Hepatic and renal betaine-homocysteine methyltransferase activity in pigs as affected by dietary intakes of sulfur amino acids, choline, and betaine

Betaine consumption as a new clinical approach to treatment and prophylaxis of folate-related pathologies

The most important pathway in the development of folate-related pathologies is an increase in the level of homocysteine (HC). HC, a cytotoxic and neurotoxic amino acid (when its level is ≥12 μmol/L), is 1 of the most widely studied compounds in cardiology, neurobiology, oncology, and embryology for the last 20 years. Given its toxicity, the processes of endogenous detoxification of HC are of particular interest to medicine. To date, the most studied pathway is that of remethylation (the conversion of HC to methionine), with the participation of B12- and B9-dependent methionine synthase. Less studied is remethylation with the participation of the choline derivatives betaine and betaine-HC-S-methyltransferase (BHMT). Therefore, the aim of this review was to conduct a theoretical analysis of available information regarding the contribution of betaine metabolism, its enzyme, and its genetic polymorphism to folate metabolism disturbances, and the development of folate-related pathologies. This review emphasizes the potential clinical significance of 2 factors that can influence the remethylation reaction of HC: the use of betaine and identifying the BHMT gene variants and their impact on the risk for developing certain folate-related pathologies, and treatment options. Moreover, with a high level of methylation of the BHMT gene and in the presence of its low-function variants (eg, rs3733890), it is necessary to use betaine as an additional methyl donor, especially during folate therapy. More clinical research is needed to identify the effects of the different BHMT gene variants on the individual risk for folate-related pathologies to better assess the clinical significance, the need for genetic testing, and betaine consumption.

Effects of duration of betaine supplementation on growth performance and blood IGF-1 in light- and normal-weight weaner pigs under commercial conditions

Context Betaine supplementation has been reported to increase insulin-like growth factor 1 (IGF-1) in pigs. Betaine is not generally added to weaner pig diets due to a lack of knowledge on the duration of supplementation and effect on targeted bodyweight class. Light-weight weaners, known for their inferior growth performance, may benefit from betaine supplementation during the early days post-weaning. Aims This experiment aimed to identify the timing of betaine supplementation over the weaner phase (early (0–7 days) or late (7–35 days) post-weaning periods) and targeted weaning weight class (light vs normal). Methods The experiment followed a 2 × 2 × 2 factorial arrangement for studying the effects of 0.1% betaine supplementation during early (0–7 days post-weaning) and late (7–35 days post-weaning) weaner phase in light-weight and normal-weight weaners. One hundred and forty-four pens (18 pigs/pen) of weaned pigs (26 days age) were allocated into a 2 × 2 × 2 factorial arrangement on the basis of weaning weight class ((light (3.6 ± 0.75 kg, mean ± s.d.) vs normal (6.6 ± 0.84 kg, mean ± s.d.)), early weaner phase diet (control vs 0.1% betaine) and late weaner phase diet (control vs 0.1% betaine). Basal diets contained sufficient methionine and choline as per industry practice. Growth performance during early, late and whole weaner phase were recorded. Blood IGF-1 was measured at 7 days and 35 days post-weaning. Key results Supplementing 0.1% betaine during the early weaner phase reduced (P < 0.05) growth rate over the early post-weaning period (0–7 days) in both light- and normal-weight weaners, although blood IGF-1 concentration (7 days post-weaning) was not affected. Betaine supplementation during early or late weaner phase did not affect growth performance over the late weaner phase (7–35 days), whole weaner phase (0–35 days) or blood IGF-1 concentration (35 days) of light- or normal-weight weaners. Light-weight weaners had a lower feed intake, and a lower average daily gain than did the normal-weight weaners during the early, late and whole post-weaning periods (all P < 0.01). Conclusions Light-weight weaners had inferior production performance during the weaner phase, which was not improved by betaine supplementation. Implications Betaine supplementation is not recommended in the weaner phase when other dietary methyl donors are sufficient.

