叶酸补充对成年人血管内皮功能的影响：随机对照试验的系统评价和剂量反应荟萃分析。

The effects of folic acid supplementation on endothelial function in adults: a systematic review and dose-response meta-analysis of randomized controlled trials.

机构信息

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Nutr J. 2023 Feb 24;22(1):12. doi: 10.1186/s12937-023-00843-y.

BACKGROUND

Endothelial dysfunction serves as an early marker for the risk of cardiovascular disease (CVD); therefore, it is an attractive site of therapeutic interventions to reduce the risk of CVD. This study was conducted to investigate the effect of folic acid supplementation on endothelial function markers in randomized controlled trials (RCTs).

METHODS

PubMed, ISI web of science, and Scopus databases were searched up to July 2022 for detecting eligible studies. A random-effects model was used for meta-analysis, and linear Meta-regression and non-linear dose-response analysis were performed to assess whether the effect of folic acid supplementation was affected by the dose and duration of intervention. Cochrane tools were also used to assess the risk of bias in the included studies.

RESULTS

Twenty-one studies, including 2025 participants (1010 cases and 1015 controls), were included in the present meta-analysis. Folic acid supplementation significantly affected the percentage of flow-mediated dilation (FMD%) (WMD: 2.59%; 95% CI: 1.51, 3.67; P < 0.001) and flow-mediated dilation (FMD) (WMD: 24.38 μm; 95% CI: 3.08, 45.68; P = 0.025), but not end-diastolic diameter (EDD) (WMD: 0.21 mm; 95% CI: - 0.09, 0.52; P = 0.176), and intercellular adhesion molecule (ICAM) (WMD: 0.18 ng/ml; 95% CI: - 10.02, 13.81; P = 0.755).

CONCLUSIONS

These findings suggest that folic acid supplementation may improve endothelial function by increasing FMD and FMD% levels.

TRIAL REGISTRATION

PROSPERO registration cod: CRD42021289744.

背景

内皮功能障碍是心血管疾病 (CVD) 风险的早期标志物；因此，它是治疗干预的一个有吸引力的靶点，以降低 CVD 的风险。本研究旨在探讨叶酸补充对随机对照试验 (RCT) 中内皮功能标志物的影响。

方法

检索了 PubMed、ISI web of science 和 Scopus 数据库，以确定符合条件的研究。采用随机效应模型进行荟萃分析，并进行线性 Meta 回归和非线性剂量反应分析，以评估叶酸补充的效果是否受到干预剂量和持续时间的影响。还使用 Cochrane 工具评估了纳入研究的偏倚风险。

结果

本荟萃分析共纳入 21 项研究，包括 2025 名参与者（1010 例病例和 1015 例对照）。叶酸补充显著影响血流介导的扩张百分比（FMD%）（WMD：2.59%；95%CI：1.51, 3.67；P<0.001）和血流介导的扩张（FMD）（WMD：24.38μm；95%CI：3.08, 45.68；P=0.025），但不影响舒张末期直径（EDD）（WMD：0.21mm；95%CI：-0.09, 0.52；P=0.176）和细胞间黏附分子（ICAM）（WMD：0.18ng/ml；95%CI：-10.02, 13.81；P=0.755）。