Serum betaine and dimethylglycine in mid-pregnancy and the risk of gestational diabetes mellitus: a case-control study

Endocrine. 2024 Aug;85(2):649-659. doi: 10.1007/s12020-024-03732-4. Epub 2024 Mar 6.

Abstract

Purpose: To investigate the associations of choline, betaine, dimethylglycine (DMG), L-carnitine, and Trimethylamine-N-oxide (TMAO) with the risk of Gestational diabetes mellitus (GDM) as well as the markers of glucose homeostasis.

Methods: We performed a case-control study including 200 diagnosed GDM cases and 200 controls matched by maternal age (±2 years) and gestational age (±2 weeks). Concentrations of serum metabolites were measured by the high-performance liquid chromatography - tandem mass spectrometry (HPLC-MS/MS).

Results: Compared to the control group, GDM group had significantly lower serum betaine concentration and betaine/choline ratio, and higher DMG concentration. Furthermore, decreased betaine concentration and betaine/choline ratio, increased DMG concentration showed significant association with the risk of GDM. In addition, serum betaine concentrations were negatively associated with blood glucose levels at 1-h post-glucose load (OGTT-1h), and both betaine and L-carnitine concentrations were positively associated with 1,5-anhydroglucitol levels. Betaine/choline ratio was negatively associated with OGTT-1h and blood glucose levels at 2-h post-glucose load (OGTT-2h) and serum choline concentrations were negatively associated with fasting blood glucose and positively associated with OGTT-2h.

Conclusion: Decreased serum betaine concentrations and betaine/choline ratio, and elevated DMG concentrations could be significant risk factors for GDM. Furthermore, betaine may be associated with blood glucose regulation and short-term glycemic fluctuations.

Keywords: Betaine; Choline; Dimethylglycine; Gestational diabetes mellitus; L-carnitine; Trimethylamine N-oxide.

MeSH terms

  • Adult
  • Betaine* / blood
  • Blood Glucose* / analysis
  • Carnitine / analogs & derivatives
  • Carnitine / blood
  • Case-Control Studies
  • Choline* / blood
  • Diabetes, Gestational* / blood
  • Diabetes, Gestational* / epidemiology
  • Female
  • Glucose Tolerance Test
  • Humans
  • Methylamines / blood
  • Pregnancy
  • Pregnancy Trimester, Second / blood
  • Risk Factors
  • Sarcosine* / analogs & derivatives
  • Sarcosine* / blood

Substances

  • Betaine
  • dimethylglycine
  • Sarcosine
  • Blood Glucose
  • Choline
  • Carnitine
  • Methylamines
  • trimethyloxamine