Abstract 15588: Dietary Choline and Betaine Intakes are Associated with Incident Cardiovascular Disease Events and Left Ventricular Mass: The Jackson Heart Study

Abstract

Introduction: Acute choline deficiency in rodent models causes lipid accumulation in liver, heart and arterial tissues. Alternatively, some studies reported an association between increased blood concentrations of total choline and cardiovascular disease. Several mechanisms have been described through which dietary intake of choline and its derivative betaine may be associated with subclinical atherosclerosis. Thus, we assessed the association between these two essential nutrients and cardiovascular risk. Methods: We analyzed data on food frequency questionnaire and baseline visit measurements on 3,924 Jackson Heart Study African American participants. Multivariable linear regression models were used to assess the association between choline and betaine intake with carotid intima-media thickness, coronary artery calcium, abdominal aortic calcium, and left ventricular mass. Cox proportional hazards regression models were used to calculate associations between choline and betaine intake with time to incident coronary heart disease (CHD) and stroke. Results: During an average seven years of follow-up, 129 incident CHD events and 100 incident stroke events were documented. Greater choline intake was associated with lower left ventricular mass (p = 0.0006 for trend across the choline quartiles, in women). After adjusting for cardiovascular disease risk factors including age, BMI, smoking, systolic blood pressure, fasting plasma glucose, plasma creatinine, cholesterol fractions, plasma homocysteine and dietary variables (intake of total energy, alcohol, folate, methionine, vitamins B6 and B12), choline intake appeared to be protective against incident stroke in men, HR = 0.19 (0.04, 0.82), when comparing the third quartile of intake to the lowest quartile of intake. In women, unexpectedly, participants in the third quartile of betaine intake showed an increased risk of incident CHD, relative to the lowest quartile, HR = 2.06 (1.02, 4.18). Conclusion: Higher dietary choline intake was associated with decreased left ventricular mass in both men and women, and appeared to be protective against incident stroke among men. The observation of greater risk of incident CHD with higher betaine intake among women requires further investigation.