Interactive Effects of Glycine Equivalent, Cysteine, and Choline on Growth Performance, Nitrogen Excretion Characteristics, and Plasma Metabolites of Broiler Chickens Using Neural Networks Optimized with Genetic Algorithms

Simple Summary

The negative effects of nitrogen emissions caused by animal husbandry on the environment can be reduced by lowering the crude protein content in the diets of broiler chickens. The nonessential amino acids glycine and serine, investigated together as glycine equivalent, can limit the growth of broiler chickens fed diets that are low in crude protein. The response of broiler chickens to dietary glycine equivalent is not constant and is affected by endogenous precursors of glycine equivalent and metabolic processes that dissipate glycine equivalent. Choline can be converted to glycine, and glycine equivalent is required to form cysteine from methionine. The present study investigated interactive effects among dietary glycine equivalent, cysteine, and choline in broiler chickens. The results showed that the gain:feed ratio increased with dietary glycine equivalent supplementation. The extent of interactive effects among glycine equivalent, cysteine, and choline on the gain:feed ratio was hardly pronounced. Very high nitrogen-utilization efficiency with low variation among treatments was found. The findings indicate that small differences in nitrogen-utilization efficiency caused low glycine equivalent dissipation for nitrogen excretion, likely resulting in small interactive effects among dietary glycine equivalent, cysteine, and choline. These results contribute to further dietary crude protein reduction in feed for broiler chickens.

Abstract

Responses of broiler chickens to dietary glycine equivalent (Gly_equi) are affected by dietary cysteine and choline. Hence, this study investigated interactive effects among dietary Gly_equi, cysteine, and choline on the growth of broiler chickens. Male Ross 308 broiler chickens were maintained in 105 metabolism units (10 birds/unit) from days 7 to 22. Excreta were collected in 12-h intervals from days 18 to 21. Blood was sampled on day 22 (1 bird/unit). Five levels each of Gly_equi (9–21 g/kg), cysteine (2–5 g/kg), and choline (0.5–1.7 g/kg) were tested under 15 diets in 7 replicates each following a fractional central composite design. Another diet was provided to five metabolism units (15 birds/unit) to measure prececal amino acid digestibility. Data were evaluated using neural networks. The gain:feed ratio (G:F) increased with digestible Gly_equi intake. Differences between low and high digestible cysteine intake were low. Effects of choline intake on G:F were low. Nitrogen-utilization efficiency (NUE) was high (≥77%), with low variation among treatments. Plasma metabolites varied among treatments and indicated that metabolism of Gly_equi, cysteine, and choline was influenced. These findings showed that interactive effects of dietary Gly_equi, cysteine, and choline on growth were small, possibly because NUE was barely influenced.

Developmental changes in physiological amino acids and hepatic methionine remethylation enzyme activities in E10-21 chick embryos and D1-49 broilers

The remethylation of homocysteine to methionine is important for chick embryos to sustain the S-adenosylmethionine transmethylation reactions, which are essential for the rapid proliferation of cells. Developmental changes in hepatic 5-methyltetrahydrofolate-homocysteine methyltransferase (MFMT), betaine-homocysteine methyltransferase (BHMT) and hepatic serine hydroxymethyltransferase (SHMT) were determined in E10-21 Cobb 500 broiler chick embryos and hatched chicks from D1-49. Hepatic levels of free serine, glycine, putrescine, spermidine and spermine levels were also determined. Analyses showed hepatic MFMT-specific activity doubled from E10 to E12, with remaining embryo development experiencing small fluctuations in activity through E21. Hepatic MFMT doubled immediately after hatch, with peak activity occurring at D3. Afterwards, hepatic MFMT-specific activity steadily declined from D7-49. Hepatic BHMT activity was higher from E10 to E16 of embryogenesis, decreased rapidly at E17 and remained lower through E21 (p < .05). Hepatic BHMT-specific activity was also lower in chicks, with the exception of a peak in specific activity on D7. BHMT activity returned to lower levels by D21. Throughout embryogenesis, hepatic SHMT activity in chick embryos remained relatively constant except for a decrease at 13E, followed by an increase at 14E. Maximal activity of SHMT was found the first day post-hatch. Additionally, SHMT activity was significantly lower in growing chicks than that in embryos. Hepatic-free serine and glycine levels were negatively correlated with SHMT in hatched chicks. Hepatic polyamine, putrescine and spermidine shared a similar development pattern: peak level in the middle of incubation, low at late embryogenesis and lowest during the post-hatch period except an increase within one week after hatch. The sharp increase in hepatic concentrations of glycine, serine and putrescine, along with increased specific activities of MHMT, BHMT and SHMT from D1-7, suggests that methionine conservation (remethylation from homocysteine) and glycine/serine is critical for young chicks for organ growth, maturation, and development.

