Niu Ying-Ying, Yan Hao-Yu, Zhong Jian-Feng, Diao Zhi-Quan, Li Jing, Li Cheng-Ping, Chen Lian-Hong, Huang Wen-Qi, Xu Miao, Xu Zhi-Tong, Liang Xiao-Feng, Li Zhi-Hao, Liu Dan
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China; Laboratory of Viral Pathogenesis and Infection Prevention and Control (Jinan University), Ministry of Education, Guangzhou, China; Disease Control and Prevention Institute of Jinan University, Jinan University, Guangzhou, China.
Am J Clin Nutr. 2025 Jan;121(1):5-13. doi: 10.1016/j.ajcnut.2024.11.001. Epub 2024 Nov 7.
Choline, an essential nutrient, plays a critical role in cognition, and may help prevent dementia and mild cognitive impairment. However, studies on dietary choline and its derivatives for preventing these conditions are limited and inconsistent.
The objective of this study was to explore the associations between dietary choline intake and the incidence of dementia, Alzheimer disease (AD), mild cognitive impairment (MCI), and current cognitive performance in the United Kingdom Biobank cohort.
Dietary choline intake was categorized into quartiles of consumption based on 24-h dietary recalls, with units expressed as milligrams per day. Diagnoses of dementia, AD, and MCI were identified using the International Classification of Diseases (ICD-9/10) codes. Current cognitive performance was assessed via the computerized touchscreen interface. After adjusting for sociodemographic factors, dietary and lifestyle behaviors, and comorbid conditions, Cox proportional hazards regression, logistic regression, and restricted cubic splines were used to analyze the association between choline intake and dementia or cognitive performance.
Among 125,594 participants (55.8% female), with a mean age of 56.1 y (range: 40-70 years) at baseline and a median follow-up of 11.8 y, 1103 cases of dementia (including 385 AD and 87 cases of MCI) were recorded. U-shaped associations were observed between choline intake and dementia and AD. Participants in the 2nd quartile of total choline intake had lower risks than those in the lowest quartile, with HR of 0.80 (95% CI: 0.67, 0.96) for dementia and 0.76 (95% CI: 0.58, 1.00) for AD. Moderate intake of choline derivative, including free choline (HR, 0.77; 95%CI, 0.65, 0.92), phosphatidylcholine (HR 0.82; 95% CI: 0.68, 0.98), sphingomyelin (HR 0.82; 95% CI: 0.69, 0.98) and glycerophosphocholine (HR 0.83; 95% CI: 0.70, 1.00), were associated with a 17%-23% lower odds of dementia. Additionally, moderate total choline intake was associated with an 8%-13% lower odds of poor cognitive performance in visual attention (OR: 0.92; 95% CI: 0.86, 0.99), fluid intelligence (OR: 0.87; 95% CI: 0.82, 0.92), and complex processing speed (OR: 0.90; 95% CI: 0.84, 0.95).
In conclusion, our findings suggest that moderate dietary choline intake, ranging from 332.89 mg/d to 353.93 mg/d, is associated with lower odds of dementia and better cognitive performance.
胆碱是一种必需营养素，在认知过程中起关键作用，可能有助于预防痴呆和轻度认知障碍。然而，关于膳食胆碱及其衍生物预防这些疾病的研究有限且结果不一致。
本研究的目的是在英国生物银行队列中探讨膳食胆碱摄入量与痴呆、阿尔茨海默病（AD）、轻度认知障碍（MCI）发病率以及当前认知表现之间的关联。
根据24小时膳食回忆将膳食胆碱摄入量分为四分位数，单位为每天毫克。使用国际疾病分类（ICD - 9/10）编码确定痴呆、AD和MCI的诊断。通过计算机触摸屏界面评估当前认知表现。在调整社会人口统计学因素、饮食和生活方式行为以及合并症后，使用Cox比例风险回归、逻辑回归和受限立方样条分析胆碱摄入量与痴呆或认知表现之间的关联。
在125594名参与者中（55.8%为女性），基线时平均年龄为56.1岁（范围：40 - 70岁），中位随访时间为11.8年，记录了1103例痴呆病例（包括385例AD和87例MCI）。在胆碱摄入量与痴呆和AD之间观察到U形关联。总胆碱摄入量处于第二四分位数的参与者比最低四分位数的参与者风险更低，痴呆的风险比（HR）为0.80（95%置信区间：0.67, 0.96），AD的HR为0.76（95%置信区间：0.58, 1.00）。适量摄入胆碱衍生物，包括游离胆碱（HR，0.77；95%置信区间，0.65, 0.92）、磷脂酰胆碱（HR 0.82；95%置信区间：0.68, 0.98）、鞘磷脂（HR 0.82；95%置信区间：0.69, 0.98）和甘油磷酸胆碱（HR 0.83；95%置信区间：0.70, 1.00），与痴呆几率降低17% - 23%相关。此外，适量的总胆碱摄入量与视觉注意力（比值比：0.92；95%置信区间：0.86, 0.99）、流体智力（比值比：0.87；95%置信区间：0.82, 0.92）和复杂处理速度（比值比：0.90；95%置信区间：0.84, 0.95）方面认知表现不佳的几率降低8% - 13%相关。
总之，我们的研究结果表明，每天摄入332.89毫克至353.93毫克的适量膳食胆碱与较低的痴呆几率和更好的认知表现相关。
