The Association of Dietary Choline and Betaine With the Risk of Type 2 Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study.

Publisher: American Diabetes Association Country of Publication: United States NLM ID: 7805975 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1935-5548 (Electronic) Linking ISSN: 01495992 NLM ISO Abbreviation: Diabetes Care Subsets: MEDLINE

Publication: Alexandria Va : American Diabetes Association
Original Publication: New York, American Diabetes Assn.

Betaine* ; Choline* ; Diet* ; Eating*; Diabetes Mellitus, Type 2/*epidemiology; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Longitudinal Studies ; Male ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Self Report ; Sex Factors ; United States/epidemiology

Objective: To examine the association between dietary intake of choline and betaine and the risk of type 2 diabetes.
Research Design and Methods: Among 13,440 Atherosclerosis Risk in Communities (ARIC) study participants, the prospective longitudinal association between dietary choline and betaine intake and the risk of type 2 diabetes was assessed using interval-censored Cox proportional hazards and logistic regression models adjusted for baseline potential confounding variables.
Results: Among 13,440 participants (55% women, mean age 54 [SD 7.4] years), 1,396 developed incident type 2 diabetes during median follow-up of 9 years from 1987 to 1998. There was no statistically significant association between every 1-SD increase in dietary choline and risk of type 2 diabetes (hazard ratio [HR] 1.01 [95% CI 0.87, 1.16]) nor between dietary betaine intake and the risk of type 2 diabetes (HR 1.01 [0.94, 1.10]). Those in the highest quartile of dietary choline intake did not have a statistically significant higher risk of type 2 diabetes than those in the lowest choline quartile (HR 1.09 [0.84, 1.42]); similarly, dietary betaine intake was not associated with the risk of type 2 diabetes comparing the highest quartile to the lowest (HR 1.06 [0.87, 1.29]). Among women, there was a higher risk of type 2 diabetes, comparing the highest to lowest dietary choline quartile (HR 1.54 [1.06, 2.25]), while in men, the association was null (HR 0.82 [0.57, 1.17]). Nevertheless, there was a nonsignificant interaction between high choline intake and sex on the risk of type 2 diabetes ( P = 0.07). The results from logistic regression were similar.
Conclusions: Overall and among male participants, dietary choline or betaine intakes were not associated with the risk of type 2 diabetes. Among female participants, there was a trend for a modestly higher risk of type 2 diabetes among those with the highest as compared with the lowest quartile of dietary choline intake. Our study should inform clinical trials on dietary choline and betaine supplementation in relationship with the risk of type 2 diabetes.
(© 2020 by the American Diabetes Association.)

Eur J Biochem. 2003 Mar;270(5):991-9. (PMID: 12603332)
BMC Genomics. 2013 Dec 10;14:867. (PMID: 24320691)
J Obes. 2012;2012:319172. (PMID: 22778916)
Diabetes Care. 2015 Feb;38(2):e13-4. (PMID: 25614692)
Nutr Rev. 2009 Nov;67(11):615-23. (PMID: 19906248)
BMC Endocr Disord. 2013 Oct 16;13:47. (PMID: 24131857)
Nutr Diabetes. 2012 Oct 08;2:e49. (PMID: 23169489)
Eur J Nutr. 2020 Dec;59(8):3857-3861. (PMID: 32198672)
Diabetes. 2006 Jul;55(7):2015-20. (PMID: 16804070)
Nutrients. 2018 Oct 16;10(10):. (PMID: 30332744)
N Engl J Med. 2017 Jul 13;377(2):143-153. (PMID: 28700845)
J Nutr. 2003 May;133(5):1302-7. (PMID: 12730414)
BMC Syst Biol. 2018 Oct 24;12(1):89. (PMID: 30355281)
Atherosclerosis. 2014 Feb;232(2):384-9. (PMID: 24468152)
N Engl J Med. 2013 Apr 25;368(17):1575-84. (PMID: 23614584)
Ann Intern Med. 2002 Apr 16;136(8):575-81. (PMID: 11955025)
BMC Cardiovasc Disord. 2007 Jul 13;7:20. (PMID: 17629908)
Int J Epidemiol. 1989;18(3 Suppl 1):S88-98. (PMID: 2681023)
Diabetes. 2013 Feb;62(2):639-48. (PMID: 23043162)
Am J Clin Nutr. 2017 Sep;106(3):888-894. (PMID: 28724646)
Atherosclerosis. 2001 Oct;158(2):297-301. (PMID: 11583707)
Eur Heart J. 2005 Aug;26(16):1633-9. (PMID: 15824077)
Nutrition. 2017 Jan;33:28-34. (PMID: 27908547)
Diabetes. 2016 Apr;65(4):902-12. (PMID: 26858359)
Diabetes Res Clin Pract. 2017 Jun;128:40-50. (PMID: 28437734)
BMJ. 2018 Sep 4;362:k1497. (PMID: 30181166)
Atherosclerosis. 2008 Feb;196(2):696-703. (PMID: 17254586)
Am J Epidemiol. 1985 Jul;122(1):51-65. (PMID: 4014201)
J Biol Chem. 2010 Jul 16;285(29):22403-13. (PMID: 20452975)
Am J Clin Nutr. 2016 Jul;104(1):173-80. (PMID: 27281307)
BMJ. 2018 Jun 13;361:k2234. (PMID: 29898883)
Diabetes Care. 2010 Jan;33 Suppl 1:S62-9. (PMID: 20042775)

N01HC55020 United States HL NHLBI NIH HHS; P30 ES010126 United States ES NIEHS NIH HHS; N01HC55018 United States HL NHLBI NIH HHS; N01HC55015 United States HL NHLBI NIH HHS; N01HC55016 United States HL NHLBI NIH HHS; P30 DK056350 United States DK NIDDK NIH HHS; N01HC55021 United States HL NHLBI NIH HHS; T32 HL007055 United States HL NHLBI NIH HHS; R01 DK055865 United States DK NIDDK NIH HHS; R01 DK089174 United States DK NIDDK NIH HHS; N01HC55022 United States HL NHLBI NIH HHS; K01 HL127159 United States HL NHLBI NIH HHS; T32 DK007686 United States DK NIDDK NIH HHS; N01HC55019 United States HL NHLBI NIH HHS

figshare 10.2337/figshare.12814169

3SCV180C9W (Betaine)
N91BDP6H0X (Choline)

Date Created: 20200909 Date Completed: 20210520 Latest Revision: 20211102

20240628

PMC7576425

10.2337/dc20-0733

32900787