|Effect of folic acid supplementation on the progression of carotid intima-media thickness: A meta-analysis of randomized controlled trials|
|Qin, Xianhui1; Xu, Minrui1; Zhang, Yan2; Li, Jianping2; Xu, Xin3; Wang, Xiaobin4,5; Xu, Xiping1; Huo, Yong2|
|关键词||Folic acid supplementation Carotid intima-media thickness Randomized Controlled trials Meta-analysis|
|WOS标题词||Science & Technology|
|类目[WOS]||Peripheral Vascular Disease|
|研究领域[WOS]||Cardiovascular System & Cardiology|
|关键词[WOS]||RENAL-TRANSPLANT RECIPIENTS ; CARDIOVASCULAR-DISEASE ; VITAMIN SUPPLEMENTATION ; HEMODIALYSIS-PATIENTS ; PLASMA HOMOCYSTEINE ; C677T POLYMORPHISM ; BLOOD HOMOCYSTEINE ; STROKE PREVENTION ; KIDNEY-TRANSPLANT ; LOWERING THERAPY|
Objectives: We conducted a meta-analysis of relevant randomized trials to assess whether folic acid supplementation reduces the progression of atherosclerosis as measured by carotid intima-media thickness (CIMT).
Methods: This analysis included 2052 subjects from ten folic acid randomized trials with the change in CIMT reported as one of the end points. Summary estimates of weighted mean differences (WMDs) and 95% CIs were obtained by using random-effect models. Meta-regression and subgroup analyses were performed to identify the source of heterogeneity.
Results: Our analysis showed that folic acid supplementation significantly reduces the progression of CIMT (WMD: -0.04 mm; 95% CI: -0.07, -0.02; P < 0.001), particularly in subjects with chronic kidney disease (CKD) (WMD: -0.16 mm; 95% CI: -0.26, -0.07; P = 0.0006) or high cardiovascular disease (CVD) risk (WMD: -0.05 mm; 95% CI: -0.11, 0.00; P = 0.06) but not in subjects who were generally healthy with only elevated homocysteine concentrations (WMD: 0.00 mm; 95% CI: -0.01, 0.01; P = 0.35). Furthermore, meta-regression analysis of the data showed that the baseline CIMT levels (P = 0.011) and the percent reduction of homocysteine (P < 0.001) were positively related to the effect size.
Consistently, a greater beneficial effect was seen in those trials with baseline CIMT levels = 0.8 mm (WMD: -0.14 mm; 95% CI: -0.19, -0.08; P < 0.0001), and a reduction in the homocysteine concentration = 30% (WMD: -0.22 mm; 95% CI: -0.38, -0.06; P = 0.009). In the corresponding comparison groups, the effect sizes were attenuated and insignificant. Conclusions: Our findings indicate that folic acid supplementation is effective in reducing the progression of CIMT, particularly in subjects with CKD or high CVD risk and among trials with higher baseline CIMT levels or a larger homocysteine reduction. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
|作者单位||1.Anhui Med Univ, Inst Biomed, Hefei, Peoples R China|
2.Peking Univ, Hosp 1, Dept Cardiol, Beijing 100871, Peoples R China
3.So Med Univ, Guangdong Inst Nephrol, Guangzhou, Guangdong, Peoples R China
4.Northwestern Univ, Childrens Mem Hosp, Feinberg Sch Med, Mary Ann & J Milburn Smith Child Hlth Res Program, Chicago, IL 60614 USA
5.Northwestern Univ, Dept Pediat, Childrens Mem Res Ctr, Chicago, IL 60611 USA
|Qin, Xianhui,Xu, Minrui,Zhang, Yan,et al. Effect of folic acid supplementation on the progression of carotid intima-media thickness: A meta-analysis of randomized controlled trials[J]. ATHEROSCLEROSIS,2012,222(2):307-313.|
|APA||Qin, Xianhui.,Xu, Minrui.,Zhang, Yan.,Li, Jianping.,Xu, Xin.,...&Huo, Yong.(2012).Effect of folic acid supplementation on the progression of carotid intima-media thickness: A meta-analysis of randomized controlled trials.ATHEROSCLEROSIS,222(2),307-313.|
|MLA||Qin, Xianhui,et al."Effect of folic acid supplementation on the progression of carotid intima-media thickness: A meta-analysis of randomized controlled trials".ATHEROSCLEROSIS 222.2(2012):307-313.|