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学科主题: 临床医学
题名:
Effect of folic acid supplementation on the progression of carotid intima-media thickness: A meta-analysis of randomized controlled trials
作者: 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
刊名: ATHEROSCLEROSIS
发表日期: 2012-06-01
DOI: 10.1016/j.atherosclerosis.2011.12.007
卷: 222, 期:2, 页:307-313
收录类别: SCI
文章类型: Review
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
英文摘要:

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.

语种: 英语
WOS记录号: WOS:000304439000002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/60180
Appears in Collections:北京大学第一临床医学院_心血管内科_期刊论文

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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

Recommended Citation:
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.
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