systematic reviews, meta-analyses, and clinical trials published in recent years, focusing on the effects of CAM on BP and HT.

SELECTION OF STUDIES

We searched EMBASE, MEDLINE, Cochrane Library and Google Scholar, obtaining a total of 4336 articles, finally limiting the search to 181 after applying filters.

SYNTHESIS OF RESULTS

Some studies on biological therapies show some usefulness in BP reduction with an adequate benefit-risk balance, although there is a scarcity of high-quality trials that support these results. Some mind-body therapies have shown hypothetical benefit; in contrast, others lack robust evidence.

CONCLUSIONS

Although some therapies present a reasonable risk-benefit ratio, they should in no case replace pharmacological treatment when indicated.

Coenzyme Q10 Stimulate Reproductive Vatality

Female infertility and pregnancy maintenance are associate with various factors, including quantity and quality of oocytes, genital inflammation, endometriosis, and other diseases. Women are even diagnosed as unexplained infertility or unexplained recurrent spontaneous abortion when failed to achieve pregnancy with current treatment, which are urgent clinical issues need to be addressed. Coenzyme Q10 (CoQ10) is a lipid-soluble electron carrier in the mitochondrial electron transport chain. It is not only essential for the mitochondria to produce energy, but also function as an antioxidant to maintain redox homeostasis in the body. Recently, the capacity of CoQ10 to reduce oxidative stress (OS), enhance mitochondrial activity, regulate gene expression and inhibit inflammatory responses, has been discovered as a novel adjuvant in male reproductive performance enhancing in both animal and human studies. Furthermore, CoQ10 is also proved to regulate immune balance, antioxidant, promote glucose and lipid metabolism. These properties will bring highlight for ovarian dysfunction reversing, ovulation ameliorating, oocyte maturation/fertilization promoting, and embryonic development optimizing. In this review, we systematically discuss the pleiotropic effects of CoQ10 in female reproductive disorders to investigate the mechanism and therapeutic potential to provide a reference in subsequent studies.

Coenzyme Q: food sources, adequate and clinically effective doses

Coenzyme Q (CoQ) plays a key role in cell bioenergetics; it is not only supplied with food, but also synthesized in the body. Endogenous CoQ synthesis decreases with age, with statin use, with cardiovascular, neurodegenerative, and other diseases. In this regard, specialized food products (SFP) enriched with CoQ are being developed. Aim of the review – compare the CoQ doses allowed for use as part of dietary supplements and SFP with doses that provide a clinical effect. Literature review was carried out using the RSCI, Pubmed databases and Google Scholar, ReserchGate systems for the keywords “ubiquinone”, “coenzyme Q10”. The amount of CoQ contained in SFP is set by domestic regulatory documents based on an adequate daily intake for adults (30 mg) and the upper allowable intake level as part of SFP and dietary supplements – 100 mg/day. Actually used doses of CoQ range from 60 to 500 mg/day. Various ways to increase the bioavailability of CoQ have been described. When patients take CoQ, a U-shaped dose-effect relationship is observed, an effective dose that significantly reduces systolic blood pressure, fasting glucose and insulin levels, the degree of hemoglobin glycation, the HOMA-IR glycemic test is in the range of 100–200 mg / day. An improvement in the antioxidant status and a decrease of pro-inflammatory cytokines concentration in the blood plasma of athletes is provided by CoQ doses of 60–300 mg/day, in patients with type 2 diabetes mellitus and coronary heart disease, doses of 100–150 mg/day. Clinically effective doses of CoQ (100–200 mg/day) when used for at least 12 weeks correspond to or are 1.5–2 times higher than the upper allowable consumption level in the composition of SFP and dietary supplements. The inclusion of CoQ in the dietary therapeutic SFP in an amount that does not reach doses that are effective in a certain pathology does not achieve the expected result. A possible way to solve the problem is to increase the acceptable levels of consumption of CoQ in SFP, as well as increasing the bioavailability of CoQ in the composition of emulsions, liposomes, phytosomes and oleogels.

Efficacy and Optimal Dose of Coenzyme Q10 Supplementation on Inflammation-Related Biomarkers: A GRADE-Assessed Systematic Review and Updated Meta-Analysis of Randomized Controlled Trials

SCOPE

Coenzyme Q10 (CoQ10) has become a popular nutritional supplement due to its wide range of beneficial biological effects. Previous meta-analyses show that the attenuation of CoQ10 on inflammatory biomarkers remains controversial. This meta-analysis aims to assess the efficacy and optimal dose of CoQ10 supplementation on inflammatory indicators in the general population.

METHODS AND RESULTS

Databases are searched up to December 2022 resulting in 6713 articles, of which 31 are retrieved for full-text assessment and included 1517 subjects. Double-blind randomized controlled trials (RCTs) of CoQ10 supplementation are eligible if they contain C reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). CoQ10 supplementation can significantly reduce the levels of circulating CRP (SMD: -0.40, 95% CI: [-0.67 to -0.13], p = 0.003), IL-6 (SMD: -0.67, 95% CI: [-1.01 to -0.33], p < 0.001), and TNF-α (SMD: -1.06, 95% CI: [-1.59 to -0.52], p < 0.001) and increase the concentration of circulating CoQ10.

CONCLUSION

This meta-analysis provides evidence for CoQ10 supplementation to reduce the level of inflammatory mediators in the general population and proposes that daily supplementation of 300-400 mg CoQ10 show superior inhibition of inflammatory factors.

Dietary Supplements Potentially Target Plasma Glutathione Levels to Improve Cardiometabolic Health in Patients with Diabetes Mellitus: A Systematic Review of Randomized Clinical Trials

Cardiovascular diseases (CVDs) continue to be the leading cause of death in people with diabetes mellitus. Severely suppressed intracellular antioxidant defenses, including low plasma glutathione (GSH) levels, are consistently linked with the pathological features of diabetes such as oxidative stress and inflammation. In fact, it has already been established that low plasma GSH levels are associated with increased risk of CVD in people with diabetes. Dietary supplements are widely used and may offer therapeutic benefits for people with diabetes at an increased risk of developing CVDs. However, such information remains to be thoroughly scrutinized. Hence, the current systematic review explored prominent search engines, including PubMed and Google Scholar, for updated literature from randomized clinical trials reporting on the effects of dietary supplements on plasma GSH levels in people with diabetes. Available evidence indicates that dietary supplements, such as coenzyme Q10, selenium, curcumin, omega-3 fatty acids, and vitamin E or D, may potentially improve cardiometabolic health in patients with diabetes. Such beneficial effects are related to enhancing plasma GSH levels and reducing cholesterol, including biomarkers of oxidative stress and inflammation. However, available evidence is very limited and additional clinical studies are still required to validate these findings, including resolving issues related to the bioavailability of these bioactive compounds.