Choline and its metabolites are differently associated with cardiometabolic risk factors, history of cardiovascular disease, and MRI-documented cerebrovascular disease in older adults,

Roe, Annie; Zhang, Shucha; Bhadelia, Rafeeque A.; Johnson, Elizabeth J.; Lichtenstein, Alice H.; Rogers, Gail; Rosenberg, Irwin H.; Smith, Caren E.; Zeisel, Steven H.; Scott, Tammy

doi:10.3945/ajcn.116.137158

Cited by 58 publications

(44 citation statements)

References 43 publications

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“…In the same study, higher plasma phosphatidylcholine was associated with characteristics of both favorable (higher high‐density lipoprotein cholesterol and lower body mass index) and unfavorable (higher low‐density lipoprotein cholesterol and triglycerides) cardiometabolic risk. These findings suggest divergent roles of choline metabolites in the pathogenesis of cardiometabolic risk factors and cerebrovascular disease . Similarly, in our study, we have observed that baseline choline concentrations are marginally associated with the prevalence of being overweight and obesity (odds ratios [95% CIs] per 1‐SD increase, 1.13 [1.00–1.29] and 1.15 [1.00–1.34], respectively).…”

Section: Discussionsupporting

confidence: 81%

“…These findings suggest divergent roles of choline metabolites in the pathogenesis of cardiometabolic risk factors and cerebrovascular disease. 31 Altogether, these findings suggested a relationship between these metabolites and cardiovascular risk factors. The associations between dietary choline and betaine on the risk of CVD have been evaluated in several prospective studies.…”

Section: Discussionmentioning

confidence: 90%

“…Interestingly, in a cross‐sectional subset of the Nutrition, Aging and Memory in Elders cohort, higher plasma choline concentrations were associated with an unfavorable cardiometabolic risk factor profile (lower high‐density lipoprotein cholesterol and higher body mass index). They were also associated with greater odds of large‐vessel cerebral vascular disease and history of CVD but lower odds of small‐vessel cerebral vascular disease.…”

Section: Discussionmentioning

confidence: 99%

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Plasma Metabolites From Choline Pathway and Risk of Cardiovascular Disease in the PREDIMED (Prevention With Mediterranean Diet) Study

Guasch‐Ferré

Ruíz-Canela

et al. 2017

JAHA

117

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BackgroundThe relationship between plasma concentrations of betaine and choline metabolism and major cardiovascular disease (CVD) end points remains unclear. We have evaluated the association between metabolites from the choline pathway and risk of incident CVD and the potential modifying effect of Mediterranean diet interventions.Methods and ResultsWe designed a case‐cohort study nested within the PREDIMED (Prevention With Mediterranean Diet) trial, including 229 incident CVD cases and 751 randomly selected participants at baseline, followed up for 4.8 years. We used liquid chromatography–tandem mass spectrometry to measure, at baseline and at 1 year of follow‐up, plasma concentrations of 5 metabolites in the choline pathway: trimethylamine N‐oxide, betaine, choline, phosphocholine, and α‐glycerophosphocholine. We have calculated a choline metabolite score using a weighted sum of these 5 metabolites. We used weighted Cox regression models to estimate CVD risk. The multivariable hazard ratios (95% confidence intervals) per 1‐SD increase in choline and α‐glycerophosphocholine metabolites were 1.24 (1.05–1.46) and 1.24 (1.03–1.50), respectively. The baseline betaine/choline ratio was inversely associated with CVD. The baseline choline metabolite score was associated with a 2.21‐fold higher risk of CVD across extreme quartiles (95% confidence interval, 1.36–3.59; P<0.001 for trend) and a 2.27‐fold higher risk of stroke (95% confidence interval, 1.24–4.16; P<0.001 for trend). Participants in the higher quartiles of the score who were randomly assigned to the control group had a higher risk of CVD compared with participants in the lower quartile and assigned to the Mediterranean diet groups (P=0.05 for interaction). No significant associations were observed for 1‐year changes in individual plasma metabolites and CVD.ConclusionsA metabolite score combining plasma metabolites from the choline pathway was associated with an increased risk of CVD in a Mediterranean population at high cardiovascular risk.Clinical Trial Registration URL: http://www.controlled-trials.com. Unique identifier: ISRCTN35739639.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Plasma Metabolites From Choline Pathway and Risk of Cardiovascular Disease in the PREDIMED (Prevention With Mediterranean Diet) Study

Guasch‐Ferré

Ruíz-Canela

et al. 2017

JAHA

117

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“…SN-glycero-3-9 Journal of Pregnancy phosphocholine is a phospholipid that serves a precursor to choline biosynthesis and an intermediate in the metabolism of phosphatidylcholine. Choline metabolites have been associated with unfavorable cardiometabolic risk factors, while phosphatidylcholine has been associated with a lower odds of hypertension [64]. L-Kynurenine is a metabolite derived from the amino acid L-tryptophan and used in the production of niacin.…”

