Roe Annie J, Zhang Shucha, Bhadelia Rafeeque A, Johnson Elizabeth J, Lichtenstein Alice H, Rogers Gail T, Rosenberg Irwin H, Smith Caren E, Zeisel Steven H, Scott Tammy M
Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
Nutrition Research Institute at the University of North Carolina Chapel Hill, Kannapolis, NC.
Am J Clin Nutr. 2017 Jun;105(6):1283-1290. doi: 10.3945/ajcn.116.137158. Epub 2017 Mar 29.
There is a potential role of choline in cardiovascular and cerebrovascular disease through its involvement in lipid and one-carbon metabolism. We evaluated the associations of plasma choline and choline-related compounds with cardiometabolic risk factors, history of cardiovascular disease, and cerebrovascular pathology. A cross-sectional subset of the Nutrition, Aging, and Memory in Elders cohort who had undergone MRI of the brain ( = 296; mean ± SD age: 73 ± 8.1 y) was assessed. Plasma concentrations of free choline, betaine, and phosphatidylcholine were measured with the use of liquid-chromatography-stable-isotope dilution-multiple-reaction monitoring-mass spectrometry. A volumetric analysis of MRI was used to determine the cerebrovascular pathology (white-matter hyperintensities and small- and large-vessel infarcts). Multiple linear and logistic regression models were used to examine relations of plasma measures with cardiometabolic risk factors, history of cardiovascular disease, and radiologic evidence of cerebrovascular pathology. Higher concentrations of plasma choline were associated with an unfavorable cardiometabolic risk-factor profile [lower high-density lipoprotein (HDL) cholesterol, higher total homocysteine, and higher body mass index (BMI)] and greater odds of large-vessel cerebral vascular disease or history of cardiovascular disease but lower odds of small-vessel cerebral vascular disease. Conversely, higher concentrations of plasma betaine were associated with a favorable cardiometabolic risk-factor profile [lower low-density lipoprotein (LDL) cholesterol and triglycerides] and lower odds of diabetes. Higher concentrations of plasma phosphatidylcholine were associated with characteristics of both a favorable cardiometabolic risk-factor profile (higher HDL cholesterol, lower BMI, lower C-reactive protein, lower waist circumference, and lower odds of hypertension and diabetes) and an unfavorable profile (higher LDL cholesterol and triglycerides). Choline and its metabolites have differential associations with cardiometabolic risk factors and subtypes of vascular disease, thereby suggesting differing roles in the pathogenesis of cardiovascular and cerebral large-vessel disease compared with that of small-vessel disease.
胆碱通过参与脂质和一碳代谢，在心血管和脑血管疾病中可能发挥作用。我们评估了血浆胆碱及胆碱相关化合物与心脏代谢危险因素、心血管疾病史和脑血管病变之间的关联。对老年人群营养、衰老与记忆队列中接受过脑部MRI检查的一个横断面子集（n = 296；平均±标准差年龄：73±8.1岁）进行了评估。使用液相色谱-稳定同位素稀释-多反应监测-质谱法测量血浆中游离胆碱、甜菜碱和磷脂酰胆碱的浓度。通过MRI体积分析确定脑血管病变（白质高信号以及小血管和大血管梗死）。使用多元线性和逻辑回归模型来研究血浆指标与心脏代谢危险因素、心血管疾病史以及脑血管病变的放射学证据之间的关系。较高的血浆胆碱浓度与不良的心脏代谢危险因素谱[较低的高密度脂蛋白（HDL）胆固醇、较高的总同型半胱氨酸和较高的体重指数（BMI）]相关，并且与大血管脑血管疾病或心血管疾病史的几率更高相关，但小血管脑血管疾病的几率更低。相反，较高的血浆甜菜碱浓度与良好的心脏代谢危险因素谱[较低的低密度脂蛋白（LDL）胆固醇和甘油三酯]相关，且患糖尿病的几率更低。较高的血浆磷脂酰胆碱浓度与良好的心脏代谢危险因素谱（较高的HDL胆固醇、较低的BMI、较低的C反应蛋白、较低的腰围以及较低的高血压和糖尿病几率）和不良谱（较高的LDL胆固醇和甘油三酯）的特征均相关。胆碱及其代谢产物与心脏代谢危险因素和血管疾病亚型存在不同的关联，这表明与小血管疾病相比，它们在心血管和脑大血管疾病的发病机制中发挥着不同的作用。
