Bai Jincheng, Lv Penghui, Li Lu, Cheng Sichao, Chang Jianjun
Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Sci Rep. 2025 Jul 2;15(1):23483. doi: 10.1038/s41598-025-08891-6.
Postmenopausal estrogen deficiency accelerates bone mineral density (BMD) decline, significantly elevating the risk of osteoporotic fractures. Choline, a vital nutrient involved in lipid homeostasis and inflammatory pathways, has been associated with skeletal health. Yet its role in preserving bone density among postmenopausal populations, a group at high risk of osteoporosis, requires further investigation. This study also examined the modifying effects of socioeconomic factors, including income and race, on the relationship between dietary choline intake and BMD. Using data from 4,160 postmenopausal women aged 50 years and older from the National Health and Nutrition Examination Survey (NHANES) 2007-2018, we employed weighted linear regression models to characterize the dose-response relationship between total dietary choline intake and lumbar spine BMD. In fully adjusted models, each 1 g/day increment in choline intake corresponded to a 0.082 g/cm² increase in lumbar spine BMD (β: 0.082, 95% CI: 0.025-0.139). Participants in the highest choline intake quartile (Q4) exhibited a 0.025 g/cm² higher BMD compared to the lowest quartile (Q1) (β: 0.025, 95% CI: (0.007, 0.042)). Stratified analyses revealed significant effect modifications by obesity (P interaction = 0.015), income (P interaction = 0.003), and race (P interaction = 0.039), with amplified protective effects observed in obese individuals (β: 0.146, 95% CI: 0.067-0.22), high-income subgroups (PIR > 4)(β: 0.121, 95% CI: 0.013-0.228), and non-Hispanic Whites (β: 0.110, 95% CI: 0.034-0.185). This study demonstrates for the first time the positive association of dietary choline with BMD in postmenopausal women, supporting the potential of choline-targeted nutrition strategies for osteoporosis prevention and emphasizing the role of socioeconomic factors in influencing bone health outcomes.
绝经后雌激素缺乏会加速骨密度（BMD）下降，显著增加骨质疏松性骨折的风险。胆碱是一种参与脂质稳态和炎症途径的重要营养素，与骨骼健康有关。然而，其在绝经后人群（骨质疏松高危人群）中对维持骨密度的作用仍需进一步研究。本研究还考察了社会经济因素（包括收入和种族）对膳食胆碱摄入量与骨密度之间关系的调节作用。利用2007 - 2018年美国国家健康与营养检查调查（NHANES）中4160名50岁及以上绝经后女性的数据，我们采用加权线性回归模型来描述膳食总胆碱摄入量与腰椎骨密度之间的剂量反应关系。在完全调整模型中，胆碱摄入量每增加1克/天，腰椎骨密度相应增加0.082克/平方厘米（β：0.082，95%置信区间：0.025 - 0.139）。胆碱摄入量最高四分位数（Q4）的参与者与最低四分位数（Q1）相比，骨密度高0.025克/平方厘米（β：0.025，95%置信区间：(0.007, 0.042)）。分层分析显示，肥胖（P交互作用 = 0.015）、收入（P交互作用 = 0.003）和种族（P交互作用 = 0.039）存在显著的效应修饰，在肥胖个体（β：0.146，95%置信区间：0.067 - 0.22）、高收入亚组（PIR > 4）（β：0.121，95%置信区间：0.013 - 0.228）和非西班牙裔白人（β：0.110，95%置信区间：0.034 - 0.185）中观察到增强的保护作用。本研究首次证明了膳食胆碱与绝经后女性骨密度之间的正相关关系，支持了以胆碱为靶点的营养策略预防骨质疏松的潜力，并强调了社会经济因素在影响骨骼健康结果中的作用。
