Korean J Fam Pract.  2021 Apr;11(2):106-112. 10.21215/kjfp.2021.11.2.106.

Association between Serum Folic Acid Level and the Risk of Atherosclerotic Cardiovascular Disease within 10 Years: The 7th (2016–2018) Korean National Health and Nutrition Examination Survey

• Lee S
• Yeo Y
• Jeon KH
• Yoo JH

• KMID: 2515048
• DOI: http://doi.org/10.21215/kjfp.2021.11.2.106

Abstract

Background
Folic acid regulates homocysteine metabolism, which is associated with the occurrence of cardiovascular diseases. We aimed to assess the relationship between folic acid level and the risk of atherosclerotic cardiovascular disease (ASCVD) within 10 years.
Methods
A cross-sectional study using the 7th (2016–2018) KNHANES selected 3,697 adults aged 40 to 79 years (1,606 male and 2,091 female) who had never been diagnosed with a cardiovascular disease. The risk of ASCVD within 10 years was calculated according to the 2013 American College of Cardiology/American Heart Association cohort guidelines.
Results
The results of the multivariate linear regression showed that a 1 ng/mL increase in serum folic acid level significantly reduced the risk of ASCVD by -0.36% (95% confidence interval [CI], -0.42 to -0.29) in all subjects, which was reduced by -0.22% (95% CI, -0.32 to -0.12) and -0.15% (95% CI, -0.23 to -0.08), in male and female, respectively. In addition, multivariate logistic regression analyses were performed to calculate the relative proportion of the cardiovascular disease high-risk group (10-year ASCVD risk ≥7.5%) in each quartile for the serum folic acid concentration. Consequently, the proportion of the high-risk group with cardiovascular disease was 5.08 times higher in the lowest quartile group than in the highest quartile group (95% CI, 3.56–7.20).
Conclusion
Our study suggests an inverse correlation between serum folic acid level and the 10-year ASCVD risk among Korean adults.

Keyword

Serum Folic Acid Level; Folate; Cardiovascular Disease; ASCVD Risk