Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta‐Analysis of Randomized Controlled Trials

Li, Yanping; Huang, Tianyi; Zheng, Yan; Muka, Tauland; Troup, Jenna; Hu, Frank B.

doi:10.1161/jaha.116.003768

Cited by 207 publications

(134 citation statements)

References 72 publications

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“…Our findings were consistent with the prior studies mentioned above. Furthermore, our findings were also supported by several previous clinical trials, which indicated that antihomocysteine therapy (eg, folic acid supplementation) was effective in reducing BPs and the risk of cardiovascular diseases . For example, a meta‐analysis of 12 randomized controlled clinical trials found that supplementation with 5000 to 10 000 μg/d of folate for at least 6 weeks could lower SBP by 2.03 mm Hg .…”

Section: Discussionsupporting

confidence: 85%

Interactions of homocysteine and conventional predisposing factors on hypertension in Chinese adults

Yang

Fan

Zhi

et al. 2017

J of Clinical Hypertension

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This study aimed to investigate whether conventional predisposing factors modify the associations of homocysteine with blood pressure levels and hypertension. A total of 2615 adults were recruited from Liaoning province. An elevated homocysteine level was significantly associated with increased hypertension risk and blood pressure (all P<.05). Interaction analyses showed that homocysteine acted synergistically with age, overweight/obesity, dyslipidemia, and family history of hypertension to affect hypertension risk, and the relative excess risk due to interaction was 1.21 (95% confidence interval, 0.07–2.35), 0.72 (95% confidence interval, 0.07–1.36), 0.45 (95% confidence interval, 0.06–0.85), and 1.87 (95% confidence interval, 0.77–2.97), respectively. Increases in blood pressure were higher in patients who were overweight/obese or had a family history of hypertension than in their counterparts (all Pinteraction <.05). This study provides some strong evidence for interactions of homocysteine with conventional predisposing factors on hypertension.

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Section: Discussionsupporting

confidence: 85%

Interactions of homocysteine and conventional predisposing factors on hypertension in Chinese adults

Yang

Fan

Zhi

et al. 2017

J of Clinical Hypertension

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“…In more recent years, however, evidence is emerging to suggest that the achievement of optimal folate status may be important not only for women of child-bearing age, but for the general population. This is due to the increased recognition of the potential protective role of folate in the primary prevention of cardiovascular disease, particularly stroke [3,4], age-related cognitive impairment [5,6] and osteoporosis [7,8]. …”

Section: Introductionmentioning

confidence: 99%

Validation of Folate-Enriched Eggs as a Functional Food for Improving Folate Intake in Consumers

et al. 2016

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Functional foods enriched with folate may be beneficial as a means of optimizing folate status in consumers. We recently developed novel eggs enriched with folate through folic acid supplementation of the hen’s feed, but their potential to influence consumer folate status is unknown because the natural folate forms incorporated into the eggs may not necessarily be retained during storage and cooking. This study aimed to determine the stability of natural folates in folate-enriched eggs under typical conditions of storage and cooking. Total folate was determined by microbiological assay following tri-enzyme treatment in folate-enriched eggs and un-enriched (barn and free-range) on the day they were laid, after storage (up to 27 days) and after using four typical cooking methods (boiling, poaching, frying, scrambling) for different durations. On the day of laying, the folate content of enriched eggs was found to be significantly higher than that of un-enriched barn or free-range eggs (mean ± SD; 123.2 ± 12.4 vs. 41.2 ± 2.8 vs. 65.6 ± 18.5 µg/100 g; p < 0.001). Storage at refrigerator and room temperature for periods up to the Best Before date resulted in no significant losses to the folate content of folate-enriched eggs. Furthermore, folate in enriched eggs remained stable when cooked by four typical methods for periods up to the maximum cooking time (e.g., 135 ± 22.5, 133.9 ± 23.0 and 132.5 ± 35.1; p = 0.73, for raw, scrambled for 50 s and scrambled for 2 min, respectively). Thus, natural folates in folate-enriched eggs remain highly stable with little or no losses following storage and cooking. These findings are important because they demonstrate the feasibility of introducing folate-enriched eggs into the diet of consumers as functional foods with enriched folate content. Further studies will confirm their effectiveness in optimizing the biomarker folate status of consumers.

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“…More importantly, a positive association was found between reduction in Hcy levels and the beneficial effect associated with folic acid therapy. [34,37] There is substantial variability in Hcy levels even within the population without folic acid fortification. [13] Therefore, from a research and population-health perspective, it is important to clarify whether there are certain subgroups of individuals who had higher Hcy levels and might benefit from Hcy-lowering therapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of MTHFR A1298C and MTRR A66G genetic mutations on homocysteine levels in the Chinese population: a systematic review and meta-analysis

Wang

Ouyang

et al. 2017

Journal of Translational Internal Medicine

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Background and Objectives: The Chinese population typically has inadequate folate intake and no mandatory folic acid fortification. Methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR) are the two key regulatory enzymes in the folate/ homocysteine (Hcy) metabolism. Hcy has been implicated in the pathogenesis of cardiovascular disease. We conducted a meta-analysis to assess whether the MTHFR gene A1298C and the MTRR gene A66G polymorphisms affect Hcy levels in the Chinese population. Methods: This analysis included 13 studies with Hcy levels reported as one of the study measurements. Summary estimates of weighted mean differences and 95% confidence intervals (CIs) were obtained using random-effect models. Results: Overall, there were no significant differences in Hcy concentrations between participants with the MTHFR 1298 CC (12 trials, n = 129), AA (n = 2166; β, −0.51 μmol/L; 95%CI: −2.14, 1.11; P = 0.53), or AC genotype (n = 958; β, 0.55 μmol/L; 95%CI: −0.72, 1.82; P = 0.40). Consistently, compared to those with the MTRR 66 GG genotype (6 trials, n = 156), similar Hcy concentrations were found in participants with the AA (n = 832; β, −0.43 μmol/L; 95%CI: −1.04, 0.17; P = 0.16) or AG (n =743; β, −0.57 μmol/L; 95%CI: −1.46, 0.31; P = 0.21) genotype. Similar results were observed for the dominant and recessive models. Conclusions: Neither the MTHFR A1298C polymorphism nor the MTRR A66G polymorphism affects Hcy levels in the Chinese population.

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Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta‐Analysis of Randomized Controlled Trials

Cited by 207 publications

References 72 publications

Interactions of homocysteine and conventional predisposing factors on hypertension in Chinese adults

Interactions of homocysteine and conventional predisposing factors on hypertension in Chinese adults

Validation of Folate-Enriched Eggs as a Functional Food for Improving Folate Intake in Consumers

Effect of MTHFR A1298C and MTRR A66G genetic mutations on homocysteine levels in the Chinese population: a systematic review and meta-analysis

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