Serum homocysteine, folate and vitamin B12 levels in patients with psoriasis

a systematic review and meta-analysis

T. Y. Tsai, H. Yen, Yu-Chen Huang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Patients with psoriasis are at increased risk for cardiovascular comorbidities. Previous studies examined the possible contribution of serum homocysteine, folate and vitamin B12 to cardiovascular risks in patients with psoriasis but had conflicting conclusions. Objectives: To perform a systematic review and meta-analysis of studies on serum homocysteine, folate and vitamin B12 levels in patients with psoriasis. Methods: Online databases were searched on 15 February 2018 to include studies comparing serum homocysteine, folate and vitamin B12 levels between patients with psoriasis and controls. A random effects model was adopted to estimate odds ratios for dichotomous data and standardized mean differences (SMDs) for continuous data. Results: A comprehensive literature search identified 24 studies eligible for inclusion. Compared with controls, patients with psoriasis had a significantly higher serum homocysteine level [SMD 0·41, 95% confidence interval (CI) 0·21–0·61; I2 = 76·7%, 18 studies], a higher prevalence of hyperhomocysteinaemia (odds ratio 3·48, 95% CI 2·08–5·83; I2 = 41·1%, seven studies) and a lower serum folate level (SMD −0·94, 95% CI −1·49 to −0·40; I2 = 95·6%, 14 studies). However, there was no difference in serum vitamin B12 levels between patients with psoriasis and the control group (SMD 0·004, 95% CI −0·49 to 0·50; I2 = 92%, 11 studies). Metaregression analysis revealed a significant inverse correlation between the SMD of homocysteine levels and folate levels. Conclusions: Patients with psoriasis might have higher serum homocysteine and lower folate levels than control patients without psoriasis. However, due to significant heterogeneity and other limitations, the associations require further examinations in more studies.

Original languageEnglish
JournalBritish Journal of Dermatology
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Homocysteine
Vitamin B 12
Psoriasis
Folic Acid
Meta-Analysis
Serum
Confidence Intervals
Odds Ratio
Hyperhomocysteinemia
Comorbidity
Databases
Control Groups

ASJC Scopus subject areas

  • Dermatology

Cite this

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title = "Serum homocysteine, folate and vitamin B12 levels in patients with psoriasis: a systematic review and meta-analysis",
abstract = "Background: Patients with psoriasis are at increased risk for cardiovascular comorbidities. Previous studies examined the possible contribution of serum homocysteine, folate and vitamin B12 to cardiovascular risks in patients with psoriasis but had conflicting conclusions. Objectives: To perform a systematic review and meta-analysis of studies on serum homocysteine, folate and vitamin B12 levels in patients with psoriasis. Methods: Online databases were searched on 15 February 2018 to include studies comparing serum homocysteine, folate and vitamin B12 levels between patients with psoriasis and controls. A random effects model was adopted to estimate odds ratios for dichotomous data and standardized mean differences (SMDs) for continuous data. Results: A comprehensive literature search identified 24 studies eligible for inclusion. Compared with controls, patients with psoriasis had a significantly higher serum homocysteine level [SMD 0·41, 95{\%} confidence interval (CI) 0·21–0·61; I2 = 76·7{\%}, 18 studies], a higher prevalence of hyperhomocysteinaemia (odds ratio 3·48, 95{\%} CI 2·08–5·83; I2 = 41·1{\%}, seven studies) and a lower serum folate level (SMD −0·94, 95{\%} CI −1·49 to −0·40; I2 = 95·6{\%}, 14 studies). However, there was no difference in serum vitamin B12 levels between patients with psoriasis and the control group (SMD 0·004, 95{\%} CI −0·49 to 0·50; I2 = 92{\%}, 11 studies). Metaregression analysis revealed a significant inverse correlation between the SMD of homocysteine levels and folate levels. Conclusions: Patients with psoriasis might have higher serum homocysteine and lower folate levels than control patients without psoriasis. However, due to significant heterogeneity and other limitations, the associations require further examinations in more studies.",
author = "Tsai, {T. Y.} and H. Yen and Yu-Chen Huang",
year = "2018",
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doi = "10.1111/bjd.17034",
language = "English",
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TY - JOUR

T1 - Serum homocysteine, folate and vitamin B12 levels in patients with psoriasis

T2 - a systematic review and meta-analysis

AU - Tsai, T. Y.

