Statin therapy and plasma coenzyme Q10 concentrations--A systematic review and meta-analysis of placebo-controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized placebo-controlled trials
PubMed 26192349 · doi:10.1016/j.phrs.2015.07.008
What was done
A systematic review and meta-analysis of randomized placebo-controlled trials was conducted to evaluate the effect of statin therapy on plasma coenzyme Q10 (CoQ10) concentrations. Literature searches included databases up to April 30, 2015. Data from 8 placebo-controlled treatment arms were pooled using fixed-effects or random-effects models based on the I² statistic, with effect sizes expressed as weighted mean differences (WMD) and 95% confidence intervals (CI). Subgroup and leave-one-out sensitivity analyses were also performed.
What was found
Statin therapy significantly reduced plasma CoQ10 concentrations compared to placebo (8 treatment arms, WMD: -0.44 μmol/L, 95% CI: -0.52 to -0.37, p < 0.001). Significant reductions were observed across individual statins: atorvastatin (WMD: -0.41 μmol/L, 95% CI: -0.53 to -0.29, p < 0.001), simvastatin (WMD: -0.47 μmol/L, 95% CI: -0.61 to -0.33, p < 0.001), rosuvastatin (WMD: -0.49 μmol/L, 95% CI: -0.67 to -0.31, p < 0.001), and pravastatin (WMD: -0.43 μmol/L, 95% CI: -0.69 to -0.16, p = 0.001). The reduction occurred with both lipophilic (WMD: -0.43 μmol/L, 95% CI: -0.53 to -0.34, p < 0.001) and hydrophilic statins (WMD: -0.47 μmol/L, 95% CI: -0.62 to -0.32, p < 0.001), and in trials lasting <12 weeks (WMD: -0.51 μmol/L, 95% CI: -0.64 to -0.39, p < 0.001) or ≥12 weeks (WMD: -0.40 μmol/L, 95% CI: -0.50 to -0.30, p < 0.001).
Why it matters
This meta-analysis demonstrates that statin therapy consistently lowers circulating CoQ10 levels across statin types, solubilities, and treatment durations. However, the abstract notes that clinical relevance remains to be confirmed.
Limits
Total participant sample size and baseline population demographics are not reported in the abstract. The meta-analysis includes only 8 treatment arms, measures only plasma CoQ10 rather than tissue/intracellular concentrations, and does not evaluate clinical outcomes such as muscle symptoms.
Cited by
- supports Statins deplete the electron transport chain and cause coenzyme Q10 deficiency.