Choline and Betaine Reduce Cardiovascular Events Following Ischemic Stroke

According to a recent study, plasma choline pathway metabolites, such as choline and betaine, appear to reduce the risk of cardiovascular events and recurrent stroke in patients with ischemic stroke, as well as providing incremental value in risk differentiation and stratification.

Choline and Betaine Reduce Cardiovascular Events Following Ischemic Stroke
Photo: Choline and Betaine Food Source | InStyleHealth


Within the China Antihypertensive Trial in Acute Ischemic Stroke, a team of researchers conducted a nested case-control study that included 323 cardiovascular events (with 264 recurrent strokes) and 323 controls (free of recurrent cardiovascular events) who were matched for age, sex, and treatment group. The primary endpoint was a composite of cardiovascular events following an ischemic stroke.

The researchers used ultra-high-performance liquid chromatography mass spectrometry to analyze plasma choline and betaine at baseline. They next used choline pathway metabolites to test discrimination, reclassification, and calibration of conditional logistic regression models.

Following an ischemic stroke, plasma choline and betaine were found to be inversely associated to cardiovascular events and recurrent stroke. Each additional standard deviation of choline and betaine was associated with 35% (95 percent confidence interval [CI], 20–48) and 30% (95 percent CI, 14–43) lower risks of subsequent cardiovascular events, respectively, and 34% (95 percent CI, 16–48) and 29% (95 percent CI, 12–43) lower risks of recurrent stroke, respectively, in fully adjusted models.

Beyond established risk variables, choline and betaine improved risk discrimination and reclassification for cardiovascular events and recurrent stroke, as evidenced by an increase in C statistics, the net reclassification index, and integrated discrimination improvement.

According to the researchers, “choline and betaine have been reported to play a critical role in neurotransmitter synthesis, cell membrane integrity, and methyl-group metabolism, exhibiting neuroprotective effects in patients with diverse neurological disorders.”


Source: Am J Clin Nutr 2021;114:1351-1359

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