The neuropharmacology and Clinical Laboratories of the Children's Hospital Medical Center in Cincinnati have recently joined to develop and offer a new test profile for assessing coenzyme Q10 status.

This unique profile includes the concentrations of total, oxidized, and reduced forms of this essential cofactor, plus the total Q10 concentration indexed with total cholesterol.

Coenzyme Q10 (also called CoQ or ubiquinone) is an endogenous cofactor which is essential for mitochondrial function and cellular energy production. It also serves as an important antioxidant, protecting membranes from oxidative injury, and conserving and regenerating vitamin E. A new method for measuring the reduced (or antioxidant) and oxidized forms of coenzyme Q10 has been developed in the CHMC neuropharmacology laboratory (see Clinical Chemistry 2001;47(2)256-265).

Because coenzyme Q10 may be depleted in certain acute and chromic disease states, the ratio of reduced to total Q10 concentration is also a useful biomarker of oxidative stress. Patients who have coenzyme Q10 deficiency also have increased risk of mitochondrial and cellular injury from excess production of free radicals. Certain drugs and malnourished states may also tend to deplete the body's coenzyme Q10 reserves. Measurement of coenzyme Q10 concentrations in plasma can assist clinicians in detecting coenzyme Q10 deficiency states, and serve as a guide for dosing when oral supplementation is indicated.

Because significant inter-product variability in the absorption and bioavailability of coenzyme Q10 has been reported with over-the-counter (OTC) Q10 preparations, the Coenzyme Q10 Profile will also assist in verifying the extent of absorption of Q10 from those products. Included in the Coenzyme Q10 Profile are the oxidized, reduced, and total Q10 concentrations. Also the fraction of the reduced Q10 in the total concentration, and the Q10: Total Cholesterol Index (or QCI0) are reported. Reference intervals and comments are also provided with each report.

Potential indications for testing coenzyme Q10 status include:

- Suspected coenzyme Q10 deficiency secondary to inheritance (rare) or other mitochondrial disease

- Cardiomyopathy

- Neurodegenerative diseases, e.g. Parkinson's, Alzheimer's, Muscular Dystrophy including Duchenne Muscular Dystrophy (DMD), and Amyotrophic Lateral Sclerosis (ALS)

- Metabolic disease

- Malnutrition

- Presurgical screening for patients who have pre-existing coenzyme Q10 deficiency or who may have increased risk of ischemia-reperfusion injury

- Prior treatment with HMG-CoA reductase inhibitors ("statin" drugs) or other drugs which may lower coenzyme Q10 levels

- Gastrointestinal malabsorption

- Assessment of coenzyme Q10 dosing adequacy

The Coenzyme Q10 Profile requires a minimum of 2 mL of heparinized blood (green to vacutainer tube), which must be placed on ice immediately and sent to the CCHMC Clinical Lab Administration Office for next morning delivery. Please call the CCHMC Clinical Lab Administration Office at (513) 636-7328 in advance for billing, ordering, shipping, and specimen collection information.

For technical questions about Coenzyme Q10 testing, please contact Dr. Peter Tang, Ph.D., Pathology and Laboratory Medicine at (513) 636-3357.

For additional information on the Coenzyme Q10 Profile, please contact Dr. Michael Miles, Pharm.D., CCHMC Division of Child Neurology at (513) 636-7871.

Michael V. Miles, PharmD Prof. Of Clinical Pediatrics and Neurology Director, Clinical Neuropharmacology Laboratory Children's Hospital Medical Center 3333 Burnet Ave. Cincinnati, OH 45229 Phone: 513/636-7871 Fax: 513/636-3980

Need More Information?

For more information on what CoQ10 is and how it works, "click" on the "What is CoQ10?" button. For more information on Q-Gel® CoQ10 specifically, "click" on the "Q-Gel® CoQ10" button. Both buttons are located on upper left hand side of the screen (you may have to "scroll up" to see them).