Dibaba Daniel T, Johnson Karen C, Kucharska-Newton Anna M, Meyer Katie, Zeisel Steven H, Bidulescu Aurelian
Tennessee Clinical and Translational Science Institute, University of Tennessee Health Science Center, Memphis, TN.
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN.
Diabetes Care. 2020 Nov;43(11):2840-2846. doi: 10.2337/dc20-0733. Epub 2020 Sep 8.
To examine the association between dietary intake of choline and betaine and the risk of type 2 diabetes.
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.
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 ( = 0.07). The results from logistic regression were similar.
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.
研究胆碱和甜菜碱的膳食摄入量与2型糖尿病风险之间的关联。
在社区动脉粥样硬化风险（ARIC）研究的13440名参与者中，使用区间删失Cox比例风险模型和经基线潜在混杂变量调整的逻辑回归模型，评估膳食胆碱和甜菜碱摄入量与2型糖尿病风险之间的前瞻性纵向关联。
在13440名参与者（55%为女性，平均年龄54岁[标准差7.4]）中，从1987年到1998年的中位随访9年期间，有1396人发生了2型糖尿病。膳食胆碱每增加1个标准差与2型糖尿病风险之间无统计学显著关联（风险比[HR]1.01[95%置信区间0.87,1.16]），膳食甜菜碱摄入量与2型糖尿病风险之间也无关联（HR 1.01[0.94,1.10]）。膳食胆碱摄入量处于最高四分位数的人群患2型糖尿病的风险与处于最低胆碱四分位数的人群相比，无统计学显著升高（HR 1.09[0.84,1.42]）；同样，将最高四分位数与最低四分位数相比，膳食甜菜碱摄入量与2型糖尿病风险无关（HR 1.06[0.87,1.29]）。在女性中，膳食胆碱摄入量最高四分位数与最低四分位数相比，2型糖尿病风险较高（HR 1.54[1.06,2.25]），而在男性中，这种关联不显著（HR 0.82[0.57,1.17]）。然而，高胆碱摄入量与性别在2型糖尿病风险上存在无统计学显著意义的交互作用（P = 0.07）。逻辑回归结果相似。
总体而言，在男性参与者中，膳食胆碱或甜菜碱摄入量与2型糖尿病风险无关。在女性参与者中，膳食胆碱摄入量最高四分位数与最低四分位数相比，有患2型糖尿病风险略高的趋势。我们的研究应为关于膳食胆碱和甜菜碱补充与2型糖尿病风险关系的临床试验提供参考。
