Abstract
PurposeTo investigate associations of total dietary choline intake and its major dietary form, phosphatidylcholine, with type 2 diabetes risk.MethodsWe included 2332 men aged 42–60 years at baseline in 1984–1989 from the Kuopio Ischaemic Heart Disease Risk Factor Study in eastern Finland. Dietary intakes were assessed with 4-d food recording at baseline. Type 2 diabetes diagnosis was based on self-administered questionnaires, fasting and 2-h oral glucose tolerance test blood glucose measurements, or by record linkage to national health registries. Multivariable-adjusted Cox proportional hazards regression models were used for statistical analysis.ResultsDuring the mean 19.3-year follow-up, 432 men had type 2 diabetes diagnosis. After multivariable adjustments, those in the highest vs. lowest choline intake quartile had 25% (95% CI 2–43%) lower relative risk (P trend across quartiles = 0.02) and those in the highest vs. lowest phosphatidylcholine quartile had 41% (95% CI 22–55%) lower relative risk (P trend < 0.001) of type 2 diabetes.ConclusionsHigher choline intake, especially phosphatidylcholine, was associated with lower type 2 diabetes risk among men.
Highlights
Choline is an essential nutrient for humans [1]
Because of the conflicting and scarce evidence of the role of choline in the development of type 2 diabetes (T2D), we investigated the associations of intake of choline and phosphatidylcholine with risk of incident T2D among middle-aged men from eastern Finland
The main finding of this prospective cohort study among middle-aged and older eastern Finnish men was that choline and phosphatidylcholine intakes were associated with a lower risk of developing T2D during the 19-year follow-up
Summary
Choline is an essential nutrient for humans [1]. In diet, it exists as free choline and as choline esters, of which phosphatidylcholine is the major dietary source of choline. Because choline is a major precursor for TMAO, high choline intake could have an adverse impact on T2D risk. In one cross-sectional study, a higher dietary choline intake was associated with lower insulin resistance [4]. An opposite finding was obtained from a large prospective study, which found a higher risk of incident T2D with a higher dietary phosphatidylcholine intake [5]. Because of the conflicting and scarce evidence of the role of choline in the development of T2D, we investigated the associations of intake of choline and phosphatidylcholine with risk of incident T2D among middle-aged men from eastern Finland
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