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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:379.)
© 2005 American Heart Association, Inc.

Vascular Biology

Betaine and Folate Status as Cooperative Determinants of Plasma Homocysteine in Humans

Pål I. Holm; Per M. Ueland; Stein Emil Vollset; Øivind Midttun; Henk J. Blom; Miranda B.A.J. Keijzer; Martin den Heijer

From the Locus for Homocysteine and Related Vitamins, University of Bergen, Norway (P.I.H., P.M.U., S.E.V., Ø.M), the Hormone Laboratory (P.I.H.) and the Laboratory of Clinical Biochemistry (P.M.U.), Haukeland University Hospital, and the Laboratory of Pediatrics and Neurology (H.J.B.) and the Department of Endocrinology (M.B.A.J.K., M.d.H.), University Medical Center Nijmegen, The Netherlands.

Correspondence to Per Magne Ueland, LOCUS for Homocysteine and Related Vitamins, Department of Pharmacology, University of Bergen, N-5021 Bergen, Norway. E-mail per.ueland{at}ikb.uib.no

Objective— Two published studies have demonstrated that betaine in the circulation is a determinant of plasma total homocysteine, but none had sufficient power to investigate the possible effect modification by folate status.

Methods and Results— We measured homocysteine, betaine, folate, vitamin B₆, and related compounds in serum/plasma from 500 healthy men and women aged 34 to 69 years before (fasting levels) and 6 hours after a standard methionine loading test. Choline, dimethylglycine, and folate were determinants of plasma betaine in a multiple regression model adjusting for age and sex. The increase in homocysteine after loading showed a strong inverse association with plasma betaine and a weaker inverse association with folate and vitamin B₆. Fasting homocysteine showed a strong inverse relation to folate, a weak relation to plasma betaine, and no relation to vitamin B₆. Notably, adjusted (for age and sex) dose-response curves for the postmethionine increase in homocysteine or fasting homocysteine versus betaine showed that the inverse associations were most pronounced at low serum folate, an observation that was confirmed by analyses of interaction.

Conclusions— Collectively, these results show that plasma betaine is a strong determinant of increase in homocysteine after methionine loading, particularly in subjects with low folate status.

In 500 healthy subjects, postmethionine load increase in tHcy showed a stronger inverse relation to betaine than to folate and vitamin B₆, whereas for fasting tHcy, betaine was a weaker determinant than folate. For both tHcy modalities, the association with betaine was most pronounced in subjects with low folate status.

Key Words: betaine • choline • homocysteine • folate • methionine

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