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. 2023 Sep 13;11(18):2524.
doi: 10.3390/healthcare11182524.

The Effect of Folic Acid Supplementation on Endothelial Function and Arterial Stiffness Markers in Adults: A Systematic Review and Meta-Analysis

Kamila Bokayeva  1 , Małgorzata Jamka  1 , Michalina Banaszak  2 , Aleksandra Makarewicz-Bukowska  1 , Ada Adamczak  1 , Maria Chrobot  1 , Adrianna Janicka  1 , Natalia Jaworska  1 , Jarosław Walkowiak  1
Affiliations

The Effect of Folic Acid Supplementation on Endothelial Function and Arterial Stiffness Markers in Adults: A Systematic Review and Meta-Analysis

Kamila Bokayeva et al. Healthcare (Basel). .

Abstract

Folic acid might improve endothelial function, but the results are inconclusive. This systematic review evaluated the effect of folic acid supplementation on endothelial parameters and arterial stiffness in adults. The study protocol was registered with the PROSPERO database (CRD42021290195). The PubMed, Web of Sciences, Cochrane and Scopus databases were searched to identify English-language randomised controlled trials of the effect of folate supplementation on arterial stiffness and endothelial function markers in adults. There were significant differences between the effect of folic acid and placebo on flow-mediated dilation (random-effects model, standardized mean differences (SMD): 0.888, 95% confidence interval (CI): 0.447, 1.329, p < 0.001) and monocyte chemotactic protein 1 (random-effects model, SMD: -1.364, 95% CI: -2.164, -0.563, p < 0.001), but there was no significant difference in the central pulse wave velocity (fixed-effects model, SMD: -0.069, 95% CI: -0.264, 0.125, p = 0.485) and peripheral pulse wave velocity (fixed-effects model, SMD: -0.093, 95% CI: -0.263, 0.077, p = 0.284). In conclusion, folic acid might have a favourable effect on endothelial function but may not affect arterial stiffness. Further studies are needed to confirm these results.

Keywords: arterial stiffness; endothelial function; flow mediated dilation; folic acid supplementation; meta-analysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram.
Figure 2
Figure 2
Forest plots of the effect of folic acid supplementation (favours A) vs. placebo (favours B) on flow-mediated dilation (random model) [29,40,41,44,48,49,58,59,60,63,64,65,66,67]. CI—confidence interval; Std—standard; Std diff—standard differences.
Figure 3
Figure 3
Forest plots of the effect of folic acid supplementation (favours A) vs. placebo (favours B) on central pulse wave velocity (fixed model) [26,40,45,50]. CI—confidence interval; Std—standard; Std diff—standard differences.
Figure 4
Figure 4
Forest plots of the effect of folic acid supplementation (favours A) vs. placebo (favours B) on peripheral pulse wave velocity (fixed model) [26,52]. CI—confidence interval; Std—standard; Std diff—standard differences.
Figure 5
Figure 5
Forest plots of the effect of folic acid supplementation (favours A) vs. placebo (favours B) on monocyte chemotactic protein 1 (random-effects model) [39,61,62]. CI—confidence interval; Std—standard; Std diff—standard differences.
Figure 6
Figure 6
Traffic-light plot of the risk of bias [26,27,28,29,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67].
Figure 7
Figure 7
Summary plot of the risk of bias.
See this image and copyright information in PMC

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