title: Choline and homocysteine interrelations in umbilical cord and maternal plasma at delivery.
abstract: BACKGROUND
  Little is known about the interactions between choline and folate and homocysteine metabolism during pregnancy despite the facts that pregnancy places considerable stress on maternal folate and choline stores and that choline is a critical nutrient for the fetus. Choline, via betaine, is an important folate-independent source of methyl groups for remethylating homocysteine in liver.
  
  
  OBJECTIVE
  Our aims were to examine the intermediates of choline oxidation in maternal and umbilical cord plasma and to determine the relations between this pathway and folate-dependent homocysteine remethylation.
  
  
  METHODS
  Blood samples were taken from 201 pregnant women and, at delivery, from the umbilical cord veins of their healthy, full-term infants. The blood samples were analyzed for plasma free choline, betaine, dimethylglycine, folate, vitamin B-12, total homocysteine (tHcy), and creatinine concentrations.
  
  
  RESULTS
  Choline concentrations in umbilical cord plasma were approximately 3 times those in maternal plasma (geometric x: 36.6 and 12.3 micromol/L, respectively; P < 0.0001). Betaine and dimethylglycine concentrations were also significantly higher in umbilical cord than in maternal plasma. Choline was positively associated with tHcy (r = 0.34, P < 0.0001), betaine (r = 0.58, P < 0.0001), and dimethylglycine (r = 0.30, P < 0.0001) in maternal blood. Much weaker relations were seen in the fetal circulation. In a multiple regression model, choline was a positive predictor of maternal tHcy, whereas vitamin B-12 and betaine were negative predictors.
  
  
  CONCLUSIONS
  The positive association between maternal choline and tHcy during pregnancy suggests that the high fetal demand for choline stimulates de novo synthesis of choline in maternal liver, with a resultant increase in tHcy concentrations. If this is confirmed, it may be appropriate to provide choline supplements during pregnancy to prevent elevated tHcy concentrations.
authors.affiliation: Department of Clinical Medicine and the National Human Genome Research Institute, the National Institutes of Health, Bethesda, MD, USA. amolloy@tcd.ie
authors.forename: Anne M
authors.initials: AM
authors.lastname: Molloy
authors.forename: James L
authors.initials: JL
authors.lastname: Mills
authors.forename: Christopher
authors.initials: C
authors.lastname: Cox
authors.forename: Sean F
authors.initials: SF
authors.lastname: Daly
authors.forename: Mary
authors.initials: M
authors.lastname: Conley
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Brody
authors.forename: Peadar N
authors.initials: PN
authors.lastname: Kirke
authors.forename: John M
authors.initials: JM
authors.lastname: Scott
authors.forename: Per M
authors.initials: PM
authors.lastname: Ueland
mesh_terms: D001622:Betaine / Q000097:blood / Q000378:metabolism; D002794:Choline / Q000097:blood* / Q000378:metabolism; D002853:Chromatography, Liquid; D003404:Creatinine / Q000097:blood / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005492:Folic Acid / Q000378:metabolism*; D006305:Health Status Indicators; D006710:Homocysteine / Q000097:blood* / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D008745:Methylation; D010084:Oxidation-Reduction; D011247:Pregnancy / Q000097:blood / Q000378:metabolism*; D012044:Regression Analysis; D012521:Sarcosine / Q000031:analogs & derivatives / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood / Q000378:metabolism
chemical_list: D006710:Homocysteine; D001622:Betaine; C025138:dimethylglycine; D005492:Folic Acid; D003404:Creatinine; D002794:Choline; D014805:Vitamin B 12; D012521:Sarcosine