The online version of this article (doi:10.1186/1475-2840-11-34) contains supplementary material, which is available to authorized users.
There are no competing interests to declare.
ML, SS analyzed the data and took the main responsibility for preparing the MS. ML is responsible for the laboratory in which assays were carried out. DOM had the primary responsibility for the initial design, for recruiting subjects and supervising the methionine load test. WJD assisted DOM in recruitment and conducting the study, carried out the betaine assays in the laboratory and made an initial attempt at analyzing and interpreting the results.PMG had overall supervision and clinical input and input into interpreting the results and edited the MS during preparation. STC was partly responsible for the initial design and has overseen the work at all stages and edited the MS. All authors approve this submission.
Since betaine is an osmolyte and methyl donor, and abnormal betaine loss is common in diabetes mellitus (>20% patients), we investigated the relationship between betaine and the post-methionine load rise in homocysteine, in diabetes and control subjects. The post-methionine load test is reported to be both an independent vascular risk factor and a measure of betaine sufficiency.
Patients with type 2 diabetes (n = 34) and control subjects (n = 17) were recruited. We measured baseline fasting plasma and 4-hour post-methionine load (L-methionine, 0.1 mg/kg body weight) concentrations of homocysteine, betaine, and the betaine metabolite N,N-dimethylglycine. Baseline urine excretions of betaine, dimethylglycine and glucose were measured on morning urine samples as the ratio to urine creatinine. Statistical determinants of the post-methionine load increase in homocysteine were identified in multiple linear regression models.
Plasma betaine concentrations and urinary betaine excretions were significantly (p < 0.001) more variable in the subjects with diabetes compared with the controls. Dimethylglycine excretion (p = 0.00014) and plasma dimethylglycine concentrations (p = 0.039) were also more variable. In diabetes, plasma betaine was a significant negative determinant (p < 0.001) of the post-methionine load increase in homocysteine. However, it was not conclusive that this was different from the relationship in the controls. In the patients with diabetes, a strong relationship was found between urinary betaine excretion and urinary glucose excretion (but not with plasma glucose).
Both high and low plasma betaine concentrations, and high and low urinary betaine excretions, are more prevalent in diabetes. The availability of betaine affects the response in the methionine load test. The benefits of increasing betaine intake should be investigated.
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- Variability of plasma and urine betaine in diabetes mellitus and its relationship to methionine load test responses: an observational study
David O McGregor
Warwick J Dellow
Peter M George
Stephen T Chambers
- BioMed Central
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