Low plasma free choline is prevalent in patients receiving long term parenteral nutrition and is associated with hepatic aminotransferase abnormalities

Buchman, Alan L.; Moukarzel, Adib; Jenden, Donald J.; Roch, Margareth; Rice, Kathleen M.; Ament, Marvin E.

doi:10.1016/0261-5614(93)90143-r

Cited by 80 publications

(54 citation statements)

References 20 publications

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“…Low plasma choline concentration occurs in up to 84% of patients who require total parenteral nutrition (TPN) (17)(18)(19)(20)113,118), as does liver damage (elevated transaminases) (18,126) and fatty liver (18). In some patients, the hepatic steatosis associated with TPN resolved with choline-supplementation and returned when standard TPN was reinstituted (18).…”

Section: Introductionmentioning

confidence: 99%

Choline: Critical Role During Fetal Development and Dietary Requirements in Adults

2006

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Choline is an essential nutrient needed for the structural integrity and signaling functions of cell membranes; for normal cholinergic neurotransmission; for normal muscle function; for lipid transport from liver; and it is the major source of methyl groups in the diet. Choline is critical during fetal development, when it influences stem cell proliferation and apoptosis, thereby altering brain and spinal cord structure and function and influencing risk for neural tube defects and lifelong memory function. Choline is derived not only from the diet, but from de novo synthesis as well. Though many foods contain choline, there is at least a twofold variation in dietary intake in humans. When deprived of dietary choline, most men and postmenopausal women developed signs of organ dysfunction (fatty liver or muscle damage), while less than half of premenopausal women developed such signs. Aside from gender differences, there is significant variation in the dietary requirement for choline that can be explained by very common genetic polymorphisms.

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Section: Introductionmentioning

confidence: 99%

Choline: Critical Role During Fetal Development and Dietary Requirements in Adults

2006

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“…25 Previous study has shown that plasma and tissue choline concentrations are closely correlated. 59 Elevations in both ALT and AST were significantly correlated with plasma free choline (r ϭ -0.34, p ϭ -.03; r ϭ -0.37, p ϭ .02, respectively), although 20% of patients with choline deficiency had normal hepatic aminotransferases.…”

Section: Prevalence Of Low Plasma Choline Concentration In Tpn Patienmentioning

confidence: 98%

“…24 Patients receiving long-term TPN have low plasma choline concentration. [25][26][27] Hepatic aminotransferase abnormalities correlate significantly with the plasma free choline level in patients receiving long-term parenteral nutrition. 25 In addition, the degree of hepatic steatosis is significantly correlated with the plasma free choline concentration.…”

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confidence: 98%

“…[25][26][27] Hepatic aminotransferase abnormalities correlate significantly with the plasma free choline level in patients receiving long-term parenteral nutrition. 25 In addition, the degree of hepatic steatosis is significantly correlated with the plasma free choline concentration. 24 In a small open-labeled pilot study, hepatic steatosis resolved completely when TPN was supplemented with choline despite no other changes in the TPN solutions or the patients' nutritional status.…”

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confidence: 98%

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Choline Deficiency During Parenteral Nutrition in Humans

Buchman

2003

Nut in Clin Prac

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“…Choline (Ch) is an essential component of various important biological compounds (including the membrane phospholipids lecithin, sphingomyelin and plasmalogen, the neurotransmitter acetylcholine and the platelet activating factor), as well as an important nutrient that is involved in many physiological functions (such as the metabolism of methyl groups and the lipid transport; Buchman et al, 1992Buchman et al, , 1993Buchman et al, , 1995Canty and Zeisel, 1994;Liapi et al, 2007;Zeisel, 1981Zeisel, , 2000. Being a component of certain phospholipids, Ch plays a critical role in generating second messengers for cell membrane signal transduction (Canty and Zeisel, 1994).…”

Section: Introductionmentioning

confidence: 99%

Effects of choline‐deprivation on paracetamol‐ or phenobarbital‐induced rat liver metabolic response

Konstandi

Segos

Galanopoulou

et al. 2008

J of Applied Toxicology

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Choline is an essential nutrient that seems to be involved in a wide variety of metabolic reactions and functions in both humans and rodents. Various pathophysiological states have been linked to choline deprivation (CD). The aim of the present study was to determine the effect of CD upon biochemical, histological and metabolic alterations induced by drugs that affect hepatic functional integrity and various drug metabolizing systems via distinct mechanisms. For this purpose, paracetamol (ACET) or phenobarbital (PB) were administered to male Wistar rats that were fed with standard rodent chow (normally fed, NF) or underwent dietary CD. The administration of ACET increased the serum aspartate aminotransferase levels in NF rats, while CD restricted this increase. On the other hand, ACET suppressed alkaline phosphatase levels only in CD rats. Moreover, CD prevented the PB-induced increase of the mitotic activity of hepatocytes. The administration of ACET down-regulated CYP1A2 and CYP2B1 expression in CD rats, while up-regulating them in NF rats. The administration of PB suppressed CYP1A2 apoprotein levels in CD rats, whereas the drug had no effect on NF rats. The PB-induced up-regulation of CYP2B, CYP2E1 and CYP1A1 isozymes was markedly higher in CD than in NF rats. In addition, PB increased glutathione-S-transferase activity only in CD rats. Hepatic glutathione content (GSH) was suppressed by ACET in NF rats, whereas the drug increased GSH in CD rats. Our data suggest that CD has a significant impact on the hepatic metabolic functions, and in particular on those related to drug metabolism. Thus, CD may modify drug effectiveness and toxicity, as well as drug-drug interactions, particularly those related to ACET and PB.

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Low plasma free choline is prevalent in patients receiving long term parenteral nutrition and is associated with hepatic aminotransferase abnormalities

Cited by 80 publications

References 20 publications

Choline: Critical Role During Fetal Development and Dietary Requirements in Adults

Choline: Critical Role During Fetal Development and Dietary Requirements in Adults

Choline Deficiency During Parenteral Nutrition in Humans

Effects of choline‐deprivation on paracetamol‐ or phenobarbital‐induced rat liver metabolic response

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