Tier 4 — mechanistic

Plasma choline and betaine and risks of cardiovascular events and recurrent stroke after ischemic stroke

Chongke Zhong, Mengyuan Miao, Bizhong Che, Jigang Du, Aili Wang, Hao Peng, Xiaoqing Bu, Jintao Zhang, Zhong Ju, Tan Xu, Jiang He, Yonghong Zhang
The American journal of clinical nutrition 2021 114(4):1351-1359

Bibliography

PubMed
PMID 34159355
DOI
10.1093/ajcn/nqab199
Funding
Funding was not specified in the indexed record or accessible funding metadata.
Competing interests
A competing-interest declaration was not available in the indexed record or accessible disclosure metadata.

Study snapshot

DesignNested case-control study
ModelHuman participants
Sample323 cardiovascular-event cases and 323 matched controls after stroke
InterventionMeasured betaine status and related metabolites; no randomized TMG treatment
DurationProspective post-stroke follow-up
EndpointsRecurrent stroke; Cardiovascular events

What the study showed, in plain terms

Published in 2021, this source examined human observational and biomarker research. Design: Nested case-control study. Sample/model: 323 cardiovascular-event cases and 323 matched controls after stroke. The exposure or intervention was Measured betaine status and related metabolites; no randomized TMG treatment. Follow-up or treatment period: Prospective post-stroke follow-up.

Higher plasma betaine was associated with fewer recurrent cardiovascular events and strokes in this patient population.

Observational exposure analysis: residual confounding and reverse causation remain possible. Associations do not establish that betaine supplementation causes the same outcome. Diet recall, case selection or illness-related metabolite changes may introduce bias.

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Key findings

  • Higher plasma betaine was associated with fewer recurrent cardiovascular events and strokes in this patient population.
  • The recorded outcome domains were Recurrent stroke; Cardiovascular events.
  • The exposure was observed rather than assigned as an isolated supplement treatment.

What this study can and cannot tell us

  • Observational exposure analysis: residual confounding and reverse causation remain possible. Associations do not establish that betaine supplementation causes the same outcome. Diet recall, case selection or illness-related metabolite changes may introduce bias.
  • Confounding, dietary patterns, illness, medication use and reverse causation can influence an association. Blood or dietary concentrations do not identify the effect of starting a capsule.
  • Source basis: Indexed abstract and bibliographic data. Missing method details, funding information or participant denominators are not inferred.

Related papers in the corpus

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Dietary Choline and Betaine and Risk of CVD: A Systematic Review and Meta-Analysis of Prospective Studies
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Dietary Choline and Betaine Are Not Associated With the Risk of Type 2 Diabetes. A Systematic Review and Meta-Analysis of Observational Studies
Elham Sharifi-Zahabi et al. · Journal of diabetes research · 2026
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Association of choline and betaine with the risk of cardiovascular disease and all-cause mortality: Meta-analysis
Qinglin Yang et al. · European journal of clinical investigation · 2023
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Association of choline and betaine levels with cancer incidence and survival: A meta-analysis
Jiyoung Youn et al. · Clinical nutrition (Edinburgh, Scotland) · 2019

Editorial review

Reviewed by the Biohack Blueprint research team

Last verified

Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology