Tier 4
Zhaohan Xu et al. · Parkinsonism & related disorders · 2025
Case-control diagnostic biomarker study. TMAO-pathway metabolite patterns, including higher betaine in some patient comparisons, helped distinguish groups with Parkinson disease and cognitive impairment.
Original sources: DOI · PubMed
Tier 4
Fei Guo et al. · International urology and nephrology · 2021
Case-control kidney biomarker pilot. Betaine and related metabolites tracked kidney function, and a combined panel discriminated CKD in the studied sample.
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Tier 4
Apolline Imbard et al. · Clinical chemistry and laboratory medicine · 2013
Cross-sectional biomarker study. Betaine correlated with folate and homocysteine-related measures, illustrating interactions across one-carbon pathways.
Original sources: DOI · PubMed
Tier 2
Francien V Velzing-Aarts et al. · The American journal of clinical nutrition · 2005
Longitudinal pregnancy study. Betaine fell during early pregnancy and later became an important inverse predictor of homocysteine.
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Tier 4
Pål I Holm et al. · Arteriosclerosis, thrombosis, and vascular biology · 2005
Cross-sectional methionine-challenge study. Higher betaine predicted a smaller post-load homocysteine rise, especially with low folate status.
Original sources: DOI · PubMed
Tier 4
Liang Shi et al. · Journal of cancer research and clinical oncology · 2024
Case-control diagnostic study. Betaine and related metabolites differed across diagnostic groups; a combined panel showed preliminary discriminatory value.
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Tier 4
Michael Lever et al. · Cardiovascular drugs and therapy · 2009
Observational drug-exposure comparison. Bezafibrate use was associated with unusually high urinary betaine loss, which correlated with homocysteine in selected groups.
Original sources: DOI · PubMed
Tier 2
Michael Lever et al. · Clinical biochemistry · 2007
Repeated-measure biomarker study. Individuals had relatively consistent urinary betaine excretion, with greater variation between people than within a person.
Original sources: DOI · PubMed
Tier 4
Monika A Mlodzik-Czyzewska et al. · Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2022
Cross-sectional genotype study. Higher plasma betaine was associated with lower BMI and weight mainly in men; other nutrient/genotype associations differed by sex.
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Tier 2
M Lever et al. · Clinica chimica acta; international journal of clinical chemistry · 1994
Comparative clinical biomarker study. Urinary betaine was often elevated in diabetes and kidney disease; circulating and urinary patterns differed.
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Tier 4
Michael Lever et al. · Clinical chemistry and laboratory medicine · 2012
Cross-sectional clinical comparison. Betaine was related to cortisol and metabolic measures but not clearly to CRP, suggesting stress and inflammation are not interchangeable explanations.
Original sources: DOI · PubMed
Tier 4
Michael Lever et al. · Cardiovascular diabetology · 2012
Observational challenge study. Betaine levels and urinary losses were more variable in diabetes, and circulating betaine predicted post-load homocysteine responses.
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Tier 2
Michael Lever et al. · Clinical biochemistry · 2004
Repeated-measure physiology study. Circulating glycine betaine showed individual stability despite fluid-balance challenges, unlike dietary proline betaine.
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Tier 4
R P F Dullaart et al. · Lipids in health and disease · 2016
Cross-sectional metabolic study. Higher betaine was associated with lower phospholipid-transfer-protein activity and a more favorable selected lipid pattern.
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Tier 2
P Lundberg et al. · Clinical chemistry · 1995
Clinical assay-validation study. NMR could quantify urinary betaine and dimethylglycine with useful analytical performance in the studied samples.
Original sources: PubMed
Tier 4
Monika A Mlodzik-Czyzewska et al. · The Journal of nutrition · 2025
Cross-sectional nutrition/genotype study. Higher betaine intake was associated with lower insulin and HOMA-IR, alongside several other nutrient/genotype associations.
Original sources: DOI · PubMed
Tier 2
Tomasz Sledzinski et al. · Obesity surgery · 2011
Before-and-after patient study. Serum betaine fell after surgery while homocysteine remained elevated. The authors proposed testing supplementation, which this study did not do.
