Coenzyme Q10 levels are low and are associated with the inflammatory cascade in septic shock Critical Care, 08/10/2011

Donnino MW et al.– Coenzyme Q10 (CoQ10) levels are significantly lower in patients with septic shock compared to healthy controls. CoQ10 is negatively associated with vascular endothelial markers and inflammatory molecules though this association diminishes when adjusting for LDL levels.

• Post–hoc analysis of a prospective randomized trial of simvastatin versus placebo in patients with septic shock .
• Adult patients with suspected or confirmed infection and the need for vasopressor support were included in the initial trial.
• For the current analysis, blood specimens were analyzed for plasma CoQ10 and low–density lipoprotein levels.
• The relationship between CoQ10 levels and inflammatory and vascular endothelial biomarkers was assessed using Pearson or Spearman correlations.

• 28 samples from 14 patients were analyzed.
• CoQ10 levels were low with a median of 0.49 (IQR: 0.26–0.62) as compared to healthy control patients (CoQ10=0.95 umol/L +/–0.29; p<0.0001).
• Statin therapy had no effect on plasma CoQ10 levels over time (p=0.13).
• There was a statistically significant relationship between CoQ10 level and vascular cell adhesion molecule (VCAM) (r2=0.2; p=0.008), tumour necrosis factor– (r2=0.28; p=0.004), interleukin (IL)–8 (r2=0.21; p=0.015), IL–10 (r2=0.18; p=0.025), E–selectin (r2=0.17; p=–0.03), IL–1ra (r2=0.21; p=0.014), IL–6 (r2=0.17; p=0.029), and IL–2 (r2=0.23; p=0.009).
• Adjusting for low–density lipoprotein (LDL) levels there was a statistically significant inverse relationship between CoQ10 and VCAM (r2=0.24; p=0.01; Figure 3) and IL–10 (r2=0.24; p=0.02).