Centre for Nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway.
Centre for Nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway.
Biochimie. 2020 Jun;173:68-75. doi: 10.1016/j.biochi.2019.11.001. Epub 2019 Nov 7.
High plasma choline has been associated with the metabolic syndrome and risk of chronic diseases, including cardiovascular disease. However, dietary choline is not correlated with choline plasma concentrations, and there are few studies and contradictory evidence regarding dietary choline and cardiovascular events. In addition, a recommended dietary allowance for choline has not been established and remains a point of contention. This study assessed the association between dietary choline, including choline forms, and risk of incident acute myocardial infarction (AMI) in patients with suspected stable angina pectoris (SAP). In total 1981 patients (80% men, median age 62) from the Western Norway B Vitamin Intervention Trial were included in this analysis. Information on dietary choline was obtained using a 169-item food frequency questionnaire. The Cardiovascular Disease in Norway project provided data on AMI. Risk associations were estimated using Cox-regression analysis using energy-adjusted choline intake. Median (25th, 75th percentile) total energy-adjusted choline intake was 288 (255, 326) mg/d. During a median (25th, 75th percentile) follow-up of 7.5 (6.3, 8.8) years, 312 (15.7%) patients experienced at least one AMI. Increased intakes of energy-adjusted choline (HR [95% CI] per 50 mg increase 1.11 [1.03, 1.20]), phosphatidylcholine (HR per 50 mg increase 1.24 [1.08, 1.42]) and sphingomyelin (HR per 5 mg increase 1.16 [1.02, 1.31]) were associated with higher AMI risk. In conclusion, higher dietary intakes of total choline, phosphatidylcholine and sphingomyelin were associated with increased risk of AMI in patients with SAP. Future studies are necessary to explore underlying mechanisms for this observation.
血浆胆碱水平升高与代谢综合征和慢性病风险相关，包括心血管疾病。然而，饮食中的胆碱与血浆胆碱浓度没有相关性，并且关于饮食胆碱与心血管事件的研究较少且存在矛盾。此外，尚未确定胆碱的推荐膳食摄入量，这仍然存在争议。本研究评估了疑似稳定型心绞痛（SAP）患者饮食胆碱（包括胆碱形式）与新发急性心肌梗死（AMI）风险之间的关系。共纳入了来自西方挪威维生素 B 干预试验的 1981 名患者（80%为男性，中位年龄 62 岁）进行了这项分析。通过 169 项食物频率问卷获取饮食胆碱信息。挪威心血管疾病项目提供了 AMI 数据。使用 Cox 回归分析估计风险关联，使用能量校正的胆碱摄入量进行分析。中位数（25 分位，75 分位）的总能量校正胆碱摄入量为 288（255，326）mg/d。在中位数（25 分位，75 分位）随访 7.5（6.3，8.8）年期间，312 名（15.7%）患者至少经历了一次 AMI。能量校正胆碱摄入量增加（每增加 50mg 的 HR [95%CI]为 1.11 [1.03，1.20]）、磷脂酰胆碱（每增加 50mg 的 HR 为 1.24 [1.08，1.42]）和鞘磷脂（每增加 5mg 的 HR 为 1.16 [1.02，1.31]）与 AMI 风险增加相关。总之，SAP 患者饮食中总胆碱、磷脂酰胆碱和鞘磷脂的摄入量较高与 AMI 风险增加相关。需要进一步研究来探讨这种观察结果的潜在机制。
