title: Plasma lipids and betaine are related in an acute coronary syndrome cohort.
abstract: BACKGROUND
  Low plasma betaine has been associated with unfavorable plasma lipid profiles and cardiovascular risk. In some studies raised plasma betaine after supplementation is associated with elevations in plasma lipids. We aimed to measure the relationships between plasma and urine betaine and plasma lipids, and the effects of lipid-lowering drugs on these.
  
  
  METHODS
  Fasting plasma samples were collected from 531 subjects (and urine samples from 415) 4 months after hospitalization for an acute coronary syndrome episode. In this cross-sectional study, plasma betaine and dimethylglycine concentrations and urine excretions were compared with plasma lipid concentrations. Subgroup comparisons were made for gender, with and without diabetes mellitus, and for drug treatment.
  
  
  RESULTS
  Plasma betaine negatively correlated with triglyceride (Spearman's r(s) = -0.22, p<0.0001) and non-high-density lipoprotein cholesterol (r(s) = -0.27, p<0.0001). Plasma betaine was a predictor of BMI (p<0.05) and plasma non-high-density lipoprotein cholesterol and triglyceride (p<0.001) independently of gender, age and the presence of diabetes. Using data grouped by plasma betaine decile, increasing plasma betaine was linearly related to decreases in BMI (p = 0.008) and plasma non-HDL cholesterol (p = 0.002). In a non-linear relationship betaine was negatively associated with elevated plasma triglycerides (p = 0.004) only for plasma betaine >45 µmol/L. Subjects taking statins had higher plasma betaine concentrations (p<0.001). Subjects treated with a fibrate had lower plasma betaine (p = 0.003) possibly caused by elevated urine betaine loss (p<0.001). The ratio of coenzyme Q to non-high-density lipoprotein cholesterol was higher in subjects with higher plasma betaine, and in subjects taking a statin.
  
  
  CONCLUSIONS
  Low plasma betaine concentrations correlated with an unfavourable lipid profile. Betaine deficiency may be common in the study population. Controlled clinical trials of betaine supplementation should be conducted in appropriate populations to determine whether correction affects cardiovascular risk.
authors: Clinical Biochemistry Unit, Canterbury Health Laboratories, Christchurch, New Zealand. michael.lever@otago.ac.nz
authors: Michael
authors: M
authors: Lever
authors: Peter M
authors: PM
authors: George
authors: Wendy
authors: W
authors: Atkinson
authors: Sarah L
authors: SL
authors: Molyneux
authors: Jane L
authors: JL
authors: Elmslie
authors: Sandy
authors: S
authors: Slow
authors: A Mark
authors: AM
authors: Richards
authors: Stephen T
authors: ST
authors: Chambers
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000652:urine; D000368:Aged; D000369:Aged, 80 and over; D001622:Betaine / Q000097:blood* / Q000378:metabolism / Q000652:urine; D015331:Cohort Studies; D048909:Diabetes Complications / Q000097:blood / Q000652:urine; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012521:Sarcosine / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism
chemical_list: D000960:Hypolipidemic Agents; D008055:Lipids; D001622:Betaine; C025138:dimethylglycine; D012521:Sarcosine