Methylamine metabolites and progression to kidney failure in type 2 diabetes: An Asian and European prospective study
Authors' conclusion
Plasma choline is an independent risk factor for DKD progression in two independent type 2 diabetes populations. Interventional trials are needed to assess whether reducing dietary choline intake could mitigate severe renal outcomes in type 2 diabetes.
Study context
- Population
- Patients with T2D of two ethnic backgrounds; baseline plasma betaine, carnitine, choline, trimethylamine and TMAO measured by mass-spectrometry
- Participants
- 1,357 vs 1,868
- Exposure
- Per 1 SD higher plasma methylamine metabolite concentration
- SURDIAGENEn = 1,357
- KTPH-DKDn = 1,868
- Outcome
- SURDIAGENE: composite of sustained doubling of serum creatinine or kidney failure with replacement therapy (KFRT); KTPH-DKD: KFRT
- Follow-up
- Median 7.1 years (IQR 4.5-10.7) in SURDIAGENE; 10.7 years (IQR 7.0-11.8) in KTPH-DKD
Methodological detailstwo independent cohorts, European and Asian origin
- Two independent cohorts
- European and Asian origin
Main finding
As reported in the abstract
| Group | Value | HR per 1 SD choline, composite renal outcome | HR per 1 SD choline, kidney failure with replacement therapy (KFRT) |
|---|---|---|---|
| SURDIAGENE | 75 events | 1.29 [1.02;1.62], P = 0.033 | |
| KTPH-DKD | 149 events | 1.84 [1.30;2.61], P < 0.001 |
Value
SURDIAGENE75 events
KTPH-DKD149 events
HR per 1 SD choline, composite renal outcome
SURDIAGENE1.29 [1.02;1.62], P = 0.033
KTPH-DKD— not stated in the abstract
HR per 1 SD choline, kidney failure with replacement therapy (KFRT)
SURDIAGENE— not stated in the abstract
KTPH-DKD1.84 [1.30;2.61], P < 0.001
Observational data: associations, not effects.
Secondary outcomes
- 40% renal function loss (RFL40), SURDIAGENE
- 1.11 [1.01;1.23], P = 0.028 · HR per 1 SD choline
Original publication
Methylamine metabolites and progression to kidney failure in type 2 diabetes: An Asian and European prospective study. Diabetes Metab. Published 30 April 2025. doi:10.
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