Abstract

BackgroundThe choline metabolite, betaine, plays a role in lipid metabolism, and may predict the development of cardiovascular disease and type 2 diabetes mellitus (T2DM). Phospholipid transfer protein (PLTP) and lecithin:cholesterol acyltransferase (LCAT) require phosphatidylcholine as substrate, raising the possibility that there is an intricate relationship of these protein factors with choline metabolism. Here we determined the relationships of PLTP and LCAT activity with betaine in subjects with and without T2DM.MethodsPlasma betaine (nuclear magnetic resonance spectroscopy), PLTP activity (liposome-vesicle HDL system), LCAT activity (exogenous substrate assay) and (apo)lipoproteins were measured in 65 type 2 diabetic (T2DM) and in 55 non-diabetic subjects.ResultsPLTP and LCAT activity were elevated in T2DM (p < 0.05), whereas the difference in betaine was not significant. In age-, sex- and diabetes status-controlled correlation analysis, betaine was inversely correlated with triglycerides and positively with HDL cholesterol (p < 0.05 to 0.01). PLTP and LCAT activity were positively correlated with triglycerides and inversely with HDL cholesterol (p < 0.05 to 0.001). PLTP (r = −0.245, p = 0.006) and LCAT activity (r = −0.195, p = 0.035) were correlated inversely with betaine. The inverse association of PLTP activity with betaine remained significant after additional adjustment for body mass index and lipoprotein variables (β = −0.179, p = 0.034), whereas its association with LCAT activity lost significance (β = −0.056, p = 0.44).ConclusionsBetaine may influence lipoprotein metabolism via an effect on PLTP activity.

Highlights

  • The choline metabolite, betaine, plays a role in lipid metabolism, and may predict the development of cardiovascular disease and type 2 diabetes mellitus (T2DM)

  • Total cholesterol was lower in T2DM which was in part attributable to lower High density lipoprotein (HDL) cholesterol

  • Phospholipid transfer protein (PLTP) and lecithin: cholesterol acyltransferase (LCAT) activity were each increased in T2DM subjects (Table 1)

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Summary

Introduction

The choline metabolite, betaine, plays a role in lipid metabolism, and may predict the development of cardiovascular disease and type 2 diabetes mellitus (T2DM). We determined the relationships of PLTP and LCAT activity with betaine in subjects with and without T2DM. Choline is to an important extent oxidized to betaine [1]. Betaine is intricately involved in lipid metabolism as evidenced by its ability to attenuate hepatic triglyceride accumulation [1]. Low betaine levels may predict cardiovascular disease (CVD) in non-diabetic subjects, and modify the extent to which trimethylamine-N-oxide (TMAO), a metabolite that results from intestinal choline metabolism, confers an increased CVD risk [4, 5].

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