AU - Yen, H.

AU - Huang, Yu-Chen

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Patients with psoriasis are at increased risk for cardiovascular comorbidities. Previous studies examined the possible contribution of serum homocysteine, folate and vitamin B12 to cardiovascular risks in patients with psoriasis but had conflicting conclusions. Objectives: To perform a systematic review and meta-analysis of studies on serum homocysteine, folate and vitamin B12 levels in patients with psoriasis. Methods: Online databases were searched on 15 February 2018 to include studies comparing serum homocysteine, folate and vitamin B12 levels between patients with psoriasis and controls. A random effects model was adopted to estimate odds ratios for dichotomous data and standardized mean differences (SMDs) for continuous data. Results: A comprehensive literature search identified 24 studies eligible for inclusion. Compared with controls, patients with psoriasis had a significantly higher serum homocysteine level [SMD 0·41, 95% confidence interval (CI) 0·21–0·61; I2 = 76·7%, 18 studies], a higher prevalence of hyperhomocysteinaemia (odds ratio 3·48, 95% CI 2·08–5·83; I2 = 41·1%, seven studies) and a lower serum folate level (SMD −0·94, 95% CI −1·49 to −0·40; I2 = 95·6%, 14 studies). However, there was no difference in serum vitamin B12 levels between patients with psoriasis and the control group (SMD 0·004, 95% CI −0·49 to 0·50; I2 = 92%, 11 studies). Metaregression analysis revealed a significant inverse correlation between the SMD of homocysteine levels and folate levels. Conclusions: Patients with psoriasis might have higher serum homocysteine and lower folate levels than control patients without psoriasis. However, due to significant heterogeneity and other limitations, the associations require further examinations in more studies.

AB - Background: Patients with psoriasis are at increased risk for cardiovascular comorbidities. Previous studies examined the possible contribution of serum homocysteine, folate and vitamin B12 to cardiovascular risks in patients with psoriasis but had conflicting conclusions. Objectives: To perform a systematic review and meta-analysis of studies on serum homocysteine, folate and vitamin B12 levels in patients with psoriasis. Methods: Online databases were searched on 15 February 2018 to include studies comparing serum homocysteine, folate and vitamin B12 levels between patients with psoriasis and controls. A random effects model was adopted to estimate odds ratios for dichotomous data and standardized mean differences (SMDs) for continuous data. Results: A comprehensive literature search identified 24 studies eligible for inclusion. Compared with controls, patients with psoriasis had a significantly higher serum homocysteine level [SMD 0·41, 95% confidence interval (CI) 0·21–0·61; I2 = 76·7%, 18 studies], a higher prevalence of hyperhomocysteinaemia (odds ratio 3·48, 95% CI 2·08–5·83; I2 = 41·1%, seven studies) and a lower serum folate level (SMD −0·94, 95% CI −1·49 to −0·40; I2 = 95·6%, 14 studies). However, there was no difference in serum vitamin B12 levels between patients with psoriasis and the control group (SMD 0·004, 95% CI −0·49 to 0·50; I2 = 92%, 11 studies). Metaregression analysis revealed a significant inverse correlation between the SMD of homocysteine levels and folate levels. Conclusions: Patients with psoriasis might have higher serum homocysteine and lower folate levels than control patients without psoriasis. However, due to significant heterogeneity and other limitations, the associations require further examinations in more studies.

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U2 - 10.1111/bjd.17034

DO - 10.1111/bjd.17034

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JO - British Journal of Dermatology

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SN - 0007-0963

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