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已发表论文
胆碱摄入量与盆腔炎性疾病风险：基于 2013 - 2018 年美国国家健康与营养调查的横断面研究
Received 3 July 2025
Accepted for publication 26 September 2025
Published 6 October 2025 Volume 2025:17 Pages 3499—3509
DOI https://doi.org/10.2147/IJWH.S551450
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Matteo Frigerio
Hongyu Jin,1 Zhaoyuan Niu,2 Xinyue Zhao1
1Department of Gynecology, Qingdao University Hospital, Qingdao University School of Medicine, Qingdao, People’s Republic of China; 2Department of Gynecology, Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
Correspondence: Zhaoyuan Niu, Email niuzhaoyuan@126.com
Background and Aim: Pelvic inflammatory disease (PID), a chronic infection of the female upper genital tract, is a leading cause of morbidity in reproductive-aged women, often resulting in chronic pelvic pain, tubal infertility, and ectopic pregnancy. Choline, an essential nutrient, plays a critical role in various metabolic processes and is known to modulate inflammatory pathways. However, the potential link between dietary choline intake and PID remains largely unexplored. This study aimed to investigate the relationship between dietary choline consumption and PID prevalence.
Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2013– 2018. A total of 3204 women were included in the analysis. The association between choline intake and PID was assessed using multivariable logistic regression and smooth curve fitting. Subgroup analyses were performed to explore potential effect modifiers, and threshold effect analysis was used to identify inflection points in the relationship.
Results: Among the 3204 women studied, 208 had PID. In fully adjusted models, higher choline intake was significantly associated with a reduced risk of PID (OR = 0.20, 95% CI: 0.04– 0.92, p = 0.038). Compared to women in the lowest quintile of choline intake, those in the highest quintile had a 45% lower risk of PID (OR = 0.55, 95% CI: 0.30– 0.98, p = 0.044). Smooth curve fitting demonstrated a nonlinear association, with an inflection point at 0.41 g/day overall and at 0.29 g/day for normotensive women. Subgroup analysis suggested that blood pressure status may modify this relationship.
Conclusion: Higher dietary choline intake was associated with a reduced prevalence of PID. These findings highlight the potential role of nutritional factors, particularly adequate choline intake, in reproductive health and support further prospective research to confirm causality.
Keywords: dietary choline intake, pelvic inflammatory disease, NHANES, cross-sectional study
1Department of Gynecology, Qingdao University Hospital, Qingdao University School of Medicine, Qingdao, People’s Republic of China; 2Department of Gynecology, Affiliated Hospital of Qingdao University, Qingdao, People’s Republic of China
Correspondence: Zhaoyuan Niu, Email niuzhaoyuan@126.com
Background and Aim: Pelvic inflammatory disease (PID), a chronic infection of the female upper genital tract, is a leading cause of morbidity in reproductive-aged women, often resulting in chronic pelvic pain, tubal infertility, and ectopic pregnancy. Choline, an essential nutrient, plays a critical role in various metabolic processes and is known to modulate inflammatory pathways. However, the potential link between dietary choline intake and PID remains largely unexplored. This study aimed to investigate the relationship between dietary choline consumption and PID prevalence.
Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2013– 2018. A total of 3204 women were included in the analysis. The association between choline intake and PID was assessed using multivariable logistic regression and smooth curve fitting. Subgroup analyses were performed to explore potential effect modifiers, and threshold effect analysis was used to identify inflection points in the relationship.
Results: Among the 3204 women studied, 208 had PID. In fully adjusted models, higher choline intake was significantly associated with a reduced risk of PID (OR = 0.20, 95% CI: 0.04– 0.92, p = 0.038). Compared to women in the lowest quintile of choline intake, those in the highest quintile had a 45% lower risk of PID (OR = 0.55, 95% CI: 0.30– 0.98, p = 0.044). Smooth curve fitting demonstrated a nonlinear association, with an inflection point at 0.41 g/day overall and at 0.29 g/day for normotensive women. Subgroup analysis suggested that blood pressure status may modify this relationship.
Conclusion: Higher dietary choline intake was associated with a reduced prevalence of PID. These findings highlight the potential role of nutritional factors, particularly adequate choline intake, in reproductive health and support further prospective research to confirm causality.
Keywords: dietary choline intake, pelvic inflammatory disease, NHANES, cross-sectional study