Yang Jianjian, Wang Jia, Li Bo, Zhang Yaxi
Department of Cardiology, Wenzhou Central Hospital, Wenzhou, Zhejiang, China.
Department of Public Health, Weihai Maternal and Child Health Hospital, The Affiliated Weihai Second Municipal Hospital of Qingdao University, Weihai, Shandong, China.
Front Nutr. 2024 Aug 2;11:1288417. doi: 10.3389/fnut.2024.1288417. eCollection 2024.
Results from studies were inconsistent with regard to the effect of folic acid on the primary prevention of stroke. The aim of this study was to analyze the association between folic acid and the primary prevention of stroke using the data from observational studies and randomized controlled trials (RCTs).
Eligible publications published until June 2024 were searched in the database of PubMed, Web of Science and Embase. This study included all observational studies and RCTs of folic acid with first stroke as the reporting endpoints. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled in the random-effects model to assess the effect of folic acid on the primary prevention of stroke.
Results from 12 observational publications with 16 research, including 312,320 participants, were combined to explore the association between dietary folic acid intake and the primary prevention of stroke. The results showed that high dietary folic acid intake was associated with a 17% reduction in stroke incidence (RR:0.83; 95% CI: 0.73-0.94), and the effect of dietary folic acid was greater in areas without grain fortification (RR:0.80; 95% CI: 0.67-0.95). The pooled results from 12 RCTs, totaling 75,042 participants, indicated that folic acid supplementation was not associated with the stroke primary prevention (RR:0.92; 95% CI: 0.80-1.05), but folic acid supplementation was effective in areas without grain fortification (RR:0.78; 95% CI: 0.68-0.89).
Our meta-analysis demonstrated that dietary folic acid is effective in stroke primary prevention, and folic acid supplementation is effective in stroke primary prevention only in areas without grain fortification.
https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD42024516991.
关于叶酸对中风一级预防的作用，研究结果并不一致。本研究旨在利用观察性研究和随机对照试验（RCT）的数据，分析叶酸与中风一级预防之间的关联。
在PubMed、科学网和Embase数据库中检索截至2024年6月发表的符合条件的出版物。本研究纳入了所有以首次中风为报告终点的叶酸观察性研究和随机对照试验。采用随机效应模型汇总相对风险（RR）和95%置信区间（CI），以评估叶酸对中风一级预防的作用。
纳入12篇观察性出版物中的16项研究，共312,320名参与者，以探讨膳食叶酸摄入量与中风一级预防之间的关联。结果显示，高膳食叶酸摄入量与中风发病率降低17%相关（RR：0.83；95%CI：0.73 - 0.94），在未进行谷物强化的地区，膳食叶酸的作用更大（RR：0.80；95%CI：0.67 - 0.95）。12项随机对照试验的汇总结果，共75,042名参与者，表明补充叶酸与中风一级预防无关（RR：0.92；95%CI：0.80 - 1.05），但在未进行谷物强化的地区，补充叶酸是有效的（RR：0.78；95%CI：0.68 - 0.89）。
我们的荟萃分析表明，膳食叶酸对中风一级预防有效，补充叶酸仅在未进行谷物强化的地区对中风一级预防有效。
https://www.crd.york.ac.uk/PROSPERO/#myprospero，标识符CRD42024516991。