Dietary Egg Protein Prevents Hyperhomocysteinemia via Upregulation of Hepatic Betaine-Homocysteine S-Methyltransferase Activity in Folate-Restricted Rats

BACKGROUND

Hyperhomocysteinemia is associated with increased cardiovascular disease risk. Whole eggs contain several nutrients known to affect homocysteine regulation, including sulfur amino acids, choline, and B vitamins.

OBJECTIVE

The aim of this study was to determine the effect of whole eggs and egg components (i.e., egg protein and choline) with respect to 1) homocysteine balance and 2) the hepatic expression and activity of betaine-homocysteine S-methyltransferase (BHMT) and cystathionine β-synthase (CBS) in a folate-restricted (FR) rat model of hyperhomocysteinemia.

METHODS

Male Sprague Dawley rats (n = 48; 6 wk of age) were randomly assigned to a casein-based diet (C; n = 12), a casein-based diet supplemented with choline (C + Cho; 1.3%, wt:wt; n = 12), an egg protein-based diet (EP; n = 12), or a whole egg-based diet (WE; n = 12). At week 2, half of the rats in each of the 4 dietary groups were provided an FR (0 g folic acid/kg) diet and half continued on the folate-sufficient (FS; 0.2 g folic acid/kg) diet for an additional 6 wk. All diets contained 20% (wt:wt) total protein. Serum homocysteine was measured by HPLC and BHMT and CBS expression and activity were evaluated using real-time quantitative polymerase chain reaction, Western blot, and enzyme activity. A 2-factor ANOVA was used for statistical comparisons.

RESULTS

Rats fed FR-C exhibited a 53% increase in circulating homocysteine concentrations compared with rats fed FS-C (P < 0.001). In contrast, serum homocysteine did not differ between rats fed FS-C and FR-EP (P = 0.078). Hepatic BHMT activity was increased by 45% and 40% by the EP (P < 0.001) and WE (P = 0.002) diets compared with the C diets, respectively.

CONCLUSIONS

Dietary intervention with egg protein prevented elevated circulating homocysteine concentrations in a rat model of hyperhomocysteinemia, due in part to upregulation of hepatic BHMT. These data may support the inclusion of egg protein for dietary recommendations targeting hyperhomocysteinemia prevention.

Responses of juvenile European flounder (Platichthys flesus) to multistress in the Vilaine estuary, during a 6-month survey

Physiological and genetic responses of age 0+ Platichthys flesus were investigated in the eutrophicated and moderately contaminated Vilaine estuary, during a 6-month survey. The main objective of this study was to explore the biological responses of fishes during their juvenile period in an estuarine system in order to detect a possible selective pressure induced by the environmental stress. Our results showed a general convergence in physiological responses along the survey: an increase in genotoxicity was associated with an increase in mRNA expression of ATPase and betaine homocysteine methyltransferase. These results could suggest an increase of cellular damage, energetic request, and detoxification rate related to the growing exposure time to stress. Considering the aging of the cohort, the genetic characteristics of the Vilaine flounder cohort came closer to the one observed in a highly stressed system, the Seine estuary, suggesting a potential selective pressure mainly induced by the chemical stress.

