Meta-analysis: CoQ10 may be effective in reducing inflammatory markers

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The powerful antioxidant may have the ability to reduce the level of inflammatory factors in people in a variety of health states.

With previous meta-analyses demonstrating mixed effects of Coenzyme Q10 (CoQ10) on inflammatory markers, researchers from China sought to assess the efficacy and optimal dose of CoQ10 supplementation on inflammatory markers in the general population.

According to the authors, this was the first study to assess the daily optimal and safe dose of CoQ10 supplementation needed to achieve anti-inflammatory effects.

These findings were published in the journal Molecular Nutrition & Food Research.

CoQ10 background

Coenzyme Q10 (CoQ10), also known as ubiquinone, is an endogenous lipophilic compound involved in many critical cellular pathways. As one of the most powerful lipid antioxidants, CoQ10 can counteract reactive oxygen species (ROS) reactions, recover other antioxidants, and prevent membranes and cells from lipid peroxidation, avoiding cell damage and cell death.

CoQ10 deficiency can result from genetic inborn errors, certain medications, and aging. The endogenous production of CoQ10 decreases after the age of 20, and myocardial concentration of CoQ10 is reduced to about half by the age of 80, according to a 2019 study.

Meta-analysis details

A systematic literature search of PubMed, Embase and Cochrane Library electronic databases was conducted for RCTs concerning the effects of CoQ10 supplementation on outcomes of common inflammatory markers between 2004 and 2022. Of the 6,713 studies identified through the initial database search, 31 studies met the inclusion criteria and were included in the meta-analysis.

In total, these trials involved over 1,500 participants, with 766 assigned to the CoQ10 group and 751 assigned to the control group. The range of mean age among these participants was 17 to 79 years with most of the studies including both males and females.

Participants were divided into six categories according to health status, distinguishing between healthy subjects and those with cardiovascular disease (CVD) and other diseases. The daily dose of CoQ10 varied from 30mg to 500mg and the duration ranged from two to 48 weeks.

Inflammation markers

The meta-analysis looked at studies that used three common inflammatory markers frequently used in studies of aging: TNF-alpha, IL-6 and CRP. Tumor necrosis factor alpha (TNF-alpha) is produced mainly by macrophages and contributes to production of interleukin-6 (IL-6), as well as C-reactive protein (CRP), which directs the chronic inflammatory process in the body.

CRP
Over 20 studies including a total of 1,145 participants measured circulating CRP after CoQ10 supplementation. Pooled estimates found that CoQ10 significantly reduced circulating CRP levels. Subgroup analyses demonstrated significant reduction of circulating CRP in individuals who received 100-200 mg daily and the maximum effect observed at 300-400 mg daily. The combined data of 16 RCTs revealed that CoQ10 significantly reduced circulating CRP among individuals over 50 years old. CRP concentration was significantly reduced in healthy people, and a decreased trend of CRP levels in CVD participants was also demonstrated after CoQ10 supplementation.

IL-6
Just over 20 trials with 880 subjects investigated the efficacy of CoQ10 supplementation on circulating IL-6 concentrations. The results of the random-effects model suggested that CoQ10 supplementation could significantly reduce the levels of circulating IL-6. Subgroup analysis showed that IL-6 levels significantly declined following a 200–300 mg CoQ10 intervention daily dose. Furthermore, subgroup analysis revealed that CoQ10 supplementation had a greater effect on IL-6 in males compared to females. Subgroup analysis showed a significant reduction of IL-6 concentrations among subjects with CVD and other diseases following CoQ10 supplementation.

TNF-alpha
Seventeen RCTs with 721 subjects investigated the impact of CoQ10 on circulating TNF-alpha concentration. Results showed that supplementation with CoQ10 significantly reduced TNF-alpha levels. Subgroup analysis indicated that a high dose of CoQ10 (300-400 mg/d) had a better effect on reducing circulating TNF-alpha levels compared to a low dose of CoQ10. Looking at age, a decrease of circulating TNF-alpha concentration was significant in subjects under 50. As for different health status, there was a significant decrease in TNF-alpha levels in the subgroup of unhealthy participants while no significant effect was observed in healthy participants.

In addition to inflammation reduction, the meta-analysis found an increase in circulating CoQ10 among participants who took more than 100 mg per day.

Conclusion

Overall, the systematic review and meta-analysis of 31 RCTs shows that daily supplement with 300-400 mg of oral CoQ10 significantly diminished levels of circulating CRP, IL-6, and TNF-alpha and increased the concentration of circulating CoQ10 in the general population.

The authors conclude that the findings “provide the latest and relatively more reliable evidence for the role of CoQ10 supplementation in reducing the level of inflammatory factors both in diseased people and healthy people.”

Source: Molecular Nutrition & Food Research
28 April 2023 doi: doi.10.1002/mnfr.202200800
“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”
Authors: H. Shanshan, et al.