期刊
EUROPEAN JOURNAL OF NEUROLOGY
卷 29, 期 2, 页码 459-468出版社
WILEY
DOI: 10.1111/ene.15133
关键词
betaine; choline; ischemic stroke; poststroke depression
资金
- National Natural Science Foundation of China [81903387]
- Natural Science Foundation of Jiangsu Province [BK20190818]
- Suzhou Science and Technology Project [SYS2019023]
- Discipline Construction Program of the Second Affiliated Hospital of Soochow University [XKTJ-TD202004]
- Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions, China
This study found that poststroke depression patients had lower levels of choline and betaine compared to those without depression. Adjusted odds ratios for the highest tertile of choline and betaine were significantly lower, and each 1 SD increase in choline or betaine was associated with a decreased risk of PSD. The addition of choline or betaine to the risk factors model improved risk reclassification for PSD.
Background and purpose Choline pathway nutrients, including choline and betaine, are reported to exert antidepressant effects. However, there is little population-based evidence on the relationships between circulating choline and betaine and poststroke depression (PSD). We aimed to prospectively explore the associations between plasma choline and betaine and depression after ischemic stroke. Methods This study was based on the China Antihypertensive Trial in Acute Ischemic Stroke. A total of 612 participants with plasma choline and betaine concentrations were included in the analysis. The study outcome was depression 3 months after ischemic stroke. Logistic regression models were performed to estimate the relationships between plasma choline and betaine and the risk of PSD. Risk reclassification and calibration of models with choline or betaine were analyzed. Results Patients with PSD had lower choline and betaine levels than those without PSD (p < 0.05). Compared with tertile 1, the multivariable-adjusted odds ratios (95% CIs) for tertile 3 of choline and betaine were 0.54 (0.35-0.83) and 0.59 (0.38-0.92), respectively. Per 1 SD increase in choline or betaine was associated with a 25% (95% CI 9%-37%) or an 19% (95% CI 3%-32%) decreased risk of PSD, respectively. Furthermore, the addition of choline or betaine to the established risk factors model improved the risk reclassification for PSD, as shown by an increase in the net reclassification index and integrated discrimination improvement (all p < 0.05). Conclusions Patients with elevated levels of choline and betaine had a lower risk of depression after acute ischemic stroke, suggesting the protective significance of choline pathway nutrients for PSD.
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