Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials
Meta-analysis of CoQ10 intervention on net changes (95% CI) of CRP.Graphical abstract
CI, confidence interval.WMD, weighted mean difference; The horizontal lines denote the 95% CIs, some of which extend beyond the limits of the scales. The square represents the point estimate of each study. The diamond represents the overall pooled estimate of the treatment effect.
The aims of this meta-analysis were to evaluate the effects of coenzyme Q10 (CoQ10) supplementation on inflammatory mediators including C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) by analyzing published randomized controlled trials (RCTs). A systematic search in PubMed, Cochrane Library and Clinicaltrials.gov was performed to identify eligible RCTs. Data synthesis was performed using a random- or a fixed-effects model depending on the results of heterogeneity tests, and pooled data were displayed as weighed mean difference (WMD) and 95% confidence interval (CI). Seventeen RCTs were selected for the meta-analysis. CoQ10 supplementation significantly reduced the levels of circulating CRP (WMD: −0.35 mg/L, 95% CI: −0.64 to −0.05, P = 0.022), IL-6 (WMD: −1.61 pg/mL, 95% CI: −2.64 to −0.58, P = 0.002) and TNF-α (WMD: −0.49 pg/mL, 95% CI: −0.93 to −0.06, P = 0.027). The results of meta-regression showed that the changes of CRP were independent of baseline CRP, treatment duration, dosage, and patients characteristics. In the meta-regression analyses, a higher baseline IL-6 level was significantly associated with greater effects of CoQ10 on IL-6 levels (P for interaction = 0.006). In conclusion, this meta-analysis of RCTs suggests significant lowering effects of CoQ10 on CRP, IL-6 and TNF-α. However, results should be interpreted with caution because of the evidence of heterogeneity and limited number of studies.