Metabolic effects of coenzyme Q10, magnesium and vitamin D in cardiovascular diseases: a systematic review

Introduction: Cardiovascular diseases (CVD) are the main causes of death in the population. According to data from the World Health Organization for 2020, of the 20.8 million deaths from these diseases, 9.2 million are due to atherosclerotic coronary disease. In this context, the beneficial metabolic effects of magnesium, vitamin D, and coenzyme Q10 can be highlighted. Objective: It was to scientifically analyze, through clinical and experimental studies, the influence of the three elements Magnesium, Vitamin D, and Coenzyme Q10 concerning cardiovascular diseases and metabolic syndrome, highlighting the improvement of metabolic disorders and heart failure. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 154 articles were found, and 80 articles were evaluated and 78 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 18 studies with a high risk of bias and 26 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =95.7% >50%. It was concluded that magnesium plays a fundamental role in glucose metabolism, insulin, and glycemic homeostasis, in the synthesis of adenosine triphosphate, proteins, and nucleic acids. However, further studies are needed to better clarify the role of magnesium in the prevention and treatment of cardiovascular diseases, especially concerning higher concentrations and increased treatment time. Vitamin D plays important roles in innate and adaptive immune responses, cell cycle, and metabolic processes, evidenced by the reported relationship between its deficiency and the prevalence of immune-mediated disorders, cancer, and cardiometabolic diseases. Coenzyme Q10 exerts an important protective antioxidant action. Clinical studies carried out showed that pathologies such as acute myocardial infarction, arterial hypertension, myopathies induced by statins, physical fatigue inherent to physical exercise, male infertility, pre-eclampsia, Parkinson's disease, periodontal diseases, and migraines had low plasma concentrations of Q10. In addition, Coenzyme Q10 reduces the amount of lipid peroxide found in atherosclerotic lesions. Thus, Q10 protects the lipids present in cell membranes, as well as plasma lipoproteins.