The effect of choline and cystine on the utilisation of methionine for protein accretion, remethylation and trans-sulfuration in juvenile shrimp Penaeus monodon

This 35-d feeding experiment examined in juvenile shrimp Penaeus monodon (3·3 g initial body weight) the effects of methionine (Met), choline and cystine on protein accretion and the activity of two key enzymes of remethylation (betaine–homocysteine methyltransferase; BHMT) and trans-sulfuration (cystathionine β-synthase; CBS). The interaction between Met and choline was tested using semi-purified diets either adequate or limiting (30 or 50 %) in total sulphur amino acid (SAA) content with a constant cystine:Met ratio. The diets contained either basal or excess choline (3 v. 7 g/kg feed). Cystine was added to two other 30 and 50 % Met-limiting diets to adjust the SAA supply to that of the control diet in order to evaluate the interaction between Met and cystine. As expected, N accretion was significantly lower with the SAA-limiting diets but increased back to control levels by the extra choline or cystine, demonstrating their sparing effect on Met utilisation for protein accretion. We show, for the first time, the activities of BHMT and CBS in shrimp hepatopancreas. Only BHMT responded to the SAA deficiencies, whereas the extra choline and cystine did not stimulate remethylation or down-regulate trans-sulfuration. Our data also suggest the capacity of P. monodon to synthesise taurine, being significantly affected by the cystine level in the 30 % SAA-limiting diets. Further research is warranted to better understand the metabolic regulation of taurine synthesis in shrimp and of the observed Met-sparing effects.

Tissue methionine cycle activity and homocysteine metabolism in female rats: impact of dietary methionine and folate plus choline

Impaired transfer of methyl groups via the methionine cycle leads to plasma hyperhomocysteinemia. The tissue sources of plasma homocysteine in vivo have not been quantified nor whether hyperhomocysteinemia is due to increased entry or decreased removal. These issues were addressed in female rats offered diets with either adequate or excess methionine (additional methyl groups) with or without folate and choline (impaired methyl group transfer) for 5 wk. Whole body and tissue metabolism was measured based on isotopomer analysis following infusion with either [1-(13)C,methyl-(2)H3]methionine or [U-(13)C]methionine plus [1-(13)C]homocysteine. Although the fraction of intracellular methionine derived from methylation of homocysteine was highest in liver (0.18-0.21), most was retained. In contrast, the pancreas exported to plasma more of methionine synthesized de novo. The pancreas also exported homocysteine to plasma, and this matched the contribution from liver. Synthesis of methionine from homocysteine was reduced in most tissues with excess methionine supply and was also lowered in liver (P<0.01) with diets devoid of folate and choline. Plasma homocysteine concentration (P<0.001) and flux (P=0.001) increased with folate plus choline deficiency, although the latter still represented <12% of estimated tissue production. Hyperhomocysteinemia also increased (P<0.01) the inflow of homocysteine into most tissues, including heart. These findings indicate that a full understanding of hyperhomocysteinemia needs to include metabolism in a variety of organs, rather than an exclusive focus on the liver. Furthermore, the high influx of homocysteine into cardiac tissue may relate to the known association between homocysteinemia and hypertension.

Potential nutritional and physiological functions of betaine in livestock

The present review summarises the potential nutritional and physiological functions of betaine as a feed additive in relation to performance criteria in livestock production. Betaine, the trimethyl derivative of the amino acid glycine, is a metabolite of plant and animal tissues. In plants, betaine is particularly synthesised and accumulated as an osmoprotectant against salt and temperature stress. In animals, betaine is the product of choline oxidation or it originates from nutritional sources. Over the past decades, numerous studies have been carried out to investigate the potential effects of betaine supplementation on animal performance. Due to its chemical structure, betaine shows the characteristics of a dipolar zwitterion resulting in osmoprotective properties. Promoting effects on the intestinal tract against osmotic stress occurring during diarrhoea or coccidiosis have been reported following betaine supplementation in pigs and poultry. There is also some evidence that dietary betaine may improve the digestibility of specific nutrients. As a product of choline oxidation, betaine is involved in transmethylation reactions of the organism. Betaine as a methyl donor provides its labile methyl groups for the synthesis of several metabolically active substances such as creatine and carnitine. Supplementation with betaine may decrease the requirement for other methyl donors such as methionine and choline. There is also some evidence for enhanced methionine availability after dietary supplementation of betaine resulting in improved animal performance. Alterations in the distribution pattern of protein and fat in the body have been reported following betaine supplementation. A more efficient use of dietary protein may result from a methionine-sparing effect of betaine, but also direct interactions of betaine with metabolism-regulating factors have to be considered. Though the mode of action of betaine as a carcass modifier remains open, there is, however, growing evidence that betaine could have a positive impact both on animal performance and carcass quality.

