BACKGROUND: Folate, choline, and betaine participate in
homocysteine metabolism. It is not known whether they interact during
pregnancy. OBJECTIVE: The objective was to investigate how folate status
affects choline, betaine, and dimethylglycine during pregnancy.
DESIGN: Fasting
plasma folate, cobalamin, free choline, betaine, dimethylglycine, and total
homocysteine (tHcy) were measured longitudinally at >12, 15, 24-27, and 34
gestational weeks (GW); at labor (nonfasting); and in the cord in participants
(n = 522) from the Reus-Tarragona Birth Cohort (NUTricio i Creixement
Intrauteri Retardat phase). Timing, dose, and duration of folic acid supplement
use were recorded. Folate status was classified as below (low) or above (high)
median plasma folate at baseline (27.6 nmol/L) and at 24-27 GW (11.4 nmol/L).
Associations between folate or betaine with tHcy were investigated by using
multiple linear regression analysis.
RESULTS: Plasma betaine decreased by 34.8%
(1.0%) throughout pregnancy, and dimethylglycine increased by 39.7% (2.7%)
between 24-27 GW and labor (all P < 0.001). Low folate status was associated
with a higher dimethylglycine/betaine ratio from 15 GW and with lower plasma
betaine and higher dimethylglycine from 24 to 27 GW, for the rest of pregnancy,
compared with high status. Regression analysis showed that by 24-27 GW, both
plasma folate and betaine were inversely associated with tHcy when folate
status was low and that the association between betaine and tHcy depended on
folate status at 24-27 and 34 GW (interaction terms: P < 0.001 and P <
0.01). Betaine was inversely associated with tHcy at labor regardless of folate
status.
CONCLUSION: Low folate status enhances the reduction in betaine and the
increase in dimethylglycine during pregnancy and strengthens the association
between betaine and tHcy. This trial was registered at clinicaltrials.gov as
NCT01778205.
Fernandez-Roig, S., et al., Low folate status enhances pregnancy changes in plasma betaine and dimethylglycine concentrations and the association between betaine and homocysteine. Am J Clin Nutr, 2013
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