Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway.
Br J Nutr. 2013 Feb 14;109(3):511-9. doi: 10.1017/S0007114512001249. Epub 2012 May 1.
Choline and betaine are nutrients involved in one-carbon metabolism. Choline is essential for neurodevelopment and brain function. We studied the associations between cognitive function and plasma concentrations of free choline and betaine. In a cross-sectional study, 2195 subjects (55 % women), aged 70-74 years, underwent extensive cognitive testing including the Kendrick Object Learning Test (KOLT), Trail Making Test (part A, TMT-A), modified versions of the Digit Symbol Test (m-DST), Block Design (m-BD), Mini-Mental State Examination (m-MMSE) and Controlled Oral Word Association Test (COWAT). Compared with low concentrations, high choline (>8·4 μmol/l) was associated with better test scores in the TMT-A (56·0 v. 61·5, P=0·004), m-DST (10·5 v. 9·8, P=0·005) and m-MMSE (11·5 v. 11·4, P=0·01). A generalised additive regression model showed a positive dose-response relationship between the m-MMSE and choline (P=0·012 from a corresponding linear regression model). Betaine was associated with the KOLT, TMT-A and COWAT, but after adjustments for potential confounders, the associations lost significance. Risk ratios (RR) for poor test performance roughly tripled when low choline was combined with either low plasma vitamin B₁₂ (≤257 pmol/l) concentrations (RR(KOLT)=2·6, 95 % CI 1·1, 6·1; RR(m-MMSE)=2·7, 95 % CI 1·1, 6·6; RR(COWAT)=3·1, 95 % CI 1·4, 7·2) or high methylmalonic acid (MMA) (≥3·95 μmol/l) concentrations (RR(m-BD)=2·8, 95 % CI 1·3, 6·1). Low betaine (≤31·1 μmol/l) combined with high MMA was associated with elevated RR on KOLT (RR(KOLT)=2·5, 95 % CI 1·0, 6·2). Low plasma free choline concentrations are associated with poor cognitive performance. There were significant interactions between low choline or betaine and low vitamin B₁₂ or high MMA on cognitive performance.
胆碱和甜菜碱是参与一碳代谢的营养物质。胆碱对神经发育和大脑功能至关重要。我们研究了认知功能与血浆游离胆碱和甜菜碱浓度之间的关系。在一项横断面研究中，2195 名年龄在 70-74 岁的受试者（55%为女性）接受了广泛的认知测试，包括肯德里克物体学习测试（KOLT）、连线测试（A 部分，TMT-A）、数字符号测试（m-DST）、积木设计（m-BD）、简易精神状态检查（m-MMSE）和受控口头词语联想测试（COWAT）。与低浓度相比，高胆碱（>8.4 μmol/L）与 TMT-A（56.0 比 61.5，P=0.004）、m-DST（10.5 比 9.8，P=0.005）和 m-MMSE（11.5 比 11.4，P=0.01）的测试分数更好相关。广义加性回归模型显示 m-MMSE 与胆碱之间存在正剂量反应关系（来自相应线性回归模型的 P=0.012）。甜菜碱与 KOLT、TMT-A 和 COWAT 相关，但在调整潜在混杂因素后，这些关联失去了意义。当低胆碱与低血浆维生素 B₁₂（<=257 pmol/L）浓度（KOLT 的 RR=2.6，95%CI 1.1，6.1；m-MMSE 的 RR=2.7，95%CI 1.1，6.6；COWAT 的 RR=3.1，95%CI 1.4，7.2）或高甲基丙二酸（MMA）（>=3.95 μmol/L）浓度（m-BD 的 RR=2.8，95%CI 1.3，6.1）结合时，不良测试结果的风险比（RR）大致增加了两倍。低甜菜碱（<=31.1 μmol/L）与高 MMA 结合时，KOLT 的 RR 升高（RR（KOLT）=2.5，95%CI 1.0，6.2）。低血浆游离胆碱浓度与认知表现不佳有关。低胆碱或甜菜碱与低维生素 B₁₂或高 MMA 之间存在显著的相互作用，对认知表现有影响。
