Hosseini-Esfahani Firoozeh, Koochakpoor Glareh, Golzarand Mahdieh, Mirmiran Parvin, Azizi Fereidoun
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Maragheh University of Medical Sciences, Maragheh, Iran.
Metab Syndr Relat Disord. 2023 Dec;21(10):573-580. doi: 10.1089/met.2023.0096. Epub 2023 Oct 10.
Our knowledge for the possible link between choline and betaine and the risk of type 2 diabetes (T2D) is very limited and contradictory. This study aimed to investigate the prospective association of dietary choline and betaine intakes with the risk of T2D in a group of Tehranian adults. In this prospective study, 6022 eligible subjects aged ≥18 years were chosen from the participants of the Tehran Lipid and Glucose Study in a secondary analysis. Diet was assessed based on a valid and reliable semiquantitative food frequency questionnaire. At baseline and follow-up examinations, biochemical and anthropometric variables were assessed. Multivariable Cox proportional hazard regression models was used to estimate the new onset of T2D concerning choline and betaine intake. The mean age ± SD of 2707 men and 3315 women were, respectively, 41.4 ± 14.2 and 39.1 ± 13.1. During a median follow-up of 6.63 years, 528 cases of T2D incidence were diagnosed. Participants with a higher intake of choline had a higher intake of protein, fiber, and B12 and a lower intake of energy and carbohydrates. After controlling of confounders a significant positive association was observed between choline intake and the hazard ratio (HR) of T2D across quartiles of choline intake [HR (CI) in the fourth quartile: 1.25 (1.14-1.38), P trend = 0.01], but this significant finding was not reported for betaine intake. For every 100 milligram increase in choline consumption, the HR of T2D increased significantly in all age, sex, and BMI subgroups. Choline consumption increased the risk of T2D in total population and subgroups. No statistically significant association was found between dietary betaine intake and the risk of T2D in total population and subgroups.
我们对于胆碱和甜菜碱与2型糖尿病（T2D）风险之间可能存在的联系的了解非常有限且相互矛盾。本研究旨在调查一组德黑兰成年人饮食中胆碱和甜菜碱摄入量与T2D风险之间的前瞻性关联。在这项前瞻性研究中，从德黑兰脂质与葡萄糖研究的参与者中选取了6022名年龄≥18岁的符合条件的受试者进行二次分析。饮食通过一份有效且可靠的半定量食物频率问卷进行评估。在基线和随访检查中，对生化和人体测量变量进行了评估。使用多变量Cox比例风险回归模型来估计与胆碱和甜菜碱摄入量相关的T2D新发病例。2707名男性和3315名女性的平均年龄±标准差分别为41.4±14.2岁和39.1±13.1岁。在中位随访6.63年期间，诊断出528例T2D发病病例。胆碱摄入量较高的参与者蛋白质、纤维和维生素B12的摄入量较高，而能量和碳水化合物的摄入量较低。在控制混杂因素后，在胆碱摄入量的四分位数范围内，观察到胆碱摄入量与T2D的风险比（HR）之间存在显著正相关[第四四分位数的HR（CI）：1.25（1.14 - 1.38），P趋势 = 0.01]，但甜菜碱摄入量未报告有这一显著发现。胆碱摄入量每增加100毫克，T2D的HR在所有年龄、性别和BMI亚组中均显著增加。胆碱消费增加了总体人群和亚组中T2D的风险。在总体人群和亚组中，未发现饮食中甜菜碱摄入量与T2D风险之间存在统计学上的显著关联。
