Choline and Betaine Intakes During Pregnancy in Relation to Risk of Gestational Diabetes Mellitus Among Chinese Women

OBJECTIVES: Choline, an essential nutrient, and its metabolite betaine have been evidenced to exert beneficial effects on maternal lipid/glucose metabolism and fetal development via animal studies. However, whether choline and betaine intakes are associated with risk of Gestational Diabetes Mellitus (GDM) among pregnant women remains unknown. This study aims to investigate associations between dietary choline and betaine intakes during pregnancy and incident GDM among Chinese women. METHODS: This case-control study enrolled 168 hospital-based GDM pregnant women and 375 healthy controls during 24–28 gestational weeks when they underwent 75-g oral glucose tolerance test in Shanghai, China. GDM was diagnosed if one or more of the following glucose levels were met: ≥5.1 nmol/L at 0 h, ≥10.0 nmol/L at 1 h, or ≥ 8.5 nmol/L at 2 h. Choline and betaine intakes during pregnancy were assessed by a validated semi-quantitative food frequency questionnaire via face-to-face interviews. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CIs) for the association between intake of total choline or betaine and GDM risk. RESULTS: Compared with the healthy pregnant women, those who developed GDM tended to be older, have relatively higher pre-pregnancy BMI, more parities, higher triglycerides, and lower high-density lipoprotein-cholesterol. Generally, there was no significant association between intake of choline or betaine and risk of GDM [OR 0.77, 95% CI (0.41, 1.43) for choline; OR 0.80, 95% CI (0.42–1.52) for betaine] after adjustment for various covariates. However, there was a significant interaction between betaine intake and parity on incident GDM (P = 0.01). Among those with no parity history, the women in the highest quartile of betaine intake had significantly lower incident GDM than those in the lowest quartile [OR 0.25, 95% CI (0.06–0.81)] after adjusting for various covariates. This inverse association was not modified by serum folate status. CONCLUSIONS: Choline intake during pregnancy was not associated with risk of GDM among these Chinese women. However, there was an inverse correlation between betaine intake and incident GDM among those Chinese women with no parity history. FUNDING SOURCES: This study was supported by Texas State University startup funds granted to Dr. Jie Zhu.