Different concentrations of choline and related compounds in the blood affect the risk of cardiovascular disease and small- and large-vessel disease in the brain.
Choline plays a role in cardiovascular and brain health and is found in a variety of foods including eggs, cruciferous vegetables, and milk. An essential nutrient, choline is important for cell structure and signaling and is a precursor to the neurotransmitter, acetylcholine. Researchers have long thought that choline, along with its related compounds, betaine, and phosphatidylcholine, plays a role in cardiovascular health.
A study by Roe et al. published in the American Journal of Clinical Nutrition examined the associations of plasma choline and choline-related compounds with cardiovascular and cerebrovascular disease risk factors. The study analyzed plasma samples, MRI images, and health and behavior information previously collected as part of the NAME (Nutrition, Aging, and Memory in Elders) study conducted by Tufts Medical Center (Boston, Massachusetts). Fasting plasma samples were assayed for free choline, betaine, and phosphatidylcholine. Plasma HDL- and LDL-cholesterol, triglyceride, glucose, folate, and vitamin B6 and B12 concentrations were also measured. Information regarding diabetes status, blood pressure, body mass index (BMI), and incidence of cardiovascular disease was gathered from patient medical histories. Cranial MRI images were analyzed for signs of vascular disease. White-matter hyperintensities and brain infarcts (indicators of vascular disease) were measured to quantify cardiovascular disease.
A total of 296 subjects were included in the study. The mean age of participants was 73 ± 8.1 years, and 73% were women. Many subjects had high blood pressure (84%) and the mean BMI was in the obese range (30.7 ± 7.7). Higher plasma choline concentrations were linked with a poor cardiometabolic risk-factor profile (lower HDL-cholesterol, higher BMI) and a greater risk of large-vessel cerebral vascular disease. While these subjects were more likely to have had a history of cardiovascular disease, they also had a lower risk of small vessel cerebral vascular disease. On the other hand, higher plasma betaine concentrations were linked with an advantageous cardiometabolic risk-factor profile (lower LDL-cholesterol and triglycerides) and a lower risk of diabetes. Subjects with higher plasma phosphatidylcholine concentrations had aspects of both good (higher HDL-cholesterol, lower BMI, lower risk of high blood pressure and diabetes) and bad (higher LDL-cholesterol and triglycerides) cardiometabolic risk-factor profiles.
In conclusion, choline and its metabolites are differentially associated with cardiometabolic risk factors and incidence of small- versus large-vessel disease. Overall, the findings of this study are generally consistent with those of previous studies and highlight need for additional research on the relationships of choline to cardio- and cerebrovascular disease.
Written By: Cindi A. Hoover, Ph.D