Horm Metab Res 2018; 50(02): 93-105
DOI: 10.1055/s-0043-125148
Review

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Maryam Akbari
1  Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
,
Reza Tabrizi
1  Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
,
Kamran B. Lankarani
2  Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Seyed Taghi Heydari
2  Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Maryam Karamali
3  Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
,
Fariba Keneshlou
4  Department of Urology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
,
Kayvan Niknam
5  Department of Anesthesiology and Pain Medicine, Rasoul Akram Medical Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
,
Fariba Kolahdooz
6  Indigenous and Global Health Research, Department of Medicine, University of Alberta, Edmonton, Canada
,
Zatollah Asemi
7  Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
› Author Affiliations
Funding The current study was founded by a grant from the Vice-chancellor for Research, SUMS, in Iran.

Abstract

Although several studies have evaluated the effect of folate supplementation on diabetes biomarkers among patients with metabolic diseases, findings are inconsistent. This review of randomized controlled trials (RCTs) was performed to summarize the evidence on the effects of folate supplementation on diabetes biomarkers among patients with metabolic diseases. Randomized-controlled trials (RCTs) published in PubMed, EMBASE, Web of Science and Cochrane Library databases up to 1 September 2017 were searched. Two review authors independently assessed study eligibility, extracted data, and evaluated risk of bias of included studies. Heterogeneity was measured with a Q-test and with I2 statistics. Data were pooled by using the fix or random-effect model based on the heterogeneity test results and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). A total of sixteen randomized controlled trials involving 763 participants were included in the final analysis. The current meta-analysis showed folate supplementation among patients with metabolic diseases significantly decreased insulin (SMD –1.28; 95% CI, –1.99, –0.56) and homeostasis model assessment of insulin resistance (HOMA-IR) (SMD –1.28; 95% CI, –1.99, –0.56). However, folate supplementation did not affect fasting plasma glucose (FPG) (SMD –0.30; 95% CI, –0.63, 0.02) and hemoglobin A1C (HbA1c) (SMD –0.29; 95% CI, –0.61, 0.03). The results of this meta-analysis study demonstrated that folate supplementation may result in significant decreases in insulin levels and HOMA-IR score, but does not affect FPG and HbA1c levels among patients with metabolic diseases.



Publication History

Received: 14 September 2017

Accepted: 11 December 2017

Publication Date:
17 January 2018 (online)

© Georg Thieme Verlag KG
Stuttgart · New York