title: Choline and its metabolites are differently associated with cardiometabolic risk factors, history of cardiovascular disease, and MRI-documented cerebrovascular disease in older adults.
abstract: Background:There is a potential role of choline in cardiovascular and cerebrovascular disease through its involvement in lipid and one-carbon metabolism.Objective:We evaluated the associations of plasma choline and choline-related compounds with cardiometabolic risk factors, history of cardiovascular disease, and cerebrovascular pathology.Design:A cross-sectional subset of the Nutrition, Aging, and Memory in Elders cohort who had undergone MRI of the brain (n= 296; mean ± SD age: 73 ± 8.1 y) was assessed. Plasma concentrations of free choline, betaine, and phosphatidylcholine were measured with the use of liquid-chromatography-stable-isotope dilution-multiple-reaction monitoring-mass spectrometry. A volumetric analysis of MRI was used to determine the cerebrovascular pathology (white-matter hyperintensities and small- and large-vessel infarcts). Multiple linear and logistic regression models were used to examine relations of plasma measures with cardiometabolic risk factors, history of cardiovascular disease, and radiologic evidence of cerebrovascular pathology.Results:Higher concentrations of plasma choline were associated with an unfavorable cardiometabolic risk-factor profile [lower high-density lipoprotein (HDL) cholesterol, higher total homocysteine, and higher body mass index (BMI)] and greater odds of large-vessel cerebral vascular disease or history of cardiovascular disease but lower odds of small-vessel cerebral vascular disease. Conversely, higher concentrations of plasma betaine were associated with a favorable cardiometabolic risk-factor profile [lower low-density lipoprotein (LDL) cholesterol and triglycerides] and lower odds of diabetes. Higher concentrations of plasma phosphatidylcholine were associated with characteristics of both a favorable cardiometabolic risk-factor profile (higher HDL cholesterol, lower BMI, lower C-reactive protein, lower waist circumference, and lower odds of hypertension and diabetes) and an unfavorable profile (higher LDL cholesterol and triglycerides).Conclusion:Choline and its metabolites have differential associations with cardiometabolic risk factors and subtypes of vascular disease, thereby suggesting differing roles in the pathogenesis of cardiovascular and cerebral large-vessel disease compared with that of small-vessel disease.
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
authors.forename: Annie J
authors.identifier: 0000-0001-5779-8488
authors.initials: AJ
authors.lastname: Roe
authors.affiliation: Nutrition Research Institute at the University of North Carolina Chapel Hill, Kannapolis, NC.
authors.forename: Shucha
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and.
authors.forename: Rafeeque A
authors.initials: RA
authors.lastname: Bhadelia
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Johnson
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
authors.forename: Alice H
authors.initials: AH
authors.lastname: Lichtenstein
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
authors.forename: Gail T
authors.initials: GT
authors.lastname: Rogers
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
authors.forename: Irwin H
authors.initials: IH
authors.lastname: Rosenberg
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
authors.forename: Caren E
authors.initials: CE
authors.lastname: Smith
authors.affiliation: Nutrition Research Institute at the University of North Carolina Chapel Hill, Kannapolis, NC.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Zeisel
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA; tammy.scott@tufts.edu.
authors.forename: Tammy M
authors.identifier: 0000-0002-5186-9430
authors.initials: TM
authors.lastname: Scott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001622:Betaine / Q000097:blood*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood*; D002561:Cerebrovascular Disorders / Q000097:blood* / Q000473:pathology; D002784:Cholesterol / Q000097:blood; D002794:Choline / Q000097:blood*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010713:Phosphatidylcholines / Q000097:blood*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D010713:Phosphatidylcholines; D014280:Triglycerides; D006710:Homocysteine; D001622:Betaine; D002097:C-Reactive Protein; D002784:Cholesterol; D002794:Choline
keywords: cardiometabolic risk; cerebrovascular disease; choline; magnetic resonance imaging; nutrition; older adults