Association of Betaine, Choline, and TMAO with Type 2 Diabetes in Rural China: A Nested Case-Control Study from the Handan Eye Study (HES).

IF 3 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pub Date : 2025-07-26 eCollection Date: 2025-01-01 DOI:10.2147/DMSO.S522576

Jun Liang, Jie Hao, Yu Qin, Ou Liu, Kunning Shao, Wei Zhao, Jiangping Wen

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引用次数: 0

Abstract

Background: Conflicting evidence exists regarding the association of gut microbiota-related metabolites - TMAO and its precursor choline and betaine with type 2 diabetes Mellitus (T2DM), particularly in rural Chinese populations. This study aimed to prospectively examine these relationships in a northern rural Chinese cohort.

Methods: A nested case-control study was conducted within the Handan Eye Study. At baseline (2006-2007), 5,512 participants aged ≥30 years were enrolled. After 6.5 years of follow-up, 209 incident T2DM cases and 394 age- and sex-matched controls were included. Plasma choline, betaine, and TMAO levels were measured using ultra-performance liquid chromatography. Logistic regression and linear models assessed associations with T2DM risk, insulin resistance (IR), and metabolic parameters.

Results: Baseline betaine level was lower in the T2DM group compared to controls (betaine: 7431.4 ng/mL versus 7821.5 ng/mL). After adjusting for BMI, waist-to-hip ratio, and diabetes history, no significant associations were found between choline, betaine, or TMAO and T2DM risk. However, higher betaine quartiles showed a trend toward reduced T2DM risk (Q4 vs Q1 OR: 0.59, 95% CI: 0.34-1.06). Betaine was inversely correlated with HOMA-IR (β = -0.16), HOMA-β (β = -0.13), and TyG index (β = -0.21) (p < 0.05). Plasma choline levels were positively associated with fruit intake frequency, while TMAO levels decreased with higher exercise intensity.

Conclusion: Betaine may play a protective role against dyslipidemia, adiposity, and T2DM risk in rural Chinese populations. Further studies are needed to explore TMAO's complex role in diabetes development.

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甜菜碱、胆碱和氧化三甲胺与中国农村2型糖尿病的关系：来自邯郸眼科研究（HES）的巢式病例对照研究

背景：关于肠道菌群相关代谢物——氧化三甲胺及其前体胆碱和甜菜碱与2型糖尿病（T2DM）的关系，存在相互矛盾的证据，特别是在中国农村人群中。本研究旨在对中国北方农村人群进行前瞻性研究。方法：在邯郸市眼科研究中进行巢式病例对照研究。在基线（2006-2007），5512名年龄≥30岁的参与者入组。经过6.5年的随访，包括209例T2DM病例和394例年龄和性别匹配的对照组。采用超高效液相色谱法测定血浆胆碱、甜菜碱和氧化三甲胺水平。Logistic回归和线性模型评估了与T2DM风险、胰岛素抵抗（IR）和代谢参数的关系。结果：T2DM组基线甜菜碱水平低于对照组（甜菜碱：7431.4 ng/mL vs 7821.5 ng/mL）。在调整BMI、腰臀比和糖尿病史后，胆碱、甜菜碱或氧化三甲胺与2型糖尿病风险之间未发现显著关联。然而，较高的甜菜碱四分位数显示出降低T2DM风险的趋势（Q4 vs Q1 OR: 0.59, 95% CI: 0.34-1.06）。甜菜碱与HOMA- ir （β = -0.16）、HOMA-β (β = -0.13)、TyG指数（β = -0.21）呈负相关（p < 0.05）。血浆胆碱水平与水果摄入频率呈正相关，而氧化三甲胺水平随着运动强度的增加而下降。结论：甜菜碱可能对中国农村人群血脂异常、肥胖和2型糖尿病风险具有保护作用。需要进一步的研究来探索氧化三甲胺在糖尿病发展中的复杂作用。

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来源期刊

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

5.90

自引率

6.10%

发文量

431

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.