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辅酶 Q10 治疗糖尿病和心血管疾病:有用还是无用?

Coenzyme Q10 for Diabetes and Cardiovascular Disease: Useful or Useless?

机构信息

National Institute of Cardiology, Brazilian Ministry of Health, Rio de Janeiro, Brazil.

Nutrindo Ideais Performance and Nutrition Research Center, Rio de Janeiro, Brazil.

出版信息

Curr Diabetes Rev. 2023;19(4):e290422204261. doi: 10.2174/1573399818666220429101336.

Abstract

INTRODUCTION

Diabetes mellitus (T2DM) and cardiovascular diseases (CVDs) have become some of the most urgent and prevalent health problems in recent decades, side by side with the growing obesity crisis. The close relationship between T2DM and CVD has become clear: endothelial dysfunction caused by oxidative stress and inflammation resulting from hyperglycaemia are the key factors in the development of vascular complications of T2DM, leading to CVD. Coenzyme Q10 (CoQ10) is a great candidate for the treatment of these diseases, acting precisely at the intersection between T2DM and CVD that is oxidative stress, due to its strong antioxidant activity and fundamental physiological role in mitochondrial bioenergetics. CoQ10 is a biologically active liposoluble compound comprising a quinone group and a side chain of 10 isoprenoid units, which is synthesized endogenously in the body from tyrosine and mevalonic acid. The main biochemical action of CoQ10 is as a cofactor in the electron transport chain that synthesizes adenosine triphosphate (ATP). As most cellular functions depend on an adequate supply of ATP, CoQ10 is essential for the health of virtually all human tissues and organs. CoQ10 supplementation has been used as an intensifier of mitochondrial function and an antioxidant with the aim of palliating or reducing oxidative damage that can worsen the physiological outcome of a wide range of diseases including T2DM and CVDs.

CONCLUSION

Although there is not enough evidence to conclude it is effective for different therapeutic indications, CoQ10 supplementation is probably safe and well-tolerated, with few drug interactions and minor side effects. Many valuable advances have been made in the use of CoQ10 in clinical practice for patients with T2DM and a high risk of CVD. However, further research is needed to assess the real safety and benefit to indicate CoQ10 supplementation in patients with T2DM.

摘要

简介

在过去几十年中,糖尿病(T2DM)和心血管疾病(CVDs)与肥胖危机一起成为了最紧迫和普遍的健康问题之一。T2DM 和 CVD 之间的密切关系已经很清楚:高血糖引起的氧化应激和炎症导致的内皮功能障碍是 T2DM 血管并发症发展为 CVD 的关键因素。辅酶 Q10(CoQ10)是治疗这些疾病的一个很好的候选药物,由于其强大的抗氧化活性和在线粒体生物能学中基本的生理作用,它恰好作用于 T2DM 和 CVD 的交叉点——氧化应激。CoQ10 是一种具有生物活性的脂溶性化合物,由醌基团和 10 个异戊二烯单位的侧链组成,它在体内由酪氨酸和甲羟戊酸合成。CoQ10 的主要生化作用是作为电子传递链合成三磷酸腺苷(ATP)的辅助因子。由于大多数细胞功能都依赖于足够的 ATP 供应,因此 CoQ10 对几乎所有人体组织和器官的健康都是必不可少的。CoQ10 补充剂已被用作线粒体功能增强剂和抗氧化剂,旨在减轻或减少氧化损伤,从而改善包括 T2DM 和 CVDs 在内的多种疾病的生理结果。

结论

虽然没有足够的证据得出结论认为它对不同的治疗指征有效,但 CoQ10 补充剂可能是安全且耐受良好的,药物相互作用很少,副作用也很小。在临床实践中,CoQ10 在 T2DM 患者和 CVD 高风险患者中的应用取得了许多有价值的进展。然而,仍需要进一步的研究来评估其真正的安全性和益处,以确定 CoQ10 补充剂是否适用于 T2DM 患者。

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