The Association of Serum Choline with Linear Growth Failure in Young Children from Rural Malawi

Overview

Journal Am J Clin Nutr

Publisher Elsevier

Specialty Nutritional Sciences

Date 2016 Jun 10

PMID 27281303

Citations 19

Authors

Richard D Semba

Pingbo Zhang

Marta Gonzalez-Freire

Ruin Moaddel

Indi Trehan

Kenneth M Maleta

M Isabel Ordiz

Luigi Ferrucci

Mark J Manary

Affiliations

Soon will be listed here.

Abstract

Background: Choline is an essential nutrient for cell structure, cell signaling, neurotransmission, lipid transport, and bone formation. Choline can be irreversibly converted to betaine, a major source of methyl groups. Trimethylene N-oxide (TMAO), a proatherogenic molecule, is produced from the metabolism of dietary choline by the gut microbiome. The relation between serum choline and its closely related metabolites with linear growth in children is unknown.

Objective: The aim was to characterize the relation between serum choline and its closely related metabolites, betaine and TMAO, with linear growth and stunting in young children.

Design: We measured serum choline, betaine, and TMAO concentrations by using liquid chromatography isotopic dilution tandem mass spectrometry in a cross-sectional study in 325 Malawian children, aged 12-59 mo, of whom 62% were stunted.

Results: Median (25th, 75th percentile) serum choline, betaine, and TMAO concentrations were 6.4 (4.8, 8.3), 12.4 (9.1, 16.3), and 1.2 (0.7, 1.8) μmol/L, respectively. Spearman correlation coefficients of age with serum choline, betaine, and TMAO were -0.57 (P < 0.0001), -0.26 (P < 0.0001), and -0.10 (P = 0.07), respectively. Correlation coefficients of height-for-age z score with serum choline, betaine-to-choline ratio, and TMAO-to-choline ratio were 0.31 (P < 0.0001), -0.24 (P < 0.0001), and -0.29 (P < 0.0001), respectively. Serum choline concentrations were strongly and significantly associated with stunting. Children with and without stunting had median (25th, 75th percentile) serum choline concentrations of 5.6 (4.4, 7.4) and 7.3 (5.9, 9.1) μmol/L (P < 0.0001).

Conclusions: Linear growth failure in young children is associated with low serum choline and elevated betaine-to-choline and TMAO-to-choline ratios. Further work is needed to understand whether low dietary choline intake explains low circulating choline among stunted children living in low-income countries and whether increasing choline intake may correct choline deficiency and improve growth and development. This trial was registered in the ISRCTN registry (www.isrctn.com) as ISRCTN14597012.

Citing Articles

Gut microbiota and childhood malnutrition: Understanding the link and exploring therapeutic interventions.

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PMID: 38708416 PMC: 11065333. DOI: 10.1002/elsc.202300070.

Choline, DHA, and Diarrheal Disease Associated with Growth Faltering in a Case-Control Study.

Diaz J, Dulience S, Wolthausen N, Jiang X, Gyimah E, Pierre F Curr Dev Nutr. 2022; 6(10):nzac140.

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Plasma lipids and growth faltering: A longitudinal cohort study in rural Gambian children.

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Choline and docosahexaenoic acid during the first 1000 days and children's health and development in low- and middle-income countries.

Bragg M, Prado E, Stewart C Nutr Rev. 2021; 80(4):656-676.

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Modifying gut integrity and microbiome in children with severe acute malnutrition using legume-based feeds (MIMBLE): A pilot trial.

Calder N, Walsh K, Olupot-Olupot P, Ssenyondo T, Muhindo R, Mpoya A Cell Rep Med. 2021; 2(5):100280.

PMID: 34095882 PMC: 8149470. DOI: 10.1016/j.xcrm.2021.100280.

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