Mechanisms of protection by the betaine-homocysteine methyltransferase/betaine system in HepG2 cells and primary mouse hepatocytes

Betaine-homocysteine methyltransferase (BHMT) regulates homocysteine levels in the liver. We previously reported that the alteration of BHMT is associated with alcoholic liver steatosis and injury. In this study, we tested whether BHMT protects hepatocytes from homocysteine-induced injury and lipid accumulation. Both BHMT transfectants of HepG2 cells and primary mouse hepatocytes with suppressed BHMT were generated. Comparisons were made between the cell models with respect to their response to homocysteine treatments. Homocysteine metabolism was impaired in HepG2 cells, and the expression of BHMT in HepG2 cells ameliorated the impairment and stabilized the levels of intracellular homocysteine after the addition of exogenous homocysteine. BHMT expression inhibited homocysteine-induced glucose-regulated protein 78 (GRP78) and C/EBP-homologous protein (CHOP) and homocysteine-induced cell death. A betaine treatment protected primary mouse hepatocytes from a homocysteine-induced increase in GRP78 and cell death but not a tunicamycin-induced increase. Homocysteine induced greater CHOP expression (2.7-fold) in BHMT small interfering RNA (siRNA)-transfected cells than in a control (1.9-fold). Homocysteine-induced cell death was increased by 40% in the siRNA-treated cells in comparison with the control. Apolipoprotein B (apoB) expression was higher and triglycerides and cholesterol were lower in HepG2 expressing BHMT. In primary mouse hepatocytes, homocysteine induced the accumulation of triglycerides and cholesterol, which was reduced in the presence of betaine. Betaine partially reduced homocysteine-induced sterol regulatory element binding protein 1 expression in HepG2 cells and increased S-adenosylmethionine in primary mouse hepatocytes.

CONCLUSION

The BHMT/betaine system directly protects hepatocytes from homocysteine-induced injury but not tunicamycin-induced injury, including an endoplasmic reticulum stress response, lipid accumulation, and cell death. This system also exhibits a more generalized effect on liver lipids by inducing ApoB expression and increasing S-adenosylmethionine/S-adenosylhomocysteine.

Betaine can partially spare choline in chicks but only when added to diets containing a minimal level of choline

The ability of betaine to serve as a methyl donor in chicks was assessed in 3 bioassays using a choline-free purified diet that contained adequate methionine (Met). In assay 1, choline and betaine were each supplemented at 300 mg/kg in a 2 x 2 factorial arrangement of diets. Supplemental choline improved (P < 0.05) growth performance over the 9-d growth period, whereas betaine alone had no effect. In assay 2, graded supplements of choline produced a linear increase (P < 0.05) in growth performance criteria over a 9-d growth period. Additionally, hepatic betaine-homocysteine (Hcy) methyltransferase (BHMT) activity decreased linearly (P < 0.05), whereas plasma total Hcy remained unchanged. Addition of 260 or 600 mg/kg betaine to the choline-free basal diet did not affect growth performance or BHMT activity, but 600 mg/kg betaine reduced (P < 0.05) plasma total Hcy. Assay 3 was designed to quantify the ability of betaine to spare choline. Minimal supplemental choline requirements of 20.8 +/- 1.50 mg/d (722 mg/kg diet) and 10.5 +/- 1.03 mg/d (412 mg/kg diet) were estimated in the absence and presence of 1000 mg/kg supplemental betaine, respectively. Based on these estimates, 50% of the dietary choline requirement must be supplied as choline per se, but the remaining 50% can be replaced by betaine. Collectively, these data suggest betaine and Met have minimal choline-sparing activity in chicks fed purified diets devoid of preformed choline. However, addition of betaine to diets containing minimal choline allows a marked reduction in the total dietary choline requirement.

