AUTHOR=Ge Peicong , Zhao Yaobo , Zhai Yuanren , Zhang Qian , Ye Xun , Wang Jia , Wang Rong , Zhang Yan , Zhang Dong , Zhao Jizong 

TITLE=Circulating choline pathway nutrients and risk of moyamoya disease

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.953426

DOI=10.3389/fnut.2022.953426

ISSN=2296-861X

ABSTRACT=Background: Circulating choline pathway nutrients play a critical role in first stroke and recurrent stroke. However, there is limited information available on the effects of choline pathway nutrients on risk of moyamoya disease (MMD) and its subtypes. We investigated the association between circulating choline, and betaine and the incident risk of MMD and its subtypes.
Methods: The case-control study enrolled 385 patients with MMD (including 110 TIA-type MMD, 157 infarction-type MMD, and 118 hemorrhagic-type MMD) and 89 matched healthy controls. Choline-related biomarkers were evaluated for reclassification and calibration of models.
Results: Serum choline and betaine were inversely related to the risk of MMD and its subtypes. The risk of MMD decreased with each increment in choline level (per 1 μmol increase: OR, 0.756; 95% CI, 0.678-0.843) and betaine level (per 1 μmol increase: OR, 0.952; 95% CI, 0.932–0.972), respectively. When choline and betaine was assessed as quartiles, compared with the lowest quartile of serum choline and betaine levels, those in the highest quartile had a significantly decreased risk of MMD (choline, Q4 versus Q1: OR, 0.023; 95% CI, 0.005-0.118)	; betaine, Q4 versus Q1: OR, 0.058; 95% CI, 0.018–0.184). In addition, both choline and betaine offered substantial risk discrimination and reclassification improvement for MMD and its subtypes beyond traditional risk factors.
Conclusions: Serum choline and betaine were associated with the decreased risk of MMD and its subtypes. Choline and betaine supplementation might facilitate the treatment of MMD.