The effect of vitamin B12 and folic acid supplementation on routine haemotological parameters in older people : an individual participant data meta-analysis

Smelt, Antonia FH (Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands) ; Gussekloo, Jacobijn (Department of Public Health and Primary Care, Leiden Universtiy Medical Center, Leiden, The Netherlands) ; Bermingham, Lynette W (Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands) ; Allen, Elizabeth (Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK) ; Dangour, Alan D (Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK) ; Eussen, Simone JPM (Department of Epidemiology, School for Cardiovascula Diseases - CARIM, Maastricht University, Maastricht, The Netherlands) ; Favrat, Bernard (Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland) ; De Groot, Lisette CPGM (Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands) ; Kok, Frans J (Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands) ; Kwok, Timothy (Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong) ; Mangoni, Arduino A (Department of Clinical Pharmacology, School of Medicine, Flinders University, Adelaide, SA, Australia) ; Ntaios, George (Department of Medicine, University of Thessaly, Larissa, Greece) ; Van De Rest, Ondine (Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands) ; Seal, Eric (Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia) ; Vaucher, Paul (School of Health Sciences, HES-SO Fribourg, Switzerland) ; Verhoef, Petra (Unilever R&D Vlaardingen, Vlaardingen, The Netherlands) ; Stijnen, Theo (Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands) ; Den Elzen, Wendy PJ (Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands ; Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands)

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.


Article Type:
scientifique
Faculty:
Santé
School:
HEdS-FR
Institute:
Recherche appliquée et développement Santé HEDS-FR
Date:
2018-03
Pagination:
11 p.
Published in:
European Journal of Clinical Nutrition
Numeration (vol. no.):
2018, vol. 72, no. 6, pp. 785–795
DOI:
ISSN:
1476-5640
Appears in Collection:



 Record created 2020-03-12, last modified 2020-03-12

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