Possible role of ubiquinone in the treatment of massive hypertriglyceridemia resistant to PUFA and fibrates

Objective. - To describe the effect of Coenzyme Q10 (CoQ10) (added to either a fibrate, or polyunsaturated fatty acids (PUFA) or association of both) in patients affected by massive hypertriglyceridemia (MHTG) resistant to fibrates and PUFA. Design. - Open, sequential, comparative intervention study. Setting. - Specialised centres for dyslipidemia management. Subjects. - Fifteen subjects (mean age: 45.1 ± 12.5:years) affected by MHTG and hyporesponsive to either fibrates, or PUFA, or fibrates-PUFA association, and 15 age-matched subjects regularly responders to PUFA and fenofibrate treatment. Interventions - Treatment for periods of 6:weeks each with the following consecutive treatments: CoQ10 150:mg/day, PUFA 3000:mg/day, fenofibrate 200:mg/day, PUFA 3000:mg/day + fenofibrate 200:mg/day, PUFA 3000:mg/day + CoQ10 150:mg/day, fenofibrate 200:mg/day + CoQ10 150:mg/day, and finally, fenofibrate 200:mg/day + PUFA 3000:mg/day + CoQ10 150:mg/day. Results. - CoQ10 supplementation did not improve any monitored parameter in the control group except for systolic and diastolic blood pressure, creatinine and Lp(a) plasma levels, both during fenofibrate and/or PUFA treatment. In MHTG group, CoQ10 supplementation significantly improved TG, TC, Lp(a), uric acid and blood pressure during fenofibrate treatment, but only Lp(a) and blood pressure during PUFA treatment. Fenofibrate appeared to have better effect on hsCRP and γ-GT plasma levels than PUFA. No significant change was observed in any group and under any treatment in regards to homocysteinemia, PAI-1, or t-PA. Conclusion. - Even though the mechanism of action through which the effects were obtained is yet to be elucidated, adding CoQ10 to fenofibrate could improve the drug's efficacy in MHTG patients not responding to fenofibrate alone.