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Effect of long-term low-dose folic acid supplementation on degree of total homocysteine-lowering: major effect modifiers

  • Binyan Wang (a1) (a2), Hongxu Wu (a1), Youbao Li (a2), Qianyun Ban (a1), Xiao Huang (a3), Lulu Chen (a1), Jianping Li (a4), Yan Zhang (a4), Yimin Cui (a5), Mingli He (a6), Genfu Tang (a1), Delu Yin (a7), Junnong Li (a8), Yong Huo (a3), Xianhui Qin (a1) (a2) and Xiping Xu (a1) (a2)...

Abstract

We sought to examine the potential modifiers in the association between long-term low-dose folic acid supplementation and the reduction of serum total homocysteine (tHcy) among hypertensive patients, using data from the China Stroke Primary Prevention Trial (CSPPT). This analysis included 16 867 participants who had complete data on tHcy measurements at both the baseline and exit visit. After a median treatment period of 4·5 years, folic acid treatment significantly reduced the tHcy levels by 1·6 μmol/l (95 % CI 1·4, 1·8). More importantly, after adjustment for baseline tHcy and other important covariates, a greater degree of tHcy reduction was observed in certain subgroups: males, the methylenetetrahydrofolate reductase (MTHFR) 677TT genotype, higher baseline tHcy levels (≥12·5 (median) v. <12·5 μmol/l), lower folate levels (<8·0 (median) v. ≥8·0 ng/ml), estimated glomerular filtration rate (eGFR) <60 ml/min per 1·73 m2 (v. 60–<90 and ≥90 ml/min per 1·73 m2), ever smokers and concomitant use of diuretics (P for all interactions <0·05). The degree of tHcy reduction associated with long-term folic acid supplementation can be significantly affected by sex, MTHFR C677T genotypes, baseline folate, tHcy, eGFR levels and smoking status.

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Corresponding author

*Corresponding authors: X. Qin, fax +86 551 5161211, email pharmaqin@126.com; X. Xu, fax +86 551 5161211, email xipingxu126@126.com

References

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