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The association between dietary choline and betaine with the risk of type 2 diabetes: The Atherosclerosis Risk in Communities (ARIC) Study

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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
Objectives: To 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 variables.

Results: Among 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.

Funding

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).

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