Statins Deplete CoQ10

It has been hypothesised that the intracellular depletion of CoEnzyme Q10 (CoQ10) due to statins, may play a role in myopathy and worsening of diabetes mellitus.

This open, randomised, four-phased crossover study compared the efficacy and safety of high dose pitavastatin (4 mg) or atorvastatin (20 mg), espeically regarding plasma levels of CoQ10, in 19 Japanese patients with heterozygous familial hypercholesterolaemia (FH).

Pitavastatin and atrovastatin caused signficiant and almost comparable reductions in serum levels of total cholesterol, low-density lipoprotein (LDL) cholesterol and triglyceride, and signfcantly increased serum levels of high-density lipoprotein (HDL) cholesterol.

Under these conditions, plasma levels of CoQ10 were reduced by atrovastatin )-26.1%, p=0.0007) but not by pitavastatin (-7.7%, p=0.39). No adverse events or abnormalities of liver and muscle enzyme were observed after either statin treatment.

Conclusion

Several studies have indicated that the depletion of plasma or tissue CoQ10 levels b lovastatin, pravastatin, stimvastatin and atrovastatin is almost the same degree as serum or plasma LDL-cholesterol reduction rate. Although statins are generally well tolerated and safe, myopathy and an asymptomatic increase in hepatic enzymes are relatively frequent.

Kawashiri M, Nohara A, Tada H, Mori M, Tsuchida M, Katsuda S, et al. Comparison of effects of vitavastatin and atorvastatin on plasma coenzyme Q10 in heterozygous familial hypercholesterolemia: restults from a crossover study. Clin Pharmacol Ther 2008 May; 83(5):731-739. Epub 2007 Oct 24.