低叶酸水平会增加血浆甜菜碱和二甲氨基乙醇浓度的妊娠变化，以及甜菜碱与同型半胱氨酸之间的关系。

Low folate status enhances pregnancy changes in plasma betaine and dimethylglycine concentrations and the association between betaine and homocysteine.

机构信息

Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain.

出版信息

Am J Clin Nutr. 2013 Jun;97(6):1252-9. doi: 10.3945/ajcn.112.054189. Epub 2013 Apr 17.

DOI:10.3945/ajcn.112.054189

PMID:23595875

Abstract

BACKGROUND

Folate, choline, and betaine participate in homocysteine metabolism. It is not known whether they interact during pregnancy.

OBJECTIVE

The objective was to investigate how folate status affects choline, betaine, and dimethylglycine during pregnancy.

DESIGN

Fasting plasma folate, cobalamin, free choline, betaine, dimethylglycine, and total homocysteine (tHcy) were measured longitudinally at <12, 15, 24-27, and 34 gestational weeks (GW); at labor (nonfasting); and in the cord in participants (n = 522) from the Reus-Tarragona Birth Cohort (NUTrició i Creixement Intrauterí Retardat phase). Timing, dose, and duration of folic acid supplement use were recorded. Folate status was classified as below (low) or above (high) median plasma folate at baseline (27.6 nmol/L) and at 24-27 GW (11.4 nmol/L). Associations between folate or betaine with tHcy were investigated by using multiple linear regression analysis.

RESULTS

Plasma betaine decreased by 34.8% (1.0%) throughout pregnancy, and dimethylglycine increased by 39.7% (2.7%) between 24-27 GW and labor (all P < 0.001). Compared with high folate status, low status was associated with a higher dimethylglycine/betaine ratio from 15 GW and with lower plasma betaine and higher dimethylglycine from 24 to 27 GW, for the rest of pregnancy. Regression analysis showed that by 24-27 GW, both plasma folate and betaine were inversely associated with tHcy when folate status was low and that the association between betaine and tHcy depended on folate status at 24-27 and 34 GW (interaction terms: P < 0.001 and P < 0.01). Betaine was inversely associated with tHcy at labor regardless of folate status.

CONCLUSION

Low folate status enhances the reduction in betaine and the increase in dimethylglycine during pregnancy and strengthens the association between betaine and tHcy. This trial was registered at clinicaltrials.gov as NCT01778205.

摘要

背景

叶酸、胆碱和甜菜碱参与同型半胱氨酸代谢。目前尚不清楚它们在怀孕期间是否相互作用。

目的

本研究旨在探讨叶酸状态如何影响妊娠期间的胆碱、甜菜碱和二甲基甘氨酸。

设计

在 Reus-Tarragona 出生队列（NUTrició i Creixement Intrauterí Retardat 阶段）的 522 名参与者中，于<12、15、24-27 和 34 孕周（GW）、分娩时（非禁食）和脐带中进行了空腹血浆叶酸、钴胺素、游离胆碱、甜菜碱、二甲基甘氨酸和总同型半胱氨酸（tHcy）的纵向测量。记录了叶酸补充剂的使用时间、剂量和持续时间。根据基线（27.6 nmol/L）和 24-27 GW（11.4 nmol/L）时的血浆叶酸中位数，将叶酸状态分为低或高。采用多元线性回归分析研究叶酸或甜菜碱与 tHcy 之间的关系。

结果

整个孕期血浆甜菜碱下降 34.8%（1.0%），24-27 GW 至分娩时二甲基甘氨酸增加 39.7%（2.7%）（均 P < 0.001）。与高叶酸状态相比，低叶酸状态与 15 GW 时的二甲基甘氨酸/甜菜碱比值较高、24-27 GW 时的血浆甜菜碱较低和二甲基甘氨酸较高有关，直至妊娠结束。回归分析显示，在 24-27 GW 时，当叶酸状态较低时，血浆叶酸和甜菜碱与 tHcy 呈负相关，而甜菜碱与 tHcy 的关系取决于 24-27 和 34 GW 时的叶酸状态（交互项：P < 0.001 和 P < 0.01）。无论叶酸状态如何，分娩时甜菜碱与 tHcy 呈负相关。