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Tier 4
Michael Lever et al. · Clinical biochemistry · 2012
Comparative observational analysis. The correlation between urinary betaine loss and homocysteine was stronger in groups with elevated plasma lipids.
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Tier 4
Shan Huang et al. · Journal of agricultural and food chemistry · 2023
Case-control metabolomics study. Higher betaine, especially combined with lower TMAO, was associated with lower odds of acute myocardial infarction.
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Tier 4
Howard Steiger et al. · Journal of psychiatry & neuroscience : JPN · 2025
Case-control biomarker study. Betaine was elevated in active anorexia nervosa; nutrient and methylation associations differed among groups.
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Tier 4
W J Dellow et al. · Diabetes research and clinical practice · 1999
Cross-sectional clinical study. High urinary betaine loss was associated with some measures of poor glucose control and proximal-tubular dysfunction, but much variation remained unexplained.
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Tier 4
Svetlana V Konstantinova et al. · The Journal of nutrition · 2008
Cross-sectional population study. Higher betaine was associated with a more favorable metabolic-risk profile, while choline often showed the opposite pattern.
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Tier 4
Weibang Yu et al. · Journal of pharmaceutical and biomedical analysis · 2018
Analytical validation with clinical application. The assay quantified TMAO, choline and betaine; the main reported prognostic association concerned choline.
Original sources: DOI · PubMed
Tier 2
Michael Lever et al. · Clinical biochemistry · 2007
Longitudinal clinical biomarker study. Abnormally high urinary betaine persisted for years in some patients.
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Tier 4
Michael Lever et al. · Clinical biochemistry · 2007
Cross-sectional lipid-clinic study. Endocrine and metabolic predictors of betaine concentrations and urinary loss differed between men and women.
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Tier 4
Mohammad Sadegh Pour Abbasi et al. · BMC endocrine disorders · 2023
Cross-sectional study. Higher betaine intake was associated with lower blood pressure and selected combined-intake lipid measures, with many other outcomes null.
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Tier 4
Alejandra M Wiedeman et al. · The Journal of nutrition · 2018
Observational secondary analysis of a nutrition RCT. Higher plasma betaine was associated with better visual-motor integration at age 2; betaine itself was not the randomized treatment.
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Tier 2
Y-M Chen et al. · International journal of obesity (2005) · 2015
Prospective community study. Higher serum betaine was associated with lower total and central adiposity, with stronger findings in men.
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Tier 2
Bi-Xia Huang et al. · The British journal of nutrition · 2016
Prospective community study. Higher circulating betaine was associated with a greater lean-mass percentage and lower prevalence of low lean mass, particularly in men.
Original sources: DOI · PubMed
Tier 4
Laura Díez-Ricote et al. · The American journal of clinical nutrition · 2022
Observational secondary analysis within PREDIMED-Plus. Increases in dietary betaine were associated with favorable changes in weight, glycemia and selected lipids during a broader lifestyle trial.
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Tier 4
Heather R Millard et al. · European journal of nutrition · 2018
Prospective cohort. A middle-high betaine-intake category was associated with greater coronary-disease risk, without a simple linear protective pattern.
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Tier 4
Rima Obeid et al. · Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2024
Prospective CKD cohort. Higher plasma betaine was associated with worse cardiovascular and renal outcomes after adjustment; kidney function also affected metabolite concentrations.
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Tier 4
HanByul Jang et al. · Nutrients · 2021
Observational lifestyle-intervention analysis. Changes in choline and the betaine-to-choline ratio were associated with lipid, diet and microbiome changes during lifestyle treatment.
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Tier 4
Michael Lever et al. · Cardiovascular drugs and therapy · 2014
Matched observational drug comparison. Urinary betaine and dimethylglycine losses were substantially higher during bezafibrate treatment; supplementation benefit was proposed but not tested.
Original sources: DOI · PubMed
Tier 4
Simone J P M Eussen et al. · The British journal of nutrition · 2007
Observational secondary analysis of a vitamin RCT. Vitamin treatment changed homocysteine and betaine, but biochemical changes did not clearly improve cognition; a betaine-memory trend was not significant.
Original sources: DOI · PubMed