Plasma coenzyme Q10 measurement is used to diagnose coenzyme Q10 deficiency in patients with mitochondrial disorders, to monitor statin therapy patients, and to monitor coenzyme Q10 levels during different treatment modalities for conditions such as Parkinson's and Alzheimer's.
Coenzyme Q10 (CoQ10) is an enzyme necessary for the production of ATP in mitochondria and for antioxidant function of lipid and mitochondrial membranes. Coenzyme Q10 is found in all cell membranes and is transported by lipoproteins into the circulatory system. About 60% of CoQ10 binds to low density lipoproteins (LDL), 25% to high density lipoproteins (HDL) and 15% to other lipoproteins. CoQ10 is found in the body in both reduced and oxidized form.
In the absence of CoQ10, the electron transfer activity in mitochondria is reduced. This results in reduced energy production for cell function. This can be particularly stressful for tissues with high energy requirements such as the heart muscle. The role of CoQ10 in statins-related myopathy is also being studied. Statins have been shown to cause CoQ10 deficiency, especially in the elderly since the enzyme usually decreases with age, and in people with congestive heart failure. The use of CoQ10 as a supplement for statin-associated myopathies has begun to gain ground, as dietary sources of the enzyme are inadequate. It can also be given as a prophylactic treatment at the start of statin therapy. It may also be administered to patients complaining of statins-related myalgia and for whom no laboratory evidence of myositis or rhabdomyolysis exists, such as e.g. elevated creatine kinase levels.
Primary CoQ10 deficiency, although rare, is characterized by neurological symptoms (seizures, developmental delay, ataxia, etc.) and muscle weakness. At least 5 different phenotypes have been described:
- Encephalomyopathy (increased serum CPK, recurrent myoglobinuria, lactic acidosis)
- Childhood cerebral ataxia and atrophy (neuropathy and hypogonadism observed)
- Infantile multi-systemic form (nystagmus, visual atrophy, sensory hearing loss, dystonia, rapidly evolving kidney disease)
- Myopathy (intolerance to exercise, fatigue, increased serum CPK)
Lack of coenzyme Q10 has been implicated in other pathological conditions, including Parkinson's disease, diabetes, Alzheimer's disease as well as in aging and oxidative stress.
Possible Interpretations of Pathological Values
- Increase: -
- Decrease: CoQ10 Deficiency
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. Correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
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