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A study found that betaine maintains liver SAM:SAH ratios to enhance phosphatidylcholine synthesis and normalize very-low-density lipoprotein (VLDL) production via promoting PEMT activity (111), and another study found that betaine stimulates apoB gene expression to form more VLDL (112)

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Notably, imipramine, by activating the FAM3A-ATP-P2 receptor-CaM-FOXA2-CPT2 pathway, decreases lipid accumulation in hepatocytes, suggesting its potential as a beneficial antidepressant for individuals with concurrent metabolic disorders (290)