Circulating choline pathway nutrients and depression after ischemic stroke
Circulating choline pathway nutrients and depression after ischemic stroke
复制标题
循环胆碱途径营养素与缺血性中风后的抑郁
DOI：
10.1111/ene.15133
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发表时间：
2021-10-17
影响因子：
5.1
通讯作者：
Zhong, Chongke
中科院分区：
文献类型：
--
作者：
Miao, Mengyuan;Du, Jigang;Zhong, Chongke
背景与目的胆碱途径营养素包括胆碱和甜菜碱，据报道具有抗抑郁作用。然而，很少有基于人群的证据循环胆碱和甜菜碱和卒中后抑郁症（PSD）之间的关系。我们的目的是前瞻性地探讨血浆胆碱和甜菜碱与缺血性卒中后抑郁的关系。方法本研究基于中国急性缺血性脑卒中降压试验。共有612名血浆胆碱和甜菜碱浓度的参与者被纳入分析。研究结果为缺血性卒中后3个月出现抑郁。采用逻辑回归模型估计血浆胆碱和甜菜碱与PSD风险之间的关系。分析了胆碱或甜菜碱模型的风险重分类和校正。结果脑卒中后抑郁患者血清胆碱和甜菜碱水平明显低于无脑卒中后抑郁患者（P < 0.05）。与三分位数1相比，胆碱和甜菜碱的三分位数3的多变量校正比值比（95%CI）分别为0.54（0.35-0.83）和0.59（0.38-0.92）。胆碱或甜菜碱每增加1 SD，PSD风险分别降低25%（95% CI 9%-37%）或19%（95% CI 3%-32%）。此外，在已建立的风险因素模型中添加胆碱或甜菜碱改善了PSD的风险重新分类，如净重新分类指数增加和综合辨别力改善所示（所有p < 0.05）。结论胆碱和甜菜碱水平升高的患者发生抑郁的风险较低，提示胆碱途径营养素对PSD具有保护意义。
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.