Jia Xiaofang, Su Chang, Zhang Jiguo, Huang Feifei, Bai Jing, Guan Fangxu, Wei Yanli, Li Li, Liu Yibing, Ji Jingang, Du Wenwen, Ouyang Yifei, Zhang Xiaofan, Zhang Bing, Wang Huijun
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
NHC Key Laboratory of Public Nutrition and Health, Beijing 100050, China.
Nutrients. 2024 Nov 28;16(23):4121. doi: 10.3390/nu16234121.
: The neuroprotective role of dietary choline during adulthood has not yet been conclusively proven. This study aims to investigate the influence of long-term choline and its constituent intakes on cognitive decline in the Chinese population. : A total of 4502 subjects (≥55 years) with at least two waves of completed data and without cognitive decline at baseline were selected from the China Health and Nutrition Survey 1997-2018. Three consecutive 24 h dietary recalls were performed to collect dietary intake information for choline, phosphatidylcholine (PC), and glycerophosphocholine (GPC) measures. Several items from the Telephone Interview for Cognitive Status (Modified) were employed to perform a cognitive assessment. Cox frailty models were used to estimate hazard ratios (HRs) and 95% CIs. : A total of 783 participants developed cognitive decline during 26,080 person-years of follow-up. Cumulative average intakes of choline, PC, and GPC were 188.0, 126.7, and 17.1 mg/d, respectively. In the total population, after full adjustment, subjects in the lower (Q2), medium (Q3), higher (Q4), and highest (Q5) quintiles of dietary choline showed 27.8% (95% CI: 0.584, 0.894), 33.9% (95% CI: 0.522, 0.836), 23.0% (95% CI: 0.599, 0.990), and 29.3% (95% CI: 0.526, 0.949) decreases in the risk of cognitive decline compared to the lowest (Q1), respectively. Similar results were observed in PC but not GPC measures. Both higher choline and PC intakes induced a lower risk of cognitive decline for subjects ≥ 65 years at baseline (Q3 and Q4) and females (Q2-Q5). A marginally significant association of GPC was found for subjects ≥ 65 years (Q5) and males (Q4). : These findings identify age and gender disparities relating to the protective associations of dietary choline, PC, and GPC with incident cognitive decline in middle-aged and older Chinese populations.
成年期膳食胆碱的神经保护作用尚未得到确凿证实。本研究旨在探讨长期胆碱及其成分摄入量对中国人群认知功能衰退的影响。
从1997 - 2018年中国健康与营养调查中选取了4502名年龄≥55岁、至少有两波完整数据且基线时无认知功能衰退的受试者。连续进行三次24小时膳食回顾，以收集胆碱、磷脂酰胆碱（PC）和甘油磷酸胆碱（GPC）的膳食摄入量信息。采用改良的认知状态电话访谈中的几个项目进行认知评估。使用Cox脆弱模型估计风险比（HRs）和95%置信区间（CIs）。
在26080人年的随访期间，共有783名参与者出现了认知功能衰退。胆碱、PC和GPC的累积平均摄入量分别为188.0、126.7和17.1毫克/天。在总体人群中，经过全面调整后，膳食胆碱处于较低（Q2）、中等（Q3）、较高（Q4）和最高（Q5）五分位数的受试者与最低（Q1）五分位数相比，认知功能衰退风险分别降低了27.8%（95% CI：0.584，0.894）、33.9%（95% CI：0.522，0.836）、23.0%（95% CI：0.599，0.990）和29.3%（95% CI：0.526，0.949）。在PC方面观察到类似结果，但在GPC方面未观察到。基线时年龄≥65岁的受试者（Q3和Q4）以及女性（Q2 - Q5）中，较高的胆碱和PC摄入量均导致较低的认知功能衰退风险。在年龄≥65岁的受试者（Q5）和男性（Q4）中发现GPC存在边缘显著关联。
这些发现确定了在中老年中国人群中，膳食胆碱、PC和GPC与新发认知功能衰退的保护关联存在年龄和性别差异。
