Nonalcoholic Steatohepatitis is associated with a state of betaine-insufficiency

BACKGROUND AND AIMS: Nonalcoholic fatty liver disease (NAFLD) develops from a complex process, which includes changes in the liver methylome. Betaine plays a pivotal role in the regulation of methylogenesis. We performed a two-stage case-control study, which included patients with biopsy-proven NAFLD in order to explore circulating levels of betaine and its association with the histological spectrum. We also explored the association between a missense p.Ser646Pro variant in DMGDH (dimethylglycine dehydrogenase mitochondrial) and NAFLD severity (n =390).
RESULTS: In the discovery phase (n = 48), betaine levels were associated with the disease severity (p = 0.0030), including liver inflammation (Spearman R: - 0.51, p = 0.001), ballooning degeneration (R: - 0.50, p = 0.01), and fibrosis (R: - 0.54, p = 0.0008). Betaine levels were significantly decreased in nonalcoholic steatohepatitis (NASH) in comparison with nonalcoholic fatty liver (NAFL). Further replication (n = 51) showed that betaine levels were associated with advanced NAFLD (p = 0.0085), and patients with NASH had a 1.26-fold decrease in betaine levels compared with those with NAFL. The rs1805074 was significantly associated with the disease severity (p = 0.011).
CONCLUSION: NAFLD severity is associated with a state of betaine-insufficiency.

Sookoian, S., et al., Nonalcoholic Steatohepatitis is associated with a state of betaine-insufficiency. Liver Int, 2016.