title: Choline and betaine intake and colorectal cancer risk in Chinese population: a case-control study.
abstract: BACKGROUND
  Few studies have examined the association of choline and betaine intake with colorectal cancer risk, although they might play an important role in colorectal cancer development because of their role as methyl donors. The aim of this study was to examine the relationship between consumption of choline and betaine and colorectal cancer risk in a Chinese population.
  
  
  RESULTS
  A case-control study was conducted between July 2010 and December 2013 in Guangzhou, China. Eight hundred and ninety consecutively recruited colorectal cancer cases were frequency matched to 890 controls by age (5-year interval) and sex. Dietary information was assessed with a validated food frequency questionnaire by face-to-face interviews. The logistic regression model was used to estimate multivariate odds ratios (ORs) and 95% confidence intervals (CIs). Total choline intake was inversely associated with colorectal cancer risk after adjustment for various lifestyle and dietary factors. The multivariate-adjusted OR was 0.54 (95%CI = 0.37-0.80, Ptrend <0.01) comparing the highest with the lowest quartile. No significant associations were observed for betaine or total choline+betaine intakes. For choline-containing compounds, lower colorectal cancer risk was associated with higher intakes of choline from phosphatidylcholine, glycerophosphocholine and sphingomyelin but not for free choline and phosphocholine. The inverse association of total choline intake with colorectal cancer risk was observed in both men and women, colon and rectal cancer. These inverse associations were not modified by folate intake.
  
  
  CONCLUSIONS
  These results indicate that high intake of total choline is associated with a lower risk of colorectal cancer.
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Min-Shan
authors.initials: MS
authors.lastname: Lu
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Yu-Jing
authors.initials: YJ
authors.lastname: Fang
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Zhi-Zhong
authors.initials: ZZ
authors.lastname: Pan
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhong
authors.affiliation: Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Mei-Chun
authors.initials: MC
authors.lastname: Zheng
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Chen
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Cai-Xia
authors.initials: CX
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001622:Betaine / Q000494:pharmacology*; D063646:Carcinogenesis / Q000187:drug effects; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D002794:Choline / Q000494:pharmacology*; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk
chemical_list: D001622:Betaine; D002794:Choline