Choline
metaboliteDietary and metabolic marker associated with lipid retention, plaque inflammation, and thrombotic MI risk.
Pathway placement
Cascade stepLipid retention & oxidation
Confidencemedium
RationaleDietary metabolite linked to plaque destabilization, thrombosis, and ACS; lipid metabolism marker.
Also acts inVascular inflammation, Coagulation / thrombus
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresIndeterminate
R — rupture / Type-I—
C — confounder / Type-II33
A — assay feasibility42
E — evidence strength50
T1DI (composite)9
Specificity differential (R−C)-18.3
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 1
2anemia / acute blood lossn/a
3hypovolemia / dehydrationn/a
4tachyarrhythmian/a
5hypoxemia / respiratory failuren/a
6hypertensive emergencyn/a
7high-demand / peri-operative stressn/a
Coverage: 1/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 4 supporting references. See the discrimination table for all markers.
Assay & specimen
Class-level default (no specific cleared assay)— generic method inferred from analyte class; confirm against a specific product insert before use.
Specimen
Serum, plasma or urine
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top) · Sterile urine container
Method / principle
LC-MS/MS (targeted metabolomics) or enzymatic colorimetric where available
Reagent / substrate
Stable-isotope-labeled internal standard (MS); or enzyme-coupled Trinder reagent
Platform
LC-MS/MS; some automated chemistry
Turnaround · availability
Send-out / research · Specialized / research
Literature evidence(4)
- Plasma metabolomic profiling of patients with acute coronary syndrome treated with potent platelet inhibitors.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2026 · PMID 41564597 · doi
- Circulating metabolites from the choline pathway and acute coronary syndromes in a Chinese case-control study.Nutrition & metabolism · 2020 · PMID 32489394 · doi
- Choline in acute coronary syndrome: an emerging biomarker with implications for the integrated assessment of plaque vulnerability.Expert review of molecular diagnostics · 2010 · PMID 20214535 · doi
- Choline in whole blood and plasma: sample preparation and stability.Clinical chemistry · 2008 · PMID 18310145 · doi
Clinical trials(1)
- Evaluation of the Role of Eggs on Antioxidant Status, Plasma Choline and Lipoprotein Metabolism in Adults With Metabolic Syndrome Consuming a Plant-based DietNCT04234334 · NA · COMPLETED · Consume 2 eggs with spinach per day, Egg Subsitute with spinach per day