Prospective Nested Case-Control Study of Dietary and Microbiological-Associated Levels and Dynamics of 5-Aminovaleric Acid Betaine (5-AVAB) in Patients with Type 2 Diabetes.

OBJECTIVE

This study aimed to evaluate the associations between dietary and microbiological factors, and the levels and dynamics of 5-amino valeric acid betaine (5-AVAB) in patients with type 2 diabetes (T2D) through a prospective nested case-control study. An added meta-analysis aimed to provide a comprehensive evaluation of the relationship between 5-AVAB levels and T2D risk.

METHODS

A total of 1200 T2D patients and 1200 age- and sex-matched controls were recruited for this study. Dietary information was collected through 24-hour dietary recall questionnaires, while fecal samples were analyzed for gut microbiota composition using 16S rRNA gene sequencing. 5-AVAB levels were measured in plasma samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Multivariate logistic regression and general linear models were applied to evaluate the associations between 5-AVAB levels, dietary factors, and gut microbiota composition.

RESULTS

The T2D patients exhibited significantly lower plasma 5-AVAB concentrations compared to the control group (P < .001). Lower 5-AVAB levels were associated with higher odds of T2D (adjusted OR = 2.89, 95% CI: 1.76-4.74). Higher intake of dietary factors, including fiber and polyunsaturated fatty acids (PUFAs), were positively associated with 5-AVAB levels. Furthermore, specific bacterial taxa were significantly associated with 5-AVAB levels. A meta-analysis of five studies corroborated the inverse association between 5-AVAB and T2D risk (pooled OR = 2.68, 95% CI: 1.61-4.46).

CONCLUSION

Our findings suggest that lower 5-AVAB levels are associated with an increased risk of T2D. Dietary factors and gut microbiota composition appear to significantly influence 5-AVAB levels. The potential use of 5-AVAB as a therapeutic target in T2D management is an exciting area of research that requires further investigation. If successful, it could lead to new treatment options for T2D patients, ultimately improving their long-term health outcomes and quality of life.