Circulating choline pathway nutrients and depression after ischemic stroke

Abstract

Background and purpose Choline pathway nutrients, including choline and betaine, are reported to exert antidepressant effects. However, there is little population‐based evidence on the relationships between circulating choline and betaine and poststroke depression (PSD). We aimed to prospectively explore the associations between plasma choline and betaine and depression after ischemic stroke. Methods This study was based on the China Antihypertensive Trial in Acute Ischemic Stroke. A total of 612 participants with plasma choline and betaine concentrations were included in the analysis. The study outcome was depression 3 months after ischemic stroke. Logistic regression models were performed to estimate the relationships between plasma choline and betaine and the risk of PSD. Risk reclassification and calibration of models with choline or betaine were analyzed. Results Patients with PSD had lower choline and betaine levels than those without PSD (p < 0.05). Compared with tertile 1, the multivariable‐adjusted odds ratios (95% CIs) for tertile 3 of choline and betaine were 0.54 (0.35–0.83) and 0.59 (0.38–0.92), respectively. Per 1 SD increase in choline or betaine was associated with a 25% (95% CI 9%–37%) or an 19% (95% CI 3%–32%) decreased risk of PSD, respectively. Furthermore, the addition of choline or betaine to the established risk factors model improved the risk reclassification for PSD, as shown by an increase in the net reclassification index and integrated discrimination improvement (all p < 0.05). Conclusions Patients with elevated levels of choline and betaine had a lower risk of depression after acute ischemic stroke, suggesting the protective significance of choline pathway nutrients for PSD.

Metabolite Biomarkers of Prolonged and Intensified Pain and Distress in Head and Neck Cancer Patients Undergoing Radio- or Chemoradiotherapy by Means of NMR-Based Metabolomics—A Preliminary Study

“…The betaine levels, along with those of choline, are reported to be higher in patients with chronic depression than in those with episodic major depressive disorder, although these differences were found to disappear after correction for multiple testing [ 75 ]. It is in line with the observation by Miao et al [ 83 ], who found that in patients with post-stroke depression (PSD), the betaine and choline levels were higher than in those without PSD. However, as revealed by the results of the large population–based study by Bjelland et al [ 84 ], choline concentrations in the blood were negatively associated with anxiety symptoms, but no significant associations were found in the case of depression.…”

Neurobehavioral and biochemical effects of choline chloride administration in rats

“…15 It was studied that low concentration of choline may cause anxiety but not depression-like symptoms. 18 It was also reported that over-supplementation of choline caused depression-like symptoms but not in normal doses. 16 Number of epidemiological studies demonstrated previously that the onset of diabetes or increasing glucose level may cause the depression-like symptoms.…”