Statin Treatment Decreases Mitochondrial Respiration But Muscle Coenzyme Q10 Levels Are Unaltered: The LIFESTAT Study

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Background: Myalgia is a common side effect to statin therapy, but the underlying mechanism is unknown. Statins may reduce Coenzyme Q10 (CoQ10) which is an essential electron carrier in the mitochondrial electron transport system, thereby impairing mitochondrial respiratory function potential leading to myalgia.

Objectives: To investigate whether statin induced myalgia is coupled to reduced intramuscular CoQ10 concentration and impaired mitochondrial respiratory function.

Methods: 64 men and women in simvastatin therapy were recruited. 25 who experienced myalgia were allocated to the myalgic group. The remaining 39 statin users had no symptoms of myalgia (non-sympt). 20 men and women with untreated high blood cholesterol levels were recruited as control group. Blood and muscle samples were obtained. Intramuscular CoQ10 concentration was measured, and mitochondrial respiratory function and reactive oxygen species (ROS) production were measured. Citrate Synthase (CS) activity was used as a biomarker for mitochondrial content in skeletal muscle.

Results: Intramuscular CoQ10 concentration was comparable between groups. Mitochondrial complex II-linked respiration was reduced in the statin myalgic and statin non-symptomatic groups compared to control. When mitochondrial respiration was normalized to CS activity respiration rate was higher in the myalgic group compared to non-symptomatic and control group. Maximal ROS production was similar between groups.

Discussion: Our results suggests that statin therapy impairs mitochondrial complex-II linked respiration, but the mitochondrial capacity for complex I+II linked respiration is intact. Myalgia is not coupled to reduced intramuscular CoQ10 levels. Intrinsic mitochondrial respiratory capacity is increased with statin induced myalgia, but not accompanied by increased ROS production.

Original languageEnglish
JournalJournal of Clinical Endocrinology and Metabolism
Issue number7
Pages (from-to)2501–2508
Publication statusPublished - Jul 2019

ID: 203980295