Zhang Xiaofeng, Shi Zhaofeng, Liu Qian, Quan Haohao, Cheng Xiaohong
Department of Nephrology, Shaanxi Provincial Hospital of Traditional Chinese Medicine.
Key Laboratory of Chinese Internal Medicine of MOE and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing.
Medicine (Baltimore). 2019 Jun;98(24):e15850. doi: 10.1097/MD.0000000000015850.
The diabetic kidney disease (DKD) has become a seriously kidney disease that commonly caused by diabetes mellitus (DM). Oxidative stress response plays an essential role in the genesis and worsening of DKD and Coenzyme Q10 (CoQ10) has been reported the promising clinical effectiveness on DKD treatment. However, there is lack of relative evidence-based medical evidence currently.
The systematic review and meta-analysis was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, which conducted to evaluate the effectiveness of CoQ10 in combination with other western medicine for DKD therapy through the randomized controlled trials (RCTs) and experimental studies.
RCTs and experimental studies were searched based on standardized searching rules in 12 medical databases from the inception up to June 2018 and a total of 8 articles (4 RCTs and 4 experimental studies) were enrolled in the meta-analysis.
The results revealed that CoQ10 combined with other western medicine show statistical differences in the laboratory parameters of fasting plasma glucose (FPG), Hemoglobin A1c (HbA1c), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), and malondialdehyde (MDA) amelioration after DKD therapy compared with control group. However, LDL-C and Urea level for RCTs and Urine output and Glucose for experimental studies on DKD was not superior to control group.
We need to make conclusion cautiously for the effectiveness of CoQ10 application on DKD therapy. More standard, multicenter, double-blind RCTs, and formal experimental studies of CoQ10 treatment for DKD were urgent to be conducted for more clinical evidence providing in the future. The underlying pharmacological mechanism of CoQ10 needs to be researched and revealed for its future application on DKD therapy.
糖尿病肾病(DKD)已成为一种由糖尿病(DM)常见引发的严重肾脏疾病。氧化应激反应在DKD的发生和恶化过程中起重要作用,且已有报道称辅酶Q10(CoQ10)在DKD治疗方面具有良好的临床疗效。然而,目前缺乏相关循证医学证据。
基于系统评价和Meta分析的首选报告项目(PRISMA)声明进行系统评价和Meta分析,旨在通过随机对照试验(RCT)和实验研究评估CoQ10联合其他西药治疗DKD的有效性。
根据标准化检索规则,检索了12个医学数据库从建库至2018年6月的RCT和实验研究,共有8篇文章(4项RCT和4项实验研究)纳入Meta分析。
结果显示,与对照组相比,CoQ10联合其他西药在DKD治疗后空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)和丙二醛(MDA)等实验室指标改善方面存在统计学差异。然而,RCT中的低密度脂蛋白胆固醇(LDL-C)和尿素水平以及DKD实验研究中的尿量和血糖并不优于对照组。
对于CoQ10应用于DKD治疗的有效性,我们需要谨慎得出结论。迫切需要开展更多规范、多中心、双盲的RCT以及CoQ10治疗DKD的正式实验研究,以便未来提供更多临床证据。CoQ10的潜在药理机制有待研究揭示,以用于其未来在DKD治疗中的应用。