Statins are prescribed for the treatment of elevated cholesterol, but they may negatively impact metabolism, muscle performance and the response to training. Coenzyme Q10 (CoQ10) supplementation may alleviate these effects. Combined simvastatin and CoQ10 treatment during physical training have never been tested. We studied the response to 8 weeks training (maximal oxygen uptake (V̇O2-max), fat oxidation (MFO), the workload at which MFO occurred, and muscle strength) in statin naïve dyslipidemic patients who received simvastatin (40 mg/day) with (S+Q, n = 9) or without (S+Pl, n = 10) CoQ10 supplementation (2×200 mg/day) or placebo (Pl+Pl, n = 7) in a randomized, double-blind placebo-controlled study.

V̇O2-max and maximal workload increased with training (main effect of time, p<0.05). MFO increased from 0.29±0.10, 0.26±0.10, and 0.38±0.09 to 0.42±0.09, 0.38±0.10 and 0.48±0.16 g/min in S+Q, S+Pl and Pl+Pl, respectively (main effect of time, p = 0.0013). The workload at MFO increased from 75±25, 56±23, and 72±17 to 106±25, 84±13 and 102±31 Watt in S+Q, S+Pl and Pl+Pl, respectively (main effect of time, p<0.0001). Maximal voluntary contraction and rate of force development were unchanged.

Exercise improved aerobic physical capacity and simvastatin with or without CoQ10 supplementation did not inhibit this adaptation. The similar increases in MFO and in the workload at which MFO occurred in response to training shows that the ability to adapt substrate selection and oxidation rates is preserved with simvastatin treatment, despite the potential negative impact of simvastatin at the mitochondrial level. CoQ10 supplementation does not augment this adaptation.

Abstract figure legend Statin naïve dyslipidemic patients were treated with simvastatin + CoQ10 or simvastatin + placebo or placebo + placebo while carrying out an exercise training program. CoQ10 concentrations in plasma increased in the group that received CoQ10 supplementation, but not in the others. If statin were given without CoQ10 supplementation, CoQ10 concentrations decreased in nine out of ten patients. Maximal oxygen uptake (VO2max) increased with training in all groups, and maximal fat oxidation capacity (MFO) also increased in all groups.

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