Yi Xin, Zhou Yanli, Jiang Dingsheng, Li Xiaoyan, Guo Yi, Jiang Xuejun
Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China ; Cardiovascular Research Institute of Wuhan University, Wuhan, Hubei 430060, P.R. China.
Department of Epidemiology, School of Public Health of Wuhan University, Wuhan, Hubei 430060, P.R. China.
Exp Ther Med. 2014 May;7(5):1100-1110. doi: 10.3892/etm.2014.1553. Epub 2014 Feb 17.
The aim of the present study was to conduct an updated meta-analysis of relevant randomized controlled trials (RCTs) in order to estimate the effect of folic acid supplementation on endothelial function and the concentration of plasma homocysteine in patients with coronary artery disease (CAD). An extensive search of PubMed was conducted to identify RCTs that compared folic acid with placebo therapy. The mean difference (MD) and 95% confidence interval (CI) were used as a measure of the correlation between folic acid supplementation and endothelial function/plasma homocysteine concentration. Of the 377 patients included in this analysis, 191 patients underwent folic acid supplementation and 186 individuals underwent placebo treatment. Compared with the use of a placebo, folic acid supplementation alone exhibited significant efficacy on increasing flow-mediated dilation (FMD; MD, 57.72 μm; 95% CI, 50.14-65.31; P<0.05) and lowering the concentration of plasma homocysteine (MD, -3.66 μmol/l; 95% CI, -5.44--1.87; P<0.05; I, 87%). There was no significant change in the response to end diastolic diameter, glyceryl-trinitrate diameter, heart rate, baseline and peak hyperemic flow and systolic and diastolic blood pressure between the folic acid and placebo groups (P>0.05). Therefore, the meta-analysis indicated that 5 mg folic acid daily supplementation for >4 weeks significantly improved FMD and lowered the concentration of plasma homocysteine in patients with CAD. However, more RCTs are required in order to confirm these observations.
本研究的目的是对相关随机对照试验（RCT）进行更新的荟萃分析，以评估补充叶酸对冠心病（CAD）患者内皮功能和血浆同型半胱氨酸浓度的影响。对PubMed进行了广泛检索，以确定比较叶酸与安慰剂治疗的随机对照试验。平均差（MD）和95%置信区间（CI）用作补充叶酸与内皮功能/血浆同型半胱氨酸浓度之间相关性的衡量指标。本分析纳入的377例患者中，191例接受叶酸补充，186例接受安慰剂治疗。与使用安慰剂相比，单独补充叶酸在增加血流介导的血管舒张（FMD；MD，57.72μm；95%CI，50.14 - 65.31；P<0.05）和降低血浆同型半胱氨酸浓度（MD，-3.66μmol/l；95%CI，-5.44 - -1.87；P<0.05；I²，87%）方面显示出显著疗效。叶酸组和安慰剂组之间在舒张末期直径、硝酸甘油直径、心率、基线和充血峰值血流以及收缩压和舒张压的反应方面没有显著变化（P>0.05）。因此，荟萃分析表明，每天补充5mg叶酸超过4周可显著改善CAD患者的FMD并降低血浆同型半胱氨酸浓度。然而，需要更多的随机对照试验来证实这些观察结果。
