Plasma choline concentration in humans fed parenterally

• Published in: The American journal of clinical nutrition Vol. 43; no. 2; pp. 219 - 224
• Main Authors: Sheard, NF, Tayek, JA, Bistrian, BR, Blackburn, GL, Zeisel, SH
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Elsevier Inc 01-02-1986; American Society for Clinical Nutrition
• Subjects: Adult; Aged; amino acids; Amino Acids - administration & dosage; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Choline; Choline - blood; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Fat Emulsions, Intravenous - administration & dosage; Female; Humans; Intensive care medicine; lipid emulsions; lipids; Male; Medical sciences; Middle Aged; Nutrition Disorders - blood; Nutrition Disorders - therapy; Parenteral Nutrition, Total; plasma; Prospective Studies; total parenteral nutrition; total parenteral nutrition; Choline; lipid emulsions; Human; Malnutrition; Resuscitation; Parenteral administration; Feeding
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/43.2.219

Choline is an essential nutrient for some mammals; it is used for membrane and neurotransmitter synthesis. We analyzed plasma samples, obtained periodically during TPN therapy, for choline concentration. Malnourished patients referred to a nutrition support service were prospectively assigned to be treated with daily infusions of amino acids with, and without, supplemental daily infusions of lipid emulsion for a period of 1 wk. After the first week, all subjects received intravenous lipid, and most were offered enteral food supplements. Initial plasma choline concentrations in the 25 malnourished patients were significantly lower than those measured in plasma samples from 23 hospitalized patients known to be eating well (6.5 ± 0.6 vs 9.7 ± 0.7 nmol/ml; mean ± SEM; p < 0.001). During the first week of TPN therapy, plasma choline concentrations in the lipid-restricted group tended to decrease (from 7.3 ± 1.0 to 4.7 ± 0.5 nmol/ml; mean ± SEM; p < 0.05), while in the lipid-supplemented group plasma choline tended to increase (from 5.6 ± 0.5 to 6.2 ± 0.7 nmol/ml; mean ± SEM; p < 0.05). Plasma choline concentration increased during wk 2–4, when all patients were treated with lipid emulsions, and some were offered enteral foods. We conclude that malnourished humans who eat no choline have diminished stores of plasma (and possibly tissue) choline.