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.
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| 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