Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Pharmacy department Iran Drug and Poisons Information Center (DPIC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Nutr Metab Cardiovasc Dis. 2019 May;29(5):432-439. doi: 10.1016/j.numecd.2018.11.006. Epub 2018 Dec 6.
Given the contradictory results of previous randomized controlled trials (RCTs), we performed a systematic review and meta-analysis to quantify and summarize the effects of folic acid supplementation on C-reactive protein (CRP).
We performed a systematic search of all available RCTs conducted up to October 2018 in the following databases: PubMed, Scopus, and Cochrane. RCTs that investigated the effect of folate on CRP were included in the present study. Data were combined with the use of generic inverse-variance random-effects models. Statistical heterogeneity between studies was evaluated using Cochran's Q-test. Ten RCTs (1179 subjects) were included in the present meta-analysis. Pooled analysis results showed that folate supplementation significantly lowered the serum CRP level (weighted mean difference (WMD): -0.685 mg/l, 95% CI: -1.053, -0.318, p < 0.001). However, heterogeneity was significant (I = 96.7%, p = 0.000). Stratified analyses indicated that sex, intervention period, and type of study population were sources of heterogeneity. Following analysis, results revealed that the greatest impact was observed in women (WMD: -0.967 mg/l, 95% CI: -1.101, -0.833, p = 0.000), patients with type 2 diabetes mellitus (WMD: -1.764 mg/l, 95% CI: -2.002, -1.526, p = 0.000), and intervention period less than 12 weeks (WMD: -0.742 mg/l, 95% CI: -0.834, -0.650, p = 0.000).
This meta-analysis suggested that folic acid supplementation could significantly lower the serum CRP level. Folic acid leads to greater CRP lowering effect in women, patients with T2DM, and those with less than 12-week intervention.
鉴于先前随机对照试验（RCT）的结果相互矛盾，我们进行了系统评价和荟萃分析，以量化和总结叶酸补充对 C 反应蛋白（CRP）的影响。
我们在以下数据库中进行了系统检索，以获取截至 2018 年 10 月进行的所有可用 RCT：PubMed、Scopus 和 Cochrane。本研究纳入了研究叶酸对 CRP 影响的 RCT。使用通用倒数方差随机效应模型合并数据。使用 Cochran's Q 检验评估研究间的统计学异质性。本荟萃分析纳入了 10 项 RCT（1179 例受试者）。汇总分析结果表明，叶酸补充显著降低血清 CRP 水平（加权均数差（WMD）：-0.685mg/l，95%CI：-1.053，-0.318，p<0.001）。但是，异质性显著（I=96.7%，p=0.000）。分层分析表明，性别、干预时间和研究人群类型是异质性的来源。进一步分析表明，女性的影响最大（WMD：-0.967mg/l，95%CI：-1.101，-0.833，p=0.000），2 型糖尿病患者（WMD：-1.764mg/l，95%CI：-2.002，-1.526，p=0.000），以及干预时间小于 12 周的患者（WMD：-0.742mg/l，95%CI：-0.834，-0.650，p=0.000）。
本荟萃分析表明，叶酸补充可显著降低血清 CRP 水平。叶酸在女性、2 型糖尿病患者和干预时间小于 12 周的患者中具有更大的 CRP 降低作用。
