Association of Serum Choline and Its Metabolites with Infant’s Growth and Neurodevelopment from Birth to 12 Months

Background : Choline is an essential nutrient that plays crucial roles in cell structure maintenance, neurotransmission, and betaine synthesis. Trimethylamine N-oxide (TMAO) is biosynthesized from choline through metabolic processes mediated by gut microbiota and the liver. However, the relationships among serum choline, its metabolites, and early neurodevelopmental and growth remain unclear. Methods : This retrospective study enrolled 109 outpatients aged 0–12 months who underwent neurodevelopmental assessments using the China Developmental Scale for Children at the Guangzhou Women and Children’s Medical Center from January 2018 to September 2019. Residual blood specimens obtained post-clinical testing were collected for subsequent analysis. To mitigate temporal bias, both neurodevelopmental assessment and blood sampling were conducted within a 30-day window for each participant. High-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) was employed to measure the serum concentrations of choline, betaine, and TMAO. Anthropometric parameters, including weight, length, and head circumference, were recorded at birth and 1, 3, 6, 8, and 12 months of age. Results : Serum choline levels were significantly associated with enhanced neurodevelopment in 6- to 12-month-old infants. Conversely, serum betaine concentrations exhibited a negative correlation with the full-scale developmental quotient and language quotient in infants aged 91 to 180 days. Serum TMAO showed no significant associations with most indices of infant neurodevelopment. Additionally, no statistically significant correlations were observed between serum choline or its metabolites and infant growth parameters from 0 to 12 months. Conclusions : Our study identified specific associations between choline concentration and neurodevelopment in 6- to 12-month-old infants, suggesting that choline status may be a pivotal determinant of neurodevelopment during early infancy.