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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #333754
Title: The association of serum choline with linear growth failure in young children from rural Malawi

Author
item SEMBA, RICHARD - JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
item ZHANG, PINGBO - JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
item GONZALEZ-FREIRE, MARTA - NATIONAL INSTITUTE ON AGING (NIA, NIH)
item MOADDEL, RUIN - NATIONAL INSTITUTE ON AGING (NIA, NIH)
item TREHAN, INDI - WASHINGTON UNIVERSITY
item MALETA, KENNETH - UNIVERSITY OF MALAWI
item ORDIZ, M - WASHINGTON UNIVERSITY
item FERRUCCI, LUIGI - NATIONAL INSTITUTE ON AGING (NIA, NIH)
item MANARY, MARK - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/4/2016
Publication Date: 6/8/2016
Citation: Semba, R.D., Zhang, P., Gonzalez-Freire, M., Moaddel, R., Trehan, I., Maleta, K.M., Ordiz, M.I., Ferrucci, L., Manary, M.J. 2016. The association of serum choline with linear growth failure in young children from rural Malawi. American Journal of Clinical Nutrition. 104(1):191-197.

Interpretive Summary: Stunting, or reduced linear growth, is the single largest factor in childhood morbidity worldwide. Choline is a vitamin used to make the membranes of cells. This study found that blood levels of choline were lower in children with poorer growth. This suggests more choline in the diet might be needed in such children.

Technical Abstract: 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. 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. 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. 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) micromol/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) umol/L (P < 0.0001). 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.