title: Higher dietary intakes of choline and betaine are associated with a lower risk of primary liver cancer: a case-control study.
abstract: The dietary intake of methyl donors is favorably associated with many diseases, but the findings regarding primary liver cancer (PLC) risk are limited. This study investigated the association between the intake of choline, betaine and methionine and PLC risk in adults. This 1:1 matched case-control study enrolled 644 hospital-based PLC patients and 644 community-based controls who were matched by sex and age, in Guangzhou, China. An interviewer-administered questionnaire and a food-frequency questionnaire were used to collect general information and dietary intake information. Conditional logistic regression showed a significantly inverse association between total choline and betaine intakes and PLC risk. The multivariable-adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for PLC for the top (vs. bottom) tertile were 0.34 (0.24-0.49; P-trend< 0.001) for total choline and 0.67 (0.48-0.93; P-trend= 0.011) for betaine. No significant association was observed between the intake of methionine and PLC risk (P > 0.05). For individual choline compounds, higher consumptions of free choline, glycerophosphocholine, phosphocholine, phosphatidylcholine and sphingomyelin were associated with a lower PLC risk (all P-trend < 0.05). The studied associations were not significantly modified by the folate intake (P-interactions: 0.488-0.890). Our findings suggest that higher choline and betaine intakes may be associated with a lower risk of PLC.
authors.affiliation: School of Public Health, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Rui-Fen
authors.initials: RF
authors.lastname: Zhou
authors.affiliation: School of Public Health, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Xiao-Lin
authors.initials: XL
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, 510080, P.R. China.
authors.forename: Zhong-Guo
authors.initials: ZG
authors.lastname: Zhou
authors.affiliation: Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, 510080, P.R. China.
authors.forename: Yao-Jun
authors.initials: YJ
authors.lastname: Zhang
authors.affiliation: School of Public Health, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Qiu-Ye
authors.initials: QY
authors.lastname: Lan
authors.affiliation: School of Public Health, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Gong-Cheng
authors.initials: GC
authors.lastname: Liao
authors.affiliation: School of Public Health, Sun Yat-sen University, Guangzhou, 510080, P.R. China.
authors.forename: Yu-Ming
authors.identifier: http://orcid.org/0000-0003-1658-5528
authors.initials: YM
authors.lastname: Chen
authors.affiliation: School of Public Health, Sun Yat-sen University, Guangzhou, 510080, P.R. China. zhuhl@mail.sysu.edu.cn.
authors.forename: Hui-Lian
authors.initials: HL
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001622:Betaine / Q000008:administration & dosage; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D002794:Choline / Q000008:administration & dosage; D004032:Diet; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008715:Methionine; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001622:Betaine; D008715:Methionine; D002794:Choline