Introduction

One of the most important nutrients for heart and vascular health is coenzyme Q10 (CoQ10). Its role in the heart is similar to the role of a spark plug in a car engine. Just as the car cannot function without that initial spark, the heart cannot function without CoQ10. Although the body can make CoQ10, considerable research shows significant benefits with supplementation in various health issues, especially those affecting the heart as well as diabetes. It is also critical that people taking cholesterol-lowering drugs (e.g., statins like Lipitor and Crestor) take supplemental CoQ10.

Results from a new double-blind study show another interesting effect on vascular health that highlights the importance of CoQ10 in protecting against cardiovascular disease, especially in people with type 2 diabetes.

Background Data:

In order to appreciate the new way CoQ10 improves cardiovascular health, it requires a brief anatomy lesson. All blood vessels have a lining of cells along the interior surface. The lining is referred to as the endothelium and the cells that form this lining are called endothelial cells. These cells are responsible for:

  • Barrier function – the endothelium acts as a semi-selective barrier controlling the passage of materials into and out of the bloodstream.
  • Inflammation – the endothelium helps to control inflammation in order to protect the deeper layers of blood vessels.
  • Blood clotting (thrombosis & fibrinolysis). The surface of the endothelium normally possesses factors that prevent the formation of blood clots. When it lacks these protective factors, it can lead to the formation of blood clots that could lead to the build up of plaque or the formation of a large clot that may break off and cause a heart attack or stroke.
  • The constriction and dilation of blood vessels. The endothelium plays a key role in controlling blood flow and blood pressure.
  • In some organs, there are highly differentiated endothelial cells to perform specialized ‘filtering’ functions. Examples of such unique endothelial structures include those found in the kidneys (the renal glomerulus) and those that protect the brain (the blood–brain barrier).

The loss of proper endothelial function is a hallmark for vascular diseases, and is often regarded as a key early event in the development of atherosclerosis (hardening of the arteries). Impaired endothelial function is often seen in patients with diabetes, hypertension, high cholesterol levels, as well as in smokers.

The main causes of endothelial dysfunction are high blood sugar levels and damaged caused by free radicals and pro-oxidants. One of the key consequences of this damage is a diminished ability to manufacture nitric oxide, a key chemical messenger used by the endothelial cells used to perform its duties. Nitric oxide is especially important in regulating proper blood vessel tone and blood flow.

New Data:

Numerous studies have shown supplementation with CoQ10 improves endothelial function, especially in patients with type 2 diabetes. Researchers at Tehran University of Medical Sciences designed a study to further evaluate the effects of CoQ10 on endothelial function in 64 patients with type 2 diabetic patients who were randomly assigned to take either 200 mg per day of CoQ10 or a placebo 12 weeks. Clinical and biochemical assessments were performed before and after the trial. The primary markers for evaluating endothelial function were measurements for as asymmetric dimethylarginine (ADMA) and nitric oxide levels. Clinical measurements also included hemoglobin A1c and a lipid profile.

ADMA is gaining a lot of attention as an indicator of endothelial function and a risk factor in cardiovascular disease. If ADMA increases in vascular endothelial cells it inhibits the activity of the enzyme nitric oxide synthase resulting in lower production of nitric oxide. Lower levels of nitric oxide makes the blood vessels more rigid as well as promotes inflammation and clot formation. Obviously, lower levels of nitric oxide would increase the risk of a heart attack or stroke.

Results after 12 weeks of supplementation showed significant improvement in ADMA, nitric oxide, low-density lipoprotein and hemoglobin A1c levels in the CoQ10 treated group compared to the placebo group. These results highlight the importance of CoQ10 supplementation in people with type 2 diabetes.

Commentary:

CoQ10 supplementation is very important in patients with type 2 diabetes. However, type 2 diabetes represents a very serious metabolic disorder that requires serious nutritional support. Taking CoQ10 alone is not the complete answer. Diabetes requires an overall comprehensive strategy that utilizes diet, lifestyle, and other nutritional products (especially PGX) helpful in blood sugar control. For example, alpha-lipoic acid. This vitamin-like substance works very closely with CoQ10 in cellular metabolism. In double-blind studies at dosage of 400 to 600 mg daily, alpha lipoic acid has been shown to improve blood sugar control, increase blood flow to peripheral nerves, and actually stimulate the regeneration of nerve fibers. In addition, alpha-lipoic acid has also been shown to lower ADMA levels.

Reference:

Hosseinzadeh-Attar M, Kolahdouz Mohammadi R, Eshraghian M, et al. Reduction in Asymmetric dimethylarginine plasma levels by Coenzyme Q10 supplementation in patients with type 2 diabetes mellitus. Minerva Endocrinol. 2015 Jul 3.

Dr. Michael Murray
7/28/2015

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