Association of serum choline levels and all-cause mortality risk in adults with hypertension: a nested case-control study

Mengmeng Song; Benjamin P Xu; Qiongyue Liang; Yaping Wei; Yun Song; Ping Chen; Ziyi Zhou; Nan Zhang; Qiangqiang He; Lishun Liu; Tong Liu; Kangping Zhang; Chunlei Hu; Binyan Wang; Xiping Xu; Hanping Shi

doi:10.1186/s12986-021-00637-1

Association of serum choline levels and all-cause mortality risk in adults with hypertension: a nested case-control study

Nutr Metab (Lond). 2021 Dec 20;18(1):108. doi: 10.1186/s12986-021-00637-1.

Authors

Mengmeng Song^{1

2}, Benjamin P Xu³, Qiongyue Liang⁴, Yaping Wei⁵, Yun Song^{6

7}, Ping Chen⁸, Ziyi Zhou^{7

9}, Nan Zhang³, Qiangqiang He^{7

9}, Lishun Liu^{7

9}, Tong Liu^{1

2}, Kangping Zhang^{1

2}, Chunlei Hu^{1

2}, Binyan Wang^{6

7}, Xiping Xu¹⁰, Hanping Shi^{11

12}

Affiliations

¹ Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, China.
² Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.
³ Department of Epidemiology and Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, 02115, USA.
⁴ State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210009, China.
⁵ Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China.
⁶ Institute for Biomedicine, Anhui Medical University, Hefei, China.
⁷ Shenzhen Evergreen Medical Institute, Shenzhen, China.
⁸ College of Pharmacy, Jinan University, Guangzhou, China.
⁹ Graduate School at Shenzhen, Tsinghua University, Shenzhen, China.
¹⁰ Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, 100083, China. xipingxu126@126.com.
¹¹ Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, China. shihp@ccmu.edu.cn.
¹² Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China. shihp@ccmu.edu.cn.

Abstract

Background: Serum choline levels were associated with multiple chronic diseases. However, the association between serum choline and all-cause mortality in Chinese adults with hypertension remains unclear. The purpose of this study is to explore the association between serum choline concentrations and all-cause mortality risk in Chinese adults with hypertension, a high-risk population.

Methods: A nested, case-control study was conducted that included 279 patients with all-cause death, and 279 matched, living controls, derived from the China Stroke Primary Prevention Trial (CSPPT). Baseline serum choline concentrations were measured by liquid chromatography with tandem quadrupole mass spectrometry (LC-MS/MS). Multivariate logistic regression analysis was used to assess the association of serum choline levels and all-cause mortality risk, with adjustment of pertinent covariables, including folic acid and homocysteine.

Results: The median age of all participants was 64.13 years [interquartile range (IQR), 57.33-70.59 years]. The median serum choline concentration for cases (9.51 μg/mL) was higher than that in controls (7.80 μg/mL) (P = 0.009). When serum choline concentration was assessed as a continuous variable (per SD increased), there was a positive relation between serum choline levels and all-cause mortality risk [odds ratios (OR), 1.29; 95% confidence intervals (95%CI), 1.06-1.57; P = 0.010]. There was an increased all-cause mortality risk for participants in quartiles 2-4 (≥ 4.00 μg/mL; OR, 1.79; 95%CI, 1.15-2.78 compared with quartile 1 (< 4.00 μg/mL). In addition, non-drinking was found to promote the incidence of all-cause mortality for those with high choline concentrations.

Conclusions: High serum choline concentrations were associated with increased all-cause mortality risk among Chinese adults with hypertension, compared to lower choline concentrations. Trial registration clinicaltrials.gov Identifier: NCT007948885; UTL: https://clinicaltrials.gov/ct2/show/NCT00794885?term=NCT00794885&draw=2&rank=1.

Keywords: All-cause mortality; Hypertension; Nested case–control; Serum choline.

Associated data

ClinicalTrials.gov/NCT00794885

Abstract

Associated data

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