Introduction and objectives: The beneficial effect of folate has been observed in various conditions; however, the available evidence on homocysteine and reduction of cardiovascular disease (CVD) in type 2 diabetes (T2D) is limited. This study aims to quantitatively assess the effects of folate on homocysteine levels and the risk of CVDs in individuals with T2D.
Methods: We comprehensively searched clinical trials from PubMed, Cochrane, and Scopus. The trials that focused on adult T2D using folate were included, while those with different interventions, T1D, and animal models of T2D were excluded. A random effect model was used due to heterogeneity. The data was analyzed using Jamovi 2.4.8. Results were presented as standardized mean differences (SMD) and 95% confidence intervals using forest plot.
Results: Evidence retrieved from 9 studies with a sample size of 426 T2D patients was analyzed. Folate supplementation led to a significant reduction in homocysteine (SMD = -1.26 µmol/L, 95% CI: -1.74 to -0.78, p < 0.05) (Figure 1). The subgroup of the sample below 50 revealed no heterogeneity compared to a sample over 50.
Conclusion: Our findings suggest that folate in T2D patients may reduce homocysteine and consequently mitigate CVD. Future trials should explore the effects of folate on homocysteine, especially using a large enough sample size.
K.O.S. Mokgalaboni: None. W.N. Phoswa: None. R.G. Mashaba: None.
