CoQ10 Effects on MDM Liver Fat Via FibroTouchI.

• Research Materials Coenzyme Q10: Utilize Coenzyme Q10 formulations that comply with Good Manufacturing Practice (GMP) standards (e.g., Bio-Quinone or equivalent quality products), with each capsule containing 100 mg of Coenzyme Q10 and excipients such as soybean oil and beeswax.

Control Medication: None.

• Treatment Protocols Mitochondrial Diabetes Group: On the basis of maintaining the original hypoglycemic treatment regimen (primarily insulin, avoiding metformin), add Coenzyme Q10 at a dose of 100 mg three times daily (total dose of 300 mg/day) for 12 consecutive weeks.

Type 1 Diabetes Control Group and Healthy Control Group: Only undergo baseline assessments without intervention.

Concomitant Medication Regulations:

Maintain the patient's original hypoglycemic treatment regimen unchanged. Avoid using medications that may affect mitochondrial function (e.g., minimize or switch metformin and statins if possible).

Do not add other medications or supplements with antioxidant or mitochondrial protective effects during the study period.

If adjustments to hypoglycemic medications are necessary due to clinical conditions, record the medication name, dosage, and reasons for adjustment in detail.

• Mitochondrial Diabetes Group

Inclusion criteria

• Confirmed as a carrier of the mitochondrial DNA m.3243A>G mutation through genetic testing;
• Meeting the diagnostic criteria for diabetes (WHO 1999 diagnostic criteria);
• Aged between 18 and 70 years;
• Willing to participate and having signed the informed consent form.

Exclusion criteria

• Type 1 or type 2 diabetes (not caused by mitochondrial gene mutations);
• Comorbid with viral hepatitis, drug-induced hepatitis, alcoholic liver disease, Wilson's disease, or other specific diseases that can lead to fatty liver;
• Severe cardiac, pulmonary, or renal insufficiency;
• Pregnant or lactating women;
• Having used coenzyme Q10 or other mitochondrial-targeted drugs within the past 3 months;
• Having contraindications to MRI examination;
• Having experienced infection, surgery, or major trauma within the past 4 weeks.

Withdrawal/Dropout Criteria:

• The subject withdraws informed consent;
• The occurrence of serious adverse events;
• Loss to follow-up;
• Medication adherence that continued participation in < 80%;
• The researcher believes the study is not in the best interest of the subject. 2. Type 1 Diabetes Control Group

Inclusion criteria

• Meeting the diagnostic criteria for type 1 diabetes, with positive islet autoantibodies (GAD, IA-2, ICA, etc.);
• Aged between 18 and 70 years;
• Willing to participate and having signed the informed consent form.

Exclusion criteria

Same as the exclusion criteria (1) to (7) for the mitochondrial diabetes group. 3. Healthy Adult Control Group

Inclusion criteria

• No history of diabetes, with fasting blood glucose < 5.6 mmol/L and HbA1c < 5.7%;
• Aged between 18 and 70 years;
• Willing to participate and having signed the informed consent form.

Exclusion criteria

Same as the exclusion criteria (1) to (7) for the mitochondrial diabetes group.