Department of Cardiology, The Affiliated Lihuili Hospital of Ningbo University Health Science Center, Ningbo, Zhejiang, 315211, China.
Department of Respiratory Medicine, Shaoxing People's Hospital, Shaoxing, China.
BMC Public Health. 2024 May 31;24(1):1460. doi: 10.1186/s12889-024-18837-8.
The role of diet choline in atherosclerotic cardiovascular disease (ASCVD) is uncertain. Findings from animal experiments are contradictory while there is a lack of clinical investigations. This study aimed to investigate the association between choline intake and ASCVD based on individuals from the National Health and Nutrition Examination Survey (NHANES) database.
This cross-sectional study was conducted in 5525 individuals from the NHANES between 2011 and 2018. Participants were categorized into the ASCVD (n = 5015) and non-ASCVD (n = 510) groups. Univariable and multivariable-adjusted regression analyses were employed to investigate the relationship between diet choline and pertinent covariates. Logistic regression analysis and restricted cubic spline analysis were used to evaluate the association between choline intake and ASCVD.
ASCVD participants had higher choline intake compared to those without ASCVD. In the higher tertiles of choline intake, there was a greater proportion of males, married individuals, highly educated individuals, and those with increased physical activity, but a lower proportion of smokers and drinkers. In the higher tertiles of choline intake, a lower proportion of individuals had a history of congestive heart failure and stroke. After adjusting for age, gender, race, ethnicity, and physical activity, an inverse association between choline intake and heart disease, stroke, and ASCVD was found. A restricted cubic spline analysis showed a mirrored J-shaped relationship between choline and ASCVD, stroke and congestive heart failure in males. There was no association between dietary choline and metabolic syndrome.
An inverse association was observed between choline intake and ASVCD among U.S. adults. Further large longitudinal studies are needed to test the causal relationship of choline and ASVCD.
饮食胆碱在动脉粥样硬化性心血管疾病（ASCVD）中的作用尚不确定。动物实验的结果相互矛盾，而临床研究则缺乏。本研究旨在基于国家健康和营养检查调查（NHANES）数据库中的个体，调查胆碱摄入与 ASCVD 之间的关系。
本横断面研究纳入了 2011 年至 2018 年期间 NHANES 中的 5525 名个体。参与者分为 ASCVD（n=5015）和非 ASCVD（n=510）两组。采用单变量和多变量调整回归分析来研究饮食胆碱与相关协变量之间的关系。采用逻辑回归分析和限制立方样条分析来评估胆碱摄入与 ASCVD 之间的关联。
与无 ASCVD 者相比，ASCVD 参与者的胆碱摄入量更高。在胆碱摄入量较高的三分位组中，男性、已婚者、受教育程度较高者和体力活动较多者的比例较高，而吸烟者和饮酒者的比例较低。在胆碱摄入量较高的三分位组中，有充血性心力衰竭和中风病史的个体比例较低。在校正年龄、性别、种族、民族和体力活动后，发现胆碱摄入与心脏病、中风和 ASCVD 呈负相关。限制立方样条分析显示，男性胆碱与 ASCVD、中风和充血性心力衰竭之间呈镜像 J 形关系。胆碱与代谢综合征之间没有关联。
美国成年人中，胆碱摄入与 ASCVD 呈负相关。需要进一步的大型纵向研究来检验胆碱与 ASCVD 的因果关系。
