“…Particularly, choline is a major source of methyl groups via oxidation to betaine, their functions involving the re-methylation of homocysteine to methionine are critical for DNA and histone methylation homeostasis, and therefore have been reported to be associated with cancer risk 2 (including liver cancer) and survival [7][8][9][10] . Experimental studies have reported that when deprived of choline, varying degrees of liver damages and liver diseases developed, including elevated transaminases 11 , affected lipid metabolism and transport 12 , fatty liver 13 , liver cirrhosis 13 and even liver cancer 14 , whereas choline or betaine supplementation ameliorated liver damage 15,16 , and choline supplementation increased global DNA methylation and DNA methyltransferase expression in HepG2 cells 17 , which implied that choline or betaine might not only be associated with hepatocarcinogenesis, but also with liver cancer survival. To date, although scarcely, three case control studies [18][19][20] have evaluated the relationship between choline/betaine and human liver cancer risk, in which consistently favorable effects of choline were found.…”