Objective The potential for choline metabolism to influence the development of diabetes has received increased attention. Previous studies on circulating choline metabolites and incident diabetes have been conducted samples of older age adults, often with a high prevalence of risk factors. Research design and methods Participants were from year 15 of follow up (2000-01) in the Coronary Artery Risk Development in Young Adults (CARDIA) Study (n=3,133; aged 33-45) with plasma choline metabolites (choline, betaine, and trimethylamine N-oxide [TMAO]). We quantified associations between choline metabolites and 15-year risk of incident diabetes (n=387) among participants free of diabetes at baseline, using Cox proportional hazards regression adjusted for sociodemographics, health behaviors, and clinical variables. Results Betaine was inversely associated with 15-year risk of incident diabetes [HR (95% CI): 0.76 (0.67, 0.88) per SD-unit betaine], and TMAO was positively associated with 15-year risk of incident diabetes [1.11 (1.01, 1.22) per SD-unit]. Choline was not significantly associated with 15-year risk of incident diabetes [1.05 (0.94, 1.16) per SD-unit]. Conclusions Our findings are consistent with other published literature supporting a role for choline metabolism in diabetes. Our study extends the current literature by analyzing a racially diverse population-based cohort of early-middle-aged individuals in which preventive activities may be most relevant.
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