@article{b2735d6a27254121b3fc83d7215e5540,
title = "A U-shaped association between serum betaine and incident risk of first ischemic stroke in hypertensive patients",
abstract = "Background & aims: Betaine (a micronutrient) has important biological functions (e.g., preventing premature apoptosis and serving as a methyl donor). We investigated the association between baseline serum betaine and the incident risk of first stroke in hypertensive patients. Methods: We conducted a nested case–control study, including 622 patients with first stroke (including 502 ischemic stroke, 118 hemorrhagic stroke and 2 uncertain type of stroke) and 622 matched controls from the China Stroke Primary Prevention Trial (CSPPT). The study was conducted from May 2008 to August 2013. The study outcomes included first stroke and its subtypes: first ischemic and hemorrhagic stroke. Results: There was a U-shaped association between baseline serum betaine and the risk of first ischemic stroke. The risk of first ischemic stroke decreased with the increment of betaine (per 10 μmol/L increase: OR, 0.87; 95%CI: 0.77–0.99) in patients with betaine <77.7 μmol/L, while the risk of first ischemic stroke increased with the betaine increment (OR, 1.17; 95%CI: 1.01–1.36) in patients with betaine ≥77.7 μmol/L. However, there was no significant association between serum betaine and risk of first hemorrhagic stroke (per 10 μmol/L increase: OR, 0.98; 95%CI: 0.82–1.17). Conclusions: There was a U-shaped association between baseline betaine levels and the risk of first ischemic stroke in hypertensive patients, with a turning point at about 77.7 μmol/L. Clinical trial registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00794885.",
keywords = "Betaine, First ischemic stroke, First stroke, Hypertension",
author = "Liling Xie and Zhao, {Bo xin} and Jiajun Luo and Youbao Li and Fengxin Zhu and Li, {Guo feng} and Mingli He and Binyan Wang and Hao Zhang and Yefeng Cai and Yong Huo and Xiaobin Wang and Hou, {Fan Fan} and Xiping Xu and Xianhui Qin and Jing Nie",
note = "Funding Information: The study was supported by funding from the following: the National Natural Science Foundation of China [81730019 and 81521003]; the National Key Research and Development Program [2016YFE0205400, 2016YFC0903103, 2018ZX09739, 2018ZX09301034003], the Science and Technology Planning Project of Guangzhou, China [201707020010]; the Science, Technology and Innovation Committee of Shenzhen [JSGG20170412155639040, GJHS20170314114526143, JSGG20180703155802047]; the Economic, Trade and Information Commission of Shenzhen Municipality [20170505161556110, 20170505160926390]; President Foundation of Nanfang Hospital, Southern Medical University [2017C007]; Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University [2017J009].Dr. Yong Huo reports grants from the National Key Research and Development Program [2016YFC0903103].Dr. Xiping Xu reports grants from the National Key Research and Development Program [2016YFE0205400, 2018ZX09739, 2018ZX09301034003], the Science and Technology Planning Project of Guangzhou, China (201707020010), the Science, Technology and Innovation Committee of Shenzhen [JSGG20170412155639040, GJHS20170314114526143, JSGG20180703155802047], the Economic, Trade and Information Commission of Shenzhen Municipality [20170505161556110, 20170505160926390].Dr. Jing Nie reports grants from the Nature and Science Foundation of China (81730019 and 81521003).Dr. Youbao Li reports grants from the President Foundation of Nanfang Hospital, Southern Medical University [2017C007].Dr. Xianhui Qin reports grants from the National Natural Science Foundation of China [81730019], Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University [2017J009]. Funding Information: The study was supported by funding from the following: the National Natural Science Foundation of China [ 81730019 and 81521003 ]; the National Key Research and Development Program [ 2016YFE0205400 , 2016YFC0903103 , 2018ZX09739 , 2018ZX09301034003 ], the Science and Technology Planning Project of Guangzhou, China [ 201707020010 ]; the Science, Technology and Innovation Committee of Shenzhen [ JSGG20170412155639040 , GJHS20170314114526143, JSGG20180703155802047 ]; the Economic, Trade and Information Commission of Shenzhen Municipality [ 20170505161556110 , 20170505160926390 ]; President Foundation of Nanfang Hospital, Southern Medical University [ 2017C007 ]; Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University [ 2017J009 ]. Funding Information: Dr. Yong Huo reports grants from the National Key Research and Development Program [ 2016YFC0903103 ]. Dr. Xiping Xu reports grants from the National Key Research and Development Program [ 2016YFE0205400 , 2018ZX09739 , 2018ZX09301034003 ], the Science and Technology Planning Project of Guangzhou, China ( 201707020010 ), the Science, Technology and Innovation Committee of Shenzhen [ JSGG20170412155639040 , GJHS20170314114526143, JSGG20180703155802047 ], the Economic, Trade and Information Commission of Shenzhen Municipality [ 20170505161556110 , 20170505160926390 ]. Dr. Jing Nie reports grants from the Nature and Science Foundation of China ( 81730019 and 81521003 ). Dr. Youbao Li reports grants from the President Foundation of Nanfang Hospital, Southern Medical University [ 2017C007 ]. Dr. Xianhui Qin reports grants from the National Natural Science Foundation of China [ 81730019 ], Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University [ 2017J009 ]. Publisher Copyright: {\textcopyright} 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism",
year = "2020",
month = aug,
doi = "10.1016/j.clnu.2019.11.011",
language = "English (US)",
volume = "39",
pages = "2517--2524",
journal = "Clinical Nutrition",
issn = "0261-5614",
publisher = "Churchill Livingstone",
number = "8",
}