Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses
Background: There is no study that has systematically investigated the breadth and validity of the associations of folate and multiple health outcomes. We aimed to evaluate the quantity, validity, and credibility of evidence regarding associations between folate and multiple health outcomes by using...
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doaj-74893e05efbd41e3a4bfb9aefe029dc72020-12-15T06:26:12ZengFrontiers Media S.A.Frontiers in Public Health2296-25652020-12-01810.3389/fpubh.2020.550753550753Association Between Folate and Health Outcomes: An Umbrella Review of Meta-AnalysesYacong Bo0Yongjian Zhu1Yuchang Tao2Xue Li3Xue Li4Desheng Zhai5Yongjun Bu6Zhongxiao Wan7Ling Wang8Yuming Wang9Zengli Yu10School of Public Health, Xinxiang Medical University, Xinxiang, ChinaDepartment of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaSchool of Public Health, Zhengzhou University, Zhengzhou, ChinaSchool of Public Health, Xinxiang Medical University, Xinxiang, ChinaCentre for Population Health Sciences, University of Edinburgh, Edinburgh, United KingdomSchool of Public Health, Xinxiang Medical University, Xinxiang, ChinaSchool of Public Health, Xinxiang Medical University, Xinxiang, ChinaSchool of Public Health, Zhengzhou University, Zhengzhou, ChinaSchool of Public Health, Zhengzhou University, Zhengzhou, ChinaDepartment of Administration, Henan University People's Hospital, Zhengzhou, ChinaSchool of Public Health, Xinxiang Medical University, Xinxiang, ChinaBackground: There is no study that has systematically investigated the breadth and validity of the associations of folate and multiple health outcomes. We aimed to evaluate the quantity, validity, and credibility of evidence regarding associations between folate and multiple health outcomes by using umbrella review of meta-analysis.Methods: We searched the MEDLINE, EMBASE, and Cochrane Library databases from inception to May 20, 2018, to identify potential meta-analyses that examined the association of folate with any health outcome. For each included meta-analysis, we estimated the summary effect size and their 95% confidence interval using the DerSimonian and Laird random-effects model. We used the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) to assess methodological quality and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation working group classification) to assess the quality of evidence for each outcome included in the umbrella review.Results: Overall, 108 articles reporting 133 meta-analyses of observational studies and 154 meta-analyses of randomized controlled trials (RCTs) were included in the study. Among them, 108 unique exposure–outcome–population triplets (referred to as unique meta-analyses hereafter) of RCTs and 87 unique meta-analyses of observational studies were reanalyzed. Beneficial effects of folate were observed in the all-cause mortality rate and in a number of chronic diseases, including several birth/pregnancy outcomes, several cancers, cardiovascular disease and metabolic-related outcomes, neurological conditions, and several other diseases. However, adverse effects of folate were observed for prostate cancer, colorectal adenomatous lesions, asthma or wheezing, and wheezing as an isolated symptom and depression.Conclusions: Current evidence allows for the conclusion that folate is associated with decreased risk of all-cause mortality and a wide range of chronic diseases. However, folate may be associated with an increased risk of prostate cancer. Further research is warranted to improve the certainty of the estimates.https://www.frontiersin.org/articles/10.3389/fpubh.2020.550753/fullfolatemeta-analysisumbrella reviewmultiple health outcomeschronic diseases |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yacong Bo Yongjian Zhu Yuchang Tao Xue Li Xue Li Desheng Zhai Yongjun Bu Zhongxiao Wan Ling Wang Yuming Wang Zengli Yu |
spellingShingle |
Yacong Bo Yongjian Zhu Yuchang Tao Xue Li Xue Li Desheng Zhai Yongjun Bu Zhongxiao Wan Ling Wang Yuming Wang Zengli Yu Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses Frontiers in Public Health folate meta-analysis umbrella review multiple health outcomes chronic diseases |
author_facet |
Yacong Bo Yongjian Zhu Yuchang Tao Xue Li Xue Li Desheng Zhai Yongjun Bu Zhongxiao Wan Ling Wang Yuming Wang Zengli Yu |
author_sort |
Yacong Bo |
title |
Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses |
title_short |
Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses |
title_full |
Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses |
title_fullStr |
Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses |
title_full_unstemmed |
Association Between Folate and Health Outcomes: An Umbrella Review of Meta-Analyses |
title_sort |
association between folate and health outcomes: an umbrella review of meta-analyses |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Public Health |
issn |
2296-2565 |
publishDate |
2020-12-01 |
description |
Background: There is no study that has systematically investigated the breadth and validity of the associations of folate and multiple health outcomes. We aimed to evaluate the quantity, validity, and credibility of evidence regarding associations between folate and multiple health outcomes by using umbrella review of meta-analysis.Methods: We searched the MEDLINE, EMBASE, and Cochrane Library databases from inception to May 20, 2018, to identify potential meta-analyses that examined the association of folate with any health outcome. For each included meta-analysis, we estimated the summary effect size and their 95% confidence interval using the DerSimonian and Laird random-effects model. We used the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) to assess methodological quality and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation working group classification) to assess the quality of evidence for each outcome included in the umbrella review.Results: Overall, 108 articles reporting 133 meta-analyses of observational studies and 154 meta-analyses of randomized controlled trials (RCTs) were included in the study. Among them, 108 unique exposure–outcome–population triplets (referred to as unique meta-analyses hereafter) of RCTs and 87 unique meta-analyses of observational studies were reanalyzed. Beneficial effects of folate were observed in the all-cause mortality rate and in a number of chronic diseases, including several birth/pregnancy outcomes, several cancers, cardiovascular disease and metabolic-related outcomes, neurological conditions, and several other diseases. However, adverse effects of folate were observed for prostate cancer, colorectal adenomatous lesions, asthma or wheezing, and wheezing as an isolated symptom and depression.Conclusions: Current evidence allows for the conclusion that folate is associated with decreased risk of all-cause mortality and a wide range of chronic diseases. However, folate may be associated with an increased risk of prostate cancer. Further research is warranted to improve the certainty of the estimates. |
topic |
folate meta-analysis umbrella review multiple health outcomes chronic diseases |
url |
https://www.frontiersin.org/articles/10.3389/fpubh.2020.550753/full |
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