figure posted on 08.09.2020, 17:33 by Daniel T. Dibaba, Karen C. Johnson, Anna M. Kucharska-Newton, Katie Meyer, Steven H. Zeisel, Aurelian Bidulescu
examine the association between dietary intake of choline and betaine with the
risk of type 2 diabetes.
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
13,440 participants (55% women, mean age 54 (SD 7.4) years) 1396 developed
incident type 2 diabetes during median follow up of 9 years from 1987 through
1998. There was no statistically significant association between every 1
standard deviation (SD) increase in dietary choline and risk of type 2 diabetes,
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 males the
association was null, HR = 0.82 (0.57, 1.17). Nevertheless, there was a
non-significant interaction between high choline intake and sex on the risk of type 2 diabetes (P-value
= 0.07). The results from logistic regression were similar.
Conclusion: 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 to 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.
The Atherosclerosis Risk in Communities (ARIC) Study is carried out as a collaborative study supported by the National Heart, Lung, and Blood Institute contracts: N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. A list of principal ARIC study staff was published in the American Journal of Epidemiology (1989; 129: 687–688). Laboratory testing and biospecimen collection at ARIC Visit 6 was supported by grant R01DK089174 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH). The authors thank the staff and participants of the ARIC study for their important contributions. Dr. A. Bidulescu was supported in part by two institutional training grants (HL07055 and DK07686) from the National Institutes of Health (NIH). Dr. S.H. Zeisel was supported by research grants from the USDA (58-1235-5-126) and the NIH (DK55865 and DK56350).