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Meta-Analysis
. 2024 Apr 22;14(1):22.
doi: 10.1038/s41387-024-00282-6.

Folic acid supplementation on inflammation and homocysteine in type 2 diabetes mellitus: systematic review and meta-analysis of randomized controlled trials

Kabelo Mokgalaboni  1 , Given R Mashaba  2 , Wendy N Phoswa  2 , Sogolo L Lebelo  2
Affiliations
Meta-Analysis

Folic acid supplementation on inflammation and homocysteine in type 2 diabetes mellitus: systematic review and meta-analysis of randomized controlled trials

Kabelo Mokgalaboni et al. Nutr Diabetes. .

Abstract

Background: The beneficial effects of folate have been observed under different conditions, but the available evidence on inflammation and reduction of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) is limited. The study aimed to explore the effects of folate on inflammation and homocysteine amongst individuals with T2DM.

Methods: PubMed, Scopus, and Cochrane Library were used to search for evidence. A random-effect model meta-analysis through Review Manager (version 5.4) and metaHun was performed. Results were reported as standardized mean differences (SMD) and 95% confidence intervals graphically using forest and funnel plots.

Results: Data from 9 trials with 426 patients living with T2DM were analyzed. Folic acid supplementation significantly revealed a large effect size on homocysteine levels compared to placebo, SMD = -1.53, 95%CI (-2.14,-0.93), p < 0.05. Additionally, we observed a medium marginal effect size on C-reactive protein (SMD = -0.68, 95%CI (-1.34, -0.01), p = 0.05). However, no significant effect on tumor necrosis factor-α (SMD = -0.86, 95%CI (-2.65, 0.93), p = 0.34), and interleukin-6 (SMD = -0.04, 95%CI (-1.08, 1.01), p = 0.95) was observed.

Conclusion: Evidence analyzed in this study suggests that folic acid supplementation in T2DM reduces homocysteine and may mitigate CVDs. However, its effect on inflammation is inconclusive.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram showing study selection.
Fig. 2
Fig. 2
Effect of folic acid supplementation on homocysteine in T2DM.
Fig. 3
Fig. 3. Effect of folic acid supplementation on inflammation.
A high sensitive-C-reactive protein (hs-CRP); B Tumor necrosis factor alpha (TNF-α); C Interleukin-6 (IL-6).
Fig. 4
Fig. 4. Publication bias evaluation on homocysteine and inflammatory markers.
A Homocysteine; B C-reactive protein (CRP); C Tumor necrosis factor (TNF)-α; D Interleukin (IL)-6.
Fig. 5
Fig. 5
Risk of bias according to ROB tool 2.0.
See this image and copyright information in PMC

References

    1. American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2022. Diabetes Care. 2022;45:S17–S38. doi: 10.2337/dc22-S002. - DOI - PubMed
    1. Dal Canto E, Ceriello A, Rydén L, Ferrini M, Hansen TB, Schnell O, et al. Diabetes as a cardiovascular risk factor: an overview of global trends of macro and micro vascular complications. Eur J Prev Cardiol. 2019;26:25–32. doi: 10.1177/2047487319878371. - DOI - PubMed
    1. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pr. 2022;183:109119. doi: 10.1016/j.diabres.2021.109119. - DOI - PMC - PubMed
    1. Giorgino F, Leonardini A, Laviola L. Cardiovascular disease and glycemic control in type 2 diabetes: Now that the dust is settling from large clinical trials. Ann N. Y Acad Sci. 2013;1281:36–50. doi: 10.1111/nyas.12044. - DOI - PMC - PubMed
    1. Hayfron-Benjamin CF, Maitland-Van Der Zee AH, van den Born BJ, Amoah AGB, Meeks KAC, Klipstein-Grobusch K, et al. Association between C reactive protein and microvascular and macrovascular dysfunction in sub-Saharan Africans with and without diabetes: The RODAM study. BMJ Open Diabetes Res Care 2020;8. 10.1136/bmjdrc-2020-001235. - PMC - PubMed

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