Homocysteine Remethylation in Broilers Fed Surfeit Choline or Betaine and Varying Levels and Sources of Methionine from Eight to Twenty-Two Days of Age

Experiments were conducted to assess the effect of surfeit choline (CHOL) or betaine (BET) on growth performance and homocysteine (HCY) remethylation of young broilers fed graded levels of DL-Met (DLM) or 2-hydroxy-4-(methylthio) butanoic acid (HMB). In Experiment 1, a corn-peanut meal diet deficient in Met (0.25% digestible) and Cys (0.28% digestible) was fed; treatments were formulated to contain graded levels (0, 0.04, or 0.08%) of Met from DLM or 0.04% HMB (adjusted for 88% purity) that were fed in the presence or absence of surfeit isomethyl CHOL (0.25%) or BET (0.28%). In Experiment 2, identical treatments were used, but an additional level of HMB (0.08%) was fed, and the basal diet was adequate in Cys (0.43% digestible). There was no overall effect of CHOL or BET on growth performance in Experiments 1 and 2 (P > 0.05); a significant improvement (P < 0.05) in weight gain and feed efficiency did occur with CHOL and BET addition to the basal diet in Experiment 2. In both experiments, weight gain increased linearly (P < 0.05) with the addition of DLM or HMB. Slope ratio methodology was used to assess HMB efficacy in Experiment 2. In the presence of adequate Cys, HMB efficacy was 81.3%; addition of surfeit BET or CHOL had minimal effect on efficacy. The stable isotope study revealed that CHOL and BET addition to diets deficient in Met and Cys or Met alone increased HCY remethylation. It also showed that CHOL and BET have greater influence on folate-dependent remethylation of HCY (via Met synthase) than on BET-dependent remethylation (via BET-HCY methyltransferase) and that levels of CHOL and BET and type of S amino acid deficiency effect remethylation and HMB efficacy.

Inborn errors of sulfur-containing amino acid metabolism

Two superimposed metabolic sequences, transsulfuration and the methionine/homocysteine cycle, form the pathway for methionine metabolism in mammalian liver. This combined pathway was formulated first to explain observations in subjects with homocystinuria caused by cystathionine synthase deficiency. Since that time additional inborn errors have been discovered, and currently we know of human subjects with isolated defects in all of the reactions of the combined pathway with only one exception: betaine homocysteine methyltransferase. Studies of these inborn errors have contributed significantly to our knowledge of human methionine metabolism and to the clinical consequences of impaired metabolism. Transsulfuration appears to function primarily for the metabolism of excess methionine, and each of the 5 defects in this pathway results in the accumulation of 1 or more of the normal metabolites. Thus, studies of these disorders may provide insight into both the potential pathological sequelae of nutritional methionine excess as well as whether laboratory testing allows the detection of excess.

Molecular identification and expression of differentially regulated genes of the European flounder, Platichthys flesus, submitted to pesticide exposure

Effects of pesticide exposure on the European flounder, Platichthys flesus, were investigated using a suppression subtractive hybridization method (SSH) to identify up- and down-regulated genes after a 30-day exposure to herbicides (a cocktail of atrazine, diuron, and isoproturon, and a single herbicide, glyphosate). A total of 256 expressed gene sequences were identified as having the potential for being differentially expressed, of which 116 could be identified by homology with databased sequences. The metabolic functions with which they are associated include energy production, general metabolism, signaling, transport, immune system, and structure. Expression of 14 of these genes was analyzed in liver, muscle, and gills by reverse transcriptase-polymerase chain reaction (RT-PCR) under experimental conditions (0, 15, and 30 days of exposure) and under field conditions (sampling in two estuaries displaying different levels of pesticide contamination). This study provides a first basis for studying the response of fish to pesticide exposure and allows the characterization of new potential genetic markers of pesticide contamination in the field.

Effect of homocysteine-lowering nutrients on blood lipids: results from four randomised, placebo-controlled studies in healthy humans

BACKGROUND

Betaine (trimethylglycine) lowers plasma homocysteine, a possible risk factor for cardiovascular disease. However, studies in renal patients and in obese individuals who are on a weight-loss diet suggest that betaine supplementation raises blood cholesterol; data in healthy individuals are lacking. Such an effect on cholesterol would counteract any favourable effect on homocysteine. We therefore investigated the effect of betaine, of its precursor choline in the form of phosphatidylcholine, and of the classical homocysteine-lowering vitamin folic acid on blood lipid concentrations in healthy humans.

