The effect of CoQ10 supplementation on cardiovascular risk factors in patients with prediabetes and type 2 diabetes mellitus: a grade-assessed systematic review and dose-response meta-analysis.

BACKGROUND: Previous research has shown that cardiovascular events are more prevalent among type 2 diabetes mellitus (T2DM) patients; therefore, it is vital to reduce cardiovascular risk factors in this population. Randomized controlled trials (RCTs) investigating the effects of coenzyme Q10 (CoQ10) supplementation on cardiovascular risk factors have reported inconsistent findings. As a result, we intended to assess the effects of CoQ10 supplementation on lipid and glucose profiles, blood pressure, oxidative stress, and inflammation in patients with prediabetes and T2DM. METHODS: A systematic literature search was carried out using electronic databases, including PubMed, Web of Science, and Scopus, from inception to May 2025to identify eligible RCTs evaluating the effect of CoQ10 supplementation on cardiovascular risk factors. We used STATA software to combine the individual study results for all outcomes studied. Heterogeneity tests of the selected trials were performed using the I2 statistic. All analyses were performed using random-effects models to account for potential between-study heterogeneity, and pooled data were determined as the weighted mean difference with a 95% confidence interval. RESULTS: Of 4894 records, 20 eligible RCTs were included in the current meta-analysis. Our meta-analysis of the pooled findings showed that CoQ10 supplementation significantly reduced triglycerides (p=0.001), fasting blood sugar (p<0.001), hemoglobin A1c (p=0.004), Homeostatic Model Assessment for Insulin Resistance (p=0.028) and C-reactive protein (P<0.001), while increasing high-density lipoprotein (p= 0.003). However, CoQ10 supplementation did not significantly affect total cholesterol, low-density lipoprotein, systolic and diastolic blood pressure, and malondialdehyde. CONCLUSIONS: Overall, the results demonstrated that CoQ10 supplementation may improve several cardiovascular risk factors in patients with prediabetes and T2DM. However, further research with long-term interventions and diverse dosages is required.