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Evidence of Plasma CoQ10‐Lowering Effect by HMG‐CoA Reductase Inhibitors: A Double‐Blind, Placebo‐Controlled Study
Abstract
Inhibitors of HMG‐CoA reductase are new safe and effective cholesterol‐lowering agents. Elevation of alanine‐amino transferase (ALT) and aspartate‐amino transferase (AST) has been described in a few cases and a myopathy with elevation of creatinine kinase (CK) has been reported rarely. The inhibition of HMG‐CoA reductase affects also the biosynthesis of ubiquinone (CoQ10). We studied two groups of five healthy volunteers treated with 20 mg/day of pravastatin (Squibb, Italy) or simvastatin (MSD) for a month. Then we treated 30 hypercholesterolemic patients in a double‐blind controlled study with pravastatin, simvastatin (20 mg/day), or placebo for 3 months. At the beginning, and 3 months thereafter we measured plasma total cholesterol, CoQ10, ALT, AST, CK, and other parameters (urea, creatinine, uric acid, total bilirubin, gamma GT, total protein). Significant changes in the healthy volunteer group were detected for total cholesterol and CoQ10 levels, which underwent about a 40% reduction after the treatment. The same extent of reduction, compared with placebo was measured in hypercholesterolemic patients treated with pravastatin or simvastatin. Our data show that the treatment with HMG‐CoA reductase inhibitors lowers both total cholesterol and CoQ10 plasma levels in normal volunteers and in hypercholesterolemic patients. CoQ10 is essential for the production of energy and also has antioxidative properties. A diminution of CoQ10 availability may be the cause of membrane alteration with consequent cellular damage.
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In the citing paper
“Consistent with previous reports ( 44,46,47 ), CoQ 10 was the more abundant of the two ubiquinones, making up 94% of the total plasma CoQ.”
From Lipidomics reveals a remarkable diversity of lipids in human plasma (2010) · cites this paper as [47]
In the citing paper
“Because the biosynthesis of CoQ is dependent upon the availability of farnesyl pyrophosphate produced by the mevalonate pathway, inhibition of the rate-limiting enzyme in this pathway, HMG-CoA reductase, by the cholesterol lowering statin drugs may lead to reductions in serum CoQ levels ( 46,47 ).”
From Lipidomics reveals a remarkable diversity of lipids in human plasma (2010) · cites this paper as [47]
In the citing paper
“slightly higher than previously published values ( 43,47,48 ).”
From Lipidomics reveals a remarkable diversity of lipids in human plasma (2010) · cites this paper as [47]
In the citing paper
“Evidence also exists for reduced CoQ in plasma of humans with diabetes (113).”
From Mitochondrial Dysfunction in Diabetes: From Molecular Mechanisms to Functional Significance and Therapeutic Opportunities (2010) · cites this paper as [113]
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Metadata
- Authors
- Ghirlanda, G., Oradei, A., Manto, A., Lippa, S., Uccioli, L., Caputo, S., Greco, A. V., & Littarru, G. P.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Corresponding author
- Ghirlanda, G.
- Venue
- The Journal of Clinical Pharmacology
- Publisher
- Wiley
- Published
- 1993-03
- Volume
- 33
- Issue
- 3
- Pages
- 226-229
- ISSN
- 0021-9754 (ISSN-L)
- 0091-2700
- 1552-4604
- OpenAlex
- W1964874366
- Cited by
- 324
- References
- 23
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 2 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 15 · 2017: 12 · 2016: 17 · 2015: 16 · 2014: 11 · 2013: 8 · 2012: 16
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Pharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Coenzyme Q10 studies and effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
- Keywords
- statins, coenzyme Q10, pravastatin, simvastatin, hypercholesterolemia, serum cholesterol, statin adverse effects, creatine kinase, liver enzymes, myopathy
- MeSH terms
- Adult, Cholesterol, Double-Blind Method, Female, Humans, Hypercholesterolemia, Lipids, Lovastatin, Male, Middle Aged, Ubiquinone, Pravastatin, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Simvastatin
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