METHODS AND FINDINGS

We measured blood lipids in four placebo-controlled, randomised intervention studies that examined the effect of betaine (three studies, n = 151), folic acid (two studies, n = 75), and phosphatidylcholine (one study, n = 26) on plasma homocysteine concentrations. We combined blood lipid data from the individual studies and calculated a weighted mean change in blood lipid concentrations relative to placebo. Betaine supplementation (6 g/d) for 6 wk increased blood LDL cholesterol concentrations by 0.36 mmol/l (95% confidence interval: 0.25-0.46), and triacylglycerol concentrations by 0.14 mmol/l (0.04-0.23) relative to placebo. The ratio of total to HDL cholesterol increased by 0.23 (0.14-0.32). Concentrations of HDL cholesterol were not affected. Doses of betaine lower than 6 g/d also raised LDL cholesterol, but these changes were not statistically significant. Further, the effect of betaine on LDL cholesterol was already evident after 2 wk of intervention. Phosphatidylcholine supplementation (providing approximately 2.6 g/d of choline) for 2 wk increased triacylglycerol concentrations by 0.14 mmol/l (0.06-0.21), but did not affect cholesterol concentrations. Folic acid supplementation (0.8 mg/d) had no effect on lipid concentrations.

CONCLUSIONS

Betaine supplementation increased blood LDL cholesterol and triacylglycerol concentrations in healthy humans, which agrees with the limited previous data. The adverse effects on blood lipids may undo the potential benefits for cardiovascular health of betaine supplementation through homocysteine lowering. In our study phosphatidylcholine supplementation slightly increased triacylglycerol concentrations in healthy humans. Previous studies of phosphatidylcholine and blood lipids showed no clear effect. Thus the effect of phosphatidylcholine supplementation on blood lipids remains inconclusive, but is probably not large. Folic acid supplementation does not seem to affect blood lipids and therefore remains the preferred treatment for lowering of blood homocysteine concentrations.

Betaine and Folate Status as Cooperative Determinants of Plasma Homocysteine in Humans

OBJECTIVE

Two published studies have demonstrated that betaine in the circulation is a determinant of plasma total homocysteine, but none had sufficient power to investigate the possible effect modification by folate status.

METHODS AND RESULTS

We measured homocysteine, betaine, folate, vitamin B(6), and related compounds in serum/plasma from 500 healthy men and women aged 34 to 69 years before (fasting levels) and 6 hours after a standard methionine loading test. Choline, dimethylglycine, and folate were determinants of plasma betaine in a multiple regression model adjusting for age and sex. The increase in homocysteine after loading showed a strong inverse association with plasma betaine and a weaker inverse association with folate and vitamin B(6). Fasting homocysteine showed a strong inverse relation to folate, a weak relation to plasma betaine, and no relation to vitamin B(6). Notably, adjusted (for age and sex) dose-response curves for the postmethionine increase in homocysteine or fasting homocysteine versus betaine showed that the inverse associations were most pronounced at low serum folate, an observation that was confirmed by analyses of interaction.

CONCLUSIONS

Collectively, these results show that plasma betaine is a strong determinant of increase in homocysteine after methionine loading, particularly in subjects with low folate status. In 500 healthy subjects, postmethionine load increase in tHcy showed a stronger inverse relation to betaine than to folate and vitamin B6, whereas for fasting tHcy, betaine was a weaker determinant than folate. For both tHcy modalities, the association with betaine was most pronounced in subjects with low folate status.

Betaine as a Determinant of Postmethionine Load Total Plasma Homocysteine Before and After B-Vitamin Supplementation

Objective— Betaine is a substrate in the betaine–homocysteine methyltransferase reaction, converting homocysteine to methionine. There are only sparse data on plasma betaine as a determinant of the plasma total homocysteine (tHcy) concentration.

