ORIGINAL ARTICLE Independent and Additive Effects of Coenzyme Q10 and Vitamin E on Cardiometabolic Outcomes and Visceral Adiposity in Women With Polycystic Ovary Syndrome Azimeh Izadi, a,b Shabnam Shirazi, a,b Shiva Taghizadeh, a,b and Bahram Pourghassem Gargari c a Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran b Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran c Department of Biochemistry and Diet Therapy, Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Received for publication December 7, 2018; accepted April 29, 2019 (ARCMED_2018_589). Available online xxx Background. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. Objective. This study was conducted to investigate the effects of CoQ10 and/or vitamin E on cardiometabolic outcomes in patients with PCOS. Methods. This randomized clinical trial was carried out among 86 women with PCOS. Patients were assigned to take CoQ10, vitamin E, CoQ10 plus vitamin E or placebo for 8 weeks. Fasting blood samples were obtained at the beginning and end of the study. Results. A significant decrease in serum triglycerides (TG) ( p ! 0.001) was found following the administration of CoQ10 and/or vitamin E supplements compared with the placebo group. Supplementation with CoQ10 and vitamin E failed to affect total cholesterol levels. However, co-administration of CoQ10 and vitamin E resulted in a significant decrease in serum total cholesterol levels (9.92 [15.11, 4.74]). Additionally, only the combination of supplements was able to significantly reduce low-density lipoprotein- cholesterol (LDL-C) (‒9.63 [‒15.34, ‒3.92]), increase high-density lipoprotein-cholesterol (HDL-C) (2.33 [0.51, 4.16), reduce atherogenic coefficient (AC) (‒0.29 [‒0.43, ‒0.16], p 5 0.03) and decrease visceral adiposity index (VAI) values. Co-Q10 and vitamin E (alone or in combination) had significant effects on non-HDL-C ( p 5 0.004), atherogenic Index of Plasma (AIP) ( p 5 !0.001) and lipid accumulation product (LAP) ( p ! 0.001) and SBP ( p 5 0.005). However, the reduction in DBP was statistically significant only for patients who received combined supplementations ( p 5 0.04). Conclusions. In conclusion, CoQ10, vitamin E (alone or in combination) had beneficial effects on cardiometabolic outcomes among women with PCOS. Ó 2019 IMSS. Published by Elsevier Inc. Key Words: Polycystic ovary syndrome, Coenzyme Q10, Vitamin E, Blood pressure, Dyslipidemias. Introduction Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women and is responsible for |80% of anovulatory infertility (1). PCOS prevalence ranges from 6 % to 20 %, given the criteria used. In Iran, the prevalence of PCOS is reported as 7e15% (2). According to the Rotterdam criteria, PCOS is characterized by the presence of two of the three criteria (hyperandrogenism, chronic anovulation, and polycystic ovaries on ultrasonography) (3). Patients with PCOS are at a lifelong risk of metabolic abnormalities (dysglycemia, dyslipidemia), visceral obesity, hypertension, and cardiovascular diseases (CVD) Conflicts of Interest: None of the authors had any conflict of interest. Address reprint requests to: Bahram Pourghassem Gargari, Department of Biochemistry and Diet Therapy, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran; Phone: (þ98) 41- 33362117; FAX: (þ98) 41-33340634.; E-mail: bahrampg@yahoo.com 0188-4409/$ - see front matter. Copyright Ó 2019 IMSS. Published by Elsevier Inc. https://doi.org/10.1016/j.arcmed.2019.04.004 Archives of Medical Research 50 (2019) 1e10