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Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: A meta-analysis of randomized controlled trials
Qin, Xianhui1; Huo, Yong2; Xie, Di3; Hou, Fanfan3; Xu, Xiping4; Wang, Xiaobin5
关键词Folic acid therapy Kidney disease Cardiovascular disease Randomized trials Meta-analysis
刊名CLINICAL NUTRITION
2013-10-01
DOI10.1016/j.clnu.2012.12.009
32期:5页:722-727
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Nutrition & Dietetics
研究领域[WOS]Nutrition & Dietetics
关键词[WOS]STAGE RENAL-DISEASE ; B-VITAMINS ; MORTALITY ; SUPPLEMENTATION ; EFFICACY ; EVENTS ; PEOPLE ; STROKE
英文摘要

Background & aims: The efficacy of homocysteine-lowering therapy with folic acid to lower homocysteine levels in an effort to reduce cardiovascular disease (CVD) risk in patients with kidney disease remains inconclusive. We conducted a meta-analysis of relevant randomized trials to further examine this issue.

Methods: This meta-analysis included 8234 patients with kidney disease from nine qualified randomized trials using folic acid therapy, and with CVD reported as one of the endpoints. Relative risk (RR) was used to measure the effect of folic acid supplementation on risk of CVD using a random effects model.

Results: When pooling the nine randomized trials, folic acid therapy reduced the risk of CVD by 10% (RR = 0.90; 95% CI:0.81-1.00, P = 0.046). A greater beneficial effect was observed among those trials without a history of grain fortification with folic acid (0.82; 0.70-0.96, P = 0.01), with lower percent baseline diabetes (<30% (median), 0.80; 0.65-0.99, P = 0.04), and in patients with end-stage renal disease (ESRD) or advanced chronic kidney disease (ACKD) (0.85; 0.77-0.94, P = 0.002). Furthermore, a meta-regression analysis suggested a positive dose-response relationship between percent baseline diabetes and log-RR for CVD risk associated with folic acid supplementation (P = 0.007). Most importantly, even the inclusion of three subgroup results did not substantially affect the results (n = 11032, RR: 0.93; 95% CI:0.87-0.99, P = 0.03).

Conclusions: Our meta-analysis indicates that folic acid supplementation may be effective for CVD prevention in patients with kidney disease, particularly in trials among patients without a history of grain fortification with folic acid, with lower percent baseline diabetes, and in patients with ESRD or ACKD. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

语种英语
WOS记录号WOS:000325600900007
引用统计
被引频次:35[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/65257
专题北京大学第一临床医学院_心血管内科
作者单位1.Anhui Med Univ, Inst Biomed, Hefei, Peoples R China
2.Peking Univ, Dept Cardiol, Hosp 1, Beijing 100871, Peoples R China
3.Southern Med Univ, Nanfang Hosp, Div Nephrol, Guangzhou, Guangdong, Peoples R China
4.Southern Med Univ, Guangdong Inst Nephrol, Guangzhou, Guangdong, Peoples R China
5.Johns Hopkins Univ, Ctr Early Life Origins Dis, Bloomberg Sch Publ Hlth, Dept Populat Family & Reprod Hlth, Baltimore, MD 21205 USA
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GB/T 7714
Qin, Xianhui,Huo, Yong,Xie, Di,et al. Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: A meta-analysis of randomized controlled trials[J]. CLINICAL NUTRITION,2013,32(5):722-727.
APA Qin, Xianhui,Huo, Yong,Xie, Di,Hou, Fanfan,Xu, Xiping,&Wang, Xiaobin.(2013).Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: A meta-analysis of randomized controlled trials.CLINICAL NUTRITION,32(5),722-727.
MLA Qin, Xianhui,et al."Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: A meta-analysis of randomized controlled trials".CLINICAL NUTRITION 32.5(2013):722-727.
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