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Effect of B-vitamin supplementation on stroke: a meta-analysis of randomized controlled trials.
PLoS One 2013; 8(11):e81577Plos

Abstract

BACKGROUND

B vitamins have been extensively used to reduce homocysteine levels; however, it remains uncertain whether B vitamins are associated with a reduced risk of stroke. Our aim was to evaluate the effects of B vitamins on stroke.

METHODOLOGY AND PRINCIPAL FINDINGS

We systematically searched PubMed, EmBase, and the Cochrane Central Register of Controlled Trials to identify studies for our analysis. Relative risk (RR) was used to measure the effect of B-vitamin supplementation on the risk of stroke. The analysis was further stratified based on factors that could affect the treatment effects. Of the 13,124 identified articles, we included 18 trials reporting data on 57,143 individuals and 2,555 stroke events. B-vitamin supplementation was not associated with a significant reduction in the risk of stroke (RR, 0.91, 95%CI: 0.82-1.01, P = 0.075; RD, -0.003, 95%CI: -0.007-0.001, P = 0.134). Subgroup analyses suggested that B-vitamin supplementation might reduce the risk of stroke if included trials had a man/woman ratio of more than 2 or subjects received dose of folic acid less than 1 mg. Furthermore, in a cumulative meta-analysis for stroke, the originally proposed nonsignificant B-vitamin effect was refuted by the evidence accumulated up to 2006. There is a small effect with borderline statistical significance based on data gathered since 2007.

CONCLUSIONS/SIGNIFICANCE

Our study indicates that B-vitamin supplementation is not associated with a lower risk of stroke based on relative and absolute measures of association. Subgroup analyses suggested that B-vitamin supplementation can effectively reduce the risk of stroke if included trials had a man/woman ratio of more than 2 or subjects received dose of folic acid less than 1 mg.

Authors+Show Affiliations

Department of Neurosurgery, Shanghai Seventh People's Hospital, Shanghai, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

24282609

Citation

Zhang, Chi, et al. "Effect of B-vitamin Supplementation On Stroke: a Meta-analysis of Randomized Controlled Trials." PloS One, vol. 8, no. 11, 2013, pp. e81577.
Zhang C, Chi FL, Xie TH, et al. Effect of B-vitamin supplementation on stroke: a meta-analysis of randomized controlled trials. PLoS ONE. 2013;8(11):e81577.
Zhang, C., Chi, F. L., Xie, T. H., & Zhou, Y. H. (2013). Effect of B-vitamin supplementation on stroke: a meta-analysis of randomized controlled trials. PloS One, 8(11), pp. e81577. doi:10.1371/journal.pone.0081577.
Zhang C, et al. Effect of B-vitamin Supplementation On Stroke: a Meta-analysis of Randomized Controlled Trials. PLoS ONE. 2013;8(11):e81577. PubMed PMID: 24282609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of B-vitamin supplementation on stroke: a meta-analysis of randomized controlled trials. AU - Zhang,Chi, AU - Chi,Feng-Ling, AU - Xie,Tian-Hao, AU - Zhou,Yu-Hao, Y1 - 2013/11/25/ PY - 2013/06/19/received PY - 2013/10/15/accepted PY - 2013/11/28/entrez PY - 2013/11/28/pubmed PY - 2014/8/6/medline SP - e81577 EP - e81577 JF - PloS one JO - PLoS ONE VL - 8 IS - 11 N2 - BACKGROUND: B vitamins have been extensively used to reduce homocysteine levels; however, it remains uncertain whether B vitamins are associated with a reduced risk of stroke. Our aim was to evaluate the effects of B vitamins on stroke. METHODOLOGY AND PRINCIPAL FINDINGS: We systematically searched PubMed, EmBase, and the Cochrane Central Register of Controlled Trials to identify studies for our analysis. Relative risk (RR) was used to measure the effect of B-vitamin supplementation on the risk of stroke. The analysis was further stratified based on factors that could affect the treatment effects. Of the 13,124 identified articles, we included 18 trials reporting data on 57,143 individuals and 2,555 stroke events. B-vitamin supplementation was not associated with a significant reduction in the risk of stroke (RR, 0.91, 95%CI: 0.82-1.01, P = 0.075; RD, -0.003, 95%CI: -0.007-0.001, P = 0.134). Subgroup analyses suggested that B-vitamin supplementation might reduce the risk of stroke if included trials had a man/woman ratio of more than 2 or subjects received dose of folic acid less than 1 mg. Furthermore, in a cumulative meta-analysis for stroke, the originally proposed nonsignificant B-vitamin effect was refuted by the evidence accumulated up to 2006. There is a small effect with borderline statistical significance based on data gathered since 2007. CONCLUSIONS/SIGNIFICANCE: Our study indicates that B-vitamin supplementation is not associated with a lower risk of stroke based on relative and absolute measures of association. Subgroup analyses suggested that B-vitamin supplementation can effectively reduce the risk of stroke if included trials had a man/woman ratio of more than 2 or subjects received dose of folic acid less than 1 mg. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24282609/Effect_of_B_vitamin_supplementation_on_stroke:_a_meta_analysis_of_randomized_controlled_trials_ L2 - http://dx.plos.org/10.1371/journal.pone.0081577 DB - PRIME DP - Unbound Medicine ER -