Division of Nutritional Sciences, Cornell University, Ithaca, NY.
Agro-Industry Faculty, Chiang Mai University, Chiang Mai, Thailand.
Am J Clin Nutr. 2019 Mar 1;109(3):648-655. doi: 10.1093/ajcn/nqy330.
Dietary choline is a precursor of trimethylamine N-oxide (TMAO), a metabolite that has been associated with an increased risk of cardiovascular disease. The mechanism underlying this association is unknown, but may include TMAO effects on blood pressure (BP).
This study assessed the association of choline intake with hypertension and BP in US adults through the use of NHANES 2007-2010 data.
This cross-sectional study was conducted in nonpregnant individuals aged ≥20 y. Choline intake was assessed with the use of two 24-h recalls. Outcomes were BP and hypertension status, which was assessed through the use of questionnaires and BP measurements. Modifying factors (e.g., sex, race/ethnicity) and dietary compared with supplemental sources of choline intake were also investigated.
The associations of total (dietary + supplemental) and dietary choline intake with the prevalence odds of hypertension differed by sex (n = 9227; P-interaction = 0.04 and 0.03, respectively). In women, both total and dietary choline intake tended to be inversely associated with hypertension (n = 4748; prevalence OR per 100 mg of choline intake: 0.89; 95% CI: 0.77, 1.02; P < 0.10 for both total and dietary choline). No association was observed in men (n = 4479; P = 0.54 and 0.49 for total choline and dietary choline, respectively). Use of choline supplements was inversely associated with hypertension in both sexes (user compared with nonuser; OR: 0.68; 95% CI: 0.49, 0.92; P = 0.01). There was little to no association of total, dietary, or supplemental choline intake with systolic or diastolic BP (n = 6,554; the mean ± SEM change in BP associated with a 100-mg difference in total choline was -0.26 ± 0.22 mm Hg for systolic BP and -0.29 ± 0.19 mm Hg for diastolic BP).
Cross-sectional NHANES data do not support the hypothesis of a positive association between choline intake and BP.
饮食中的胆碱是三甲胺 N-氧化物（TMAO）的前体，这种代谢物与心血管疾病风险增加有关。这种关联的机制尚不清楚，但可能包括 TMAO 对血压（BP）的影响。
本研究通过使用 2007-2010 年 NHANES 数据，评估美国成年人胆碱摄入量与高血压和 BP 的关系。
本横断面研究纳入年龄≥20 岁的非妊娠个体。使用 24 小时回顾法评估胆碱摄入量。BP 和高血压状况为研究结局，通过问卷调查和 BP 测量进行评估。还研究了修饰因子（如性别、种族/民族）以及饮食与补充来源的胆碱摄入。
总（饮食+补充）和饮食胆碱摄入量与高血压患病率之间的关联因性别而异（n=9227；P 交互作用=0.04 和 0.03）。在女性中，总胆碱和饮食胆碱摄入量均与高血压呈负相关趋势（n=4748；每 100mg 胆碱摄入量的患病率 OR：0.89；95%CI：0.77，1.02；总胆碱和饮食胆碱摄入量均 P＜0.10）。在男性中未观察到这种关联（n=4479；P=0.54 和 0.49，分别为总胆碱和饮食胆碱）。在两性中，胆碱补充剂的使用与高血压呈负相关（使用者与非使用者；OR：0.68；95%CI：0.49，0.92；P=0.01）。总、饮食或补充胆碱摄入量与收缩压或舒张压的关联很小或没有（n=6554；与总胆碱相差 100mg 时，收缩压的平均±SEM 变化为-0.26±0.22mmHg，舒张压的平均±SEM 变化为-0.29±0.19mmHg）。
NHANES 的横断面数据不支持胆碱摄入量与 BP 之间存在正相关的假设。