Section: Discussionmentioning

confidence: 99%

Early Pregnancy Serum Metabolite Profiles Associated with Hypertensive Disorders of Pregnancy in African American Women: A Pilot Study

Ferranti

Frediani

Mitchell

et al. 2020

Journal of Pregnancy

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Hypertensive disorders of pregnancy (HDP) are the most common cardiometabolic complications of pregnancy, affecting nearly 10% of US pregnancies and contributing substantially to maternal and infant morbidity and mortality. In the US, women of African American race are at increased risk for HDP. Early biomarkers that reliably identify women at risk for HDP remain elusive, yet are essential for the early identification and targeting of interventions to improve maternal and infant outcomes. We employed high-resolution metabolomics (HRM) to identify metabolites and metabolic pathways that were altered in early (8-14 weeks) gestation serum samples of pregnant African American women who developed HDP after 20 weeks’ gestation (n=20)—either preeclampsia (PE; n=11) or gestational hypertension (gHTN; n=9)—compared to those who delivered full term without complications (n=80). We found four metabolic pathways that were significantly (p<0.05) altered in women who developed PE and five pathways that were significantly (p<0.05) altered in women who developed gHTN compared to women who delivered full term without complications. We also found that four specific metabolites (p<0.05) were distinctly upregulated (retinoate, kynurenine) or downregulated (SN-glycero-3-phosphocholine, 2′4′-dihydroxyacetophenone) in women who developed PE compared to gHTN. These findings support that there are systemic metabolic disruptions that are detectable in early pregnancy (8-14 weeks of gestation) among pregnant African American women who develop PE and gHTN. Furthermore, the early pregnancy metabolic disruptions associated with PE and gHTN are distinct, implying they are unique entities rather than conditions along a spectrum of the same disease process despite the common clinical feature of high blood pressure.

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“…As one grows older, the risk suffering from diabetes, 14 hypertension, 15 cardiovascular, and cerebrovascular diseases increased. 16 These diseases are also significant risks of cardiac arrest. 17 Cardiac etiology was the most common reason for cardiac arrest, about 50% to 60% of which is induced by heart-related diseases, such as myocardial infarction, arrhythmia, or cardiac failure, and so forth.…”

Section: Verification Of Prediction Modelmentioning

confidence: 99%

Development a clinical prediction model of the neurological outcome for patients with coma and survived 24 hours after cardiopulmonary resuscitation

Wang

Tang

Zhang

et al. 2020

Clinical Cardiology

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Background Cardiac arrest is still a global public health problem at present. The neurological outcome is the core indicator of the prognosis of cardiac arrest. However, there is no effective means or tools to predict the neurological outcome of patients with coma and survived 24 hours after successful cardiopulmonary resuscitation (CPR). Hypothesis Therefore, we expect to construct a prediction model to predict the neurological outcome for patients with coma and survived 24 hours after successful CPR. Methods A retrospective cohort study was used to construct a prediction model of the neurological function for patients with coma and survived 24 hours after successful CPR. From January 2007 to December 2015, a total of 262 patients met the inclusion and exclusion criteria. Results The predictive model was developed using preselected variables by a systematic review of the literature. Finally, we get five sets of models (three sets of construction models and two sets of internal verification models) which with similar predictive value. The stepwise model, which including seven variables (age, noncardiac etiology, nonshockable rhythm, bystander CPR, total epinephrine dose, APTT, and SOFA score), was the simplest model, so we choose it as our final predictive model. The area under the ROC curve (AUC), specificity, and sensitivity of the stepwise model were respectively 0.82 (0.77, 0.87), 0.72and 0.82. The AUC, specificity, and sensitivity of the bootstrap stepwise (BS stepwise) model were respectively 0.82 (0.77, 0.87), 0.71, and 0.82. Conclusion This new and validated predictive model may provide individualized estimates of neurological function for patients with coma and survived 24 hours after successful CPR using readily obtained clinical risk factors. External validation studies are required further to demonstrate the model's accuracy in diverse patient populations.

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Choline and its metabolites are differently associated with cardiometabolic risk factors, history of cardiovascular disease, and MRI-documented cerebrovascular disease in older adults,

Cited by 58 publications

References 43 publications

Plasma Metabolites From Choline Pathway and Risk of Cardiovascular Disease in the PREDIMED (Prevention With Mediterranean Diet) Study

Plasma Metabolites From Choline Pathway and Risk of Cardiovascular Disease in the PREDIMED (Prevention With Mediterranean Diet) Study

Early Pregnancy Serum Metabolite Profiles Associated with Hypertensive Disorders of Pregnancy in African American Women: A Pilot Study

Development a clinical prediction model of the neurological outcome for patients with coma and survived 24 hours after cardiopulmonary resuscitation

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