TY - JOUR
T1 - The effect of vitamin B12 and folic acid supplementation on routine haematological parameters in older people: an individual participant data meta-analysis
AU - Smelt, Antonia F. H.
AU - Gussekloo, Jacobijn
AU - Bermingham, Lynette W.
AU - Allen, Elizabeth
AU - Dangour, Alan D.
AU - Eussen, Simone J. P. M.
AU - Favrat, Bernard
AU - De Groot, Lisette C. P. G. M.
AU - Kok, Frans J.
AU - Kwok, Timothy
AU - Mangoni, Arduino A.
AU - Ntaios, George
AU - Van de Rest, Ondine
AU - Seal, Eric
AU - Vaucher, Paul
AU - Verhoef, Petra
AU - Stijnen, Theo
AU - Den Elzen, Wendy P. J.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background/objectives Low vitamin B12 and folate levels in community-dwelling older people are usually corrected with supplements. However, the effect of this supplementation on haematological parameters in older persons is not known. Therefore, we executed a systematic review and individual participant data meta-analysis of randomised placebo-controlled trials (RCTs). Subjects/methods We performed a systematic search in PubMed, EMBASE, Web of Science, Cochrane and CENTRAL for RCTs published between January 1950 and April 2016, where community-dwelling elderly (60+ years) who were treated with vitamin B12 or folic acid or placebo. The presence of anaemia was not required. We analysed the data on haematological parameters with a two-stage IPD meta-analysis. Results We found 494 full papers covering 14 studies. Data were shared by the authors of four RCTs comparing vitamin B12 with placebo (n = 343) and of three RCTs comparing folic acid with placebo (n = 929). We found no effect of vitamin B12 supplementation on haemoglobin (change 0.00 g/dL, 95% CI: -0.19; 0.18), and no effect of folic acid supplementation (change -0.09 g/dL, 95% CI: -0.19; 0.01). The effects of supplementation on other haematological parameters were similar. The effects did not differ by sex or by age group. Also, no effect was found in a subgroup of patients with anaemia and a subgroup of patients who were treated >4 weeks. Conclusions Evidence on the effects of supplementation of low concentrations of vitamin B12 and folate on haematological parameters in community-dwelling older people is inconclusive. Further research is needed before firm recommendations can be made concerning the supplementation of vitamin B12 and folate.
AB - Background/objectives Low vitamin B12 and folate levels in community-dwelling older people are usually corrected with supplements. However, the effect of this supplementation on haematological parameters in older persons is not known. Therefore, we executed a systematic review and individual participant data meta-analysis of randomised placebo-controlled trials (RCTs). Subjects/methods We performed a systematic search in PubMed, EMBASE, Web of Science, Cochrane and CENTRAL for RCTs published between January 1950 and April 2016, where community-dwelling elderly (60+ years) who were treated with vitamin B12 or folic acid or placebo. The presence of anaemia was not required. We analysed the data on haematological parameters with a two-stage IPD meta-analysis. Results We found 494 full papers covering 14 studies. Data were shared by the authors of four RCTs comparing vitamin B12 with placebo (n = 343) and of three RCTs comparing folic acid with placebo (n = 929). We found no effect of vitamin B12 supplementation on haemoglobin (change 0.00 g/dL, 95% CI: -0.19; 0.18), and no effect of folic acid supplementation (change -0.09 g/dL, 95% CI: -0.19; 0.01). The effects of supplementation on other haematological parameters were similar. The effects did not differ by sex or by age group. Also, no effect was found in a subgroup of patients with anaemia and a subgroup of patients who were treated >4 weeks. Conclusions Evidence on the effects of supplementation of low concentrations of vitamin B12 and folate on haematological parameters in community-dwelling older people is inconclusive. Further research is needed before firm recommendations can be made concerning the supplementation of vitamin B12 and folate.
KW - COBALAMIN DEFICIENCY
KW - ELDERLY POPULATION
KW - FOLATE-DEFICIENCY
KW - CONTROLLED-TRIAL
KW - DOUBLE-BLIND
KW - PREVALENCE
KW - ANEMIA
KW - ADULTS
KW - WOMEN
KW - HOMOCYSTEINE
U2 - 10.1038/s41430-018-0118-x
DO - 10.1038/s41430-018-0118-x
M3 - (Systematic) Review article
SN - 0954-3007
VL - 72
SP - 785
EP - 795
JO - European Journal of Clinical Nutrition
JF - European Journal of Clinical Nutrition
IS - 6
ER -