The Interplay Between Dietary Choline and Cardiometabolic Disorders: A Review of Current Evidence.

Sotiria Psallida, Theodora Stratigou, Eleni Geladari, Natalia G Vallianou, Dimitris Kounatidis, Irene Karampela, Maria Dalamaga, Fotis Panagopoulos, Dimitrios Tsilingiris

Journal: Current nutrition reports 2024;13(2):152-165

PMID: 38427291

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Abstract

PURPOSE OF REVIEW

Choline is an essential nutrient for human health and cellular homeostasis as it is necessary for the synthesis of lipid cell membranes, lipoproteins, and the synthesis of the neurotransmitter acetylcholine. The aim of this review is to analyze the beneficial effects of choline and its significance in cellular metabolism and various inflammatory pathways, such as the inflammasome. We will discuss the significance of dietary choline in cardiometabolic disorders, such as non-alcoholic fatty liver disease (NAFLD), cardiovascular disease (CVD), and chronic kidney disease (CKD) as well as in cognitive function and associated neuropsychiatric disorders.

RECENT FINDINGS

Choline deficiency has been related to the development of NAFLD and cognitive disability in the offspring as well as in adulthood. In sharp contrast, excess dietary intake of choline mediated via the increased production of trimethylamine by the gut microbiota and increased trimethylamine-N-oxide (TMAO) levels has been related to atherosclerosis in most studies. In this context, CVD and CKD through the accumulation of TMAO, p-Cresyl-sulfate (pCS), and indoxyl-sulfate (IS) in serum may be the result of the interplay between excess dietary choline, the increased production of TMAO by the gut microbiota, and the resulting activation of inflammatory responses and fibrosis. A balanced diet, with no excess nor any deficiency in dietary choline, is of outmost importance regarding the prevention of cardiometabolic disorders as well as cognitive function. Large-scale studies with the use of next-generation probiotics, especially Akkermansia muciniphila and Faecalibacterium prausnitzii, should further examine their therapeutic potential in this context.

Address: Department of Internal Medicine, Evangelismos General Hospital, 45-47 Ipsilantou str, Athens, Greece. [email protected].; Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str, Athens, Greece. [email protected].; Department of Internal Medicine, Hippokration General Hospital, 114 Vassilissis Sofias str, Athens, Greece.; Department of Microbiology, KAT General Hospital of Attica, 2 Nikis str, Athens, Greece.; Department of Internal Medicine, Evangelismos General Hospital, 45-47 Ipsilantou str, Athens, Greece.; Department of Endocrinology and Metabolism, Evangelismos General Hospital, 45-47 Ipsilantou str, Athens, Greece.; 2nd Department of Critical Care, Medical School, University of Athens, Attikon General University Hospital, 1 Rimini str, Athens, Greece.; First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68100, Alexandroupoli, Greece.; Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str, Athens, Greece. [email protected].

DOI: 10.1007/s13668-024-00521-3

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https://medlineplus.gov/chronickidneydisease.html

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https://antibodies.cancer.gov/detail/CPTC-BRIP1-5

MeSH Terms: Humans, Choline, Cardiovascular Diseases, Gastrointestinal Microbiome, Renal Insufficiency, Chronic, Diet, Non-alcoholic Fatty Liver Disease, Choline Deficiency, Methylamines