Methods and Results— Ninety patients undergoing coronary angiography were randomized into 4 groups administered oral: (1) folic acid (0.8 mg), vitamin B12 (0.4 mg), and vitamin B6 (40 mg); (2) folic acid and vitamin B12; (3) vitamin B6 alone; or (4) placebo. Nonfasting blood samples were collected at baseline and 3, 14, and 28 days and 3, 6, and 12 months after treatment start. A 4-hour methionine-loading test (0.1 g/kg) was performed at baseline and after 3 months. At baseline, median (interquartile range) plasma betaine was 36.9 μmol/L (range: 30.3 to 46.8) and was increased by 15% after methionine loading. The postmethionine load (PML) increase in tHcy was inversely related to plasma betaine (β=−0.29, P =0.02) and even more strongly to PML betaine (β=−0.47, P <0.001). After 3 months of intervention, the relation between the PML increase in tHcy and PML betaine was weakened (β=−0.33, P =0.007).

Conclusions— Plasma betaine is a strong determinant of the PML increase in tHcy in subjects not supplemented with B-vitamins.

Low Dose Betaine Supplementation Leads to Immediate and Long Term Lowering of Plasma Homocysteine in Healthy Men and Women

High plasma homocysteine is a risk for cardiovascular disease and can be lowered through supplementation with 6 g/d of betaine. However, dietary intake of betaine is approximately 0.5-2 g/d. Therefore, we investigated whether betaine supplementation in the range of dietary intake lowers plasma homocysteine concentrations in healthy adults. Four groups of 19 healthy subjects ingested three doses of betaine or placebo daily for 6 wk. A methionine loading test was performed during run in, on d 1 of betaine supplementation, and after 2 and 6 wk of betaine supplementation. Fasting plasma homocysteine after 6-wk daily intakes of 1.5, 3 and 6 g of betaine was 12% (P < 0.01), 15% (P < 0.002) and 20% (P < 0.0001) less than in the placebo group, respectively. Furthermore, the increase in plasma homocysteine after methionine loading on the 1st d of betaine supplementation was 16% (P < 0.06), 23% (P < 0.008) and 35% (P < 0.0002) less than in the placebo group, respectively, and after 6 wk of supplementation was 23% (P < 0.02), 30% (P < 0.003) and 40% (P < 0.0002) less, respectively. Thus, doses of betaine in the range of dietary intake reduce fasting and postmethionine loading plasma homocysteine concentrations. A betaine-rich diet might therefore lower cardiovascular disease risk.

Interaction between dietary methionine and methyl donor intake on rat liver betaine-homocysteine methyltransferase gene expression and organization of the human gene

We previously showed that rat liver betaine-homocysteine methyltransferase (BHMT) mRNA content and activity increased 4-fold when rats were fed a methionine-deficient diet containing adequate choline, compared with rats fed the same diet with control levels of methionine (Park, E. I., Renduchintala, M. S., and Garrow, T. A. (1997) J. Nutr. Biochem. 8, 541-545). A further 2-fold increase was observed in rats fed the methionine-deficient diet with supplemental betaine. The nutrition studies reported here were designed to determine whether other methyl donors would induce rat liver BHMT gene expression when added to a methionine-deficient diet and to define the relationship between the degree of methionine restriction and level of methyl donor intake on BHMT expression. Therefore, rats were fed amino acid-defined diets varying in methionine and methyl donor composition. The effect of diet on BHMT expression was evaluated using Northern, Western, and enzyme activity analyses. Similar to when betaine was added to a methionine-deficient diet, choline or sulfonium analogs of betaine induced BHMT expression. The diet-induced induction of hepatic BHMT activity was mediated by increases in the steady-state level of its mRNA and immunodetectable protein. Using methyl donor-free diets, we found that methionine restriction was required but alone not sufficient for the high induction of BHMT expression. Concomitant with methionine restriction, dietary methyl groups were required for high levels of BHMT induction, and a dose-dependent relationship was observed between methyl donor intake and BHMT induction. Furthermore, the severity of methionine restriction influenced the magnitude of BHMT induction. To study the molecular mechanisms that regulate the expression of BHMT, we have cloned the human BHMT gene. This gene spans about 20 kilobases of DNA and contains 8 exons and 7 introns. Using RNA isolated from human liver and hepatoma cells, a major transcriptional start site has been mapped using the 5' rapid amplification of cDNA ends technique, and this start site is 26 nucleotides downstream from a putative TATA box.