The addition of choline to parenteral nutrition.
Choline is a quaternary amine endogenously synthesized from the amino acid methionine or absorbed via the portal circulation. It is ubiquitous in the diet, although it has a greater presence in organ meats. Choline is an essential component of all cell membranes, and has been considered a required dietary nutrient since 1998 by the US Institute of Medicine's Food and Nutrition Board. Choline is necessary for DNA repair, mediated by its role as a methyl donor. It also serves as the precursor for the neurotransmitter acetylcholine. Evidence has accumulated that hepatic steatosis, which occurs during parenteral nutrition therapy, develops as a result of choline deficiency because endogenous production of choline from parenterally infused methionine is deficient. In addition, memory deficits and skeletal muscle abnormalities have been described, and choline deficiency appears to activate cellular apoptosis. Provision of intravenous choline ameliorates hepatic steatosis associated with parenteral nutrition infusion.
Buchman
Alan L
AL
Intestinal Rehabilitation and Transplant Center, Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. a-buchman@northwestern.edu
D000368:Aged; D002056:Burns / Q000150:complications; D002648:Child; D002794:Choline / Q000008:administration & dosage* / Q000378:metabolism / Q000633:toxicity; D002796:Choline Deficiency / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D007774:Lactation; D008103:Liver Cirrhosis / Q000150:complications; D008107:Liver Diseases / Q000209:etiology; D010288:Parenteral Nutrition / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D051437:Renal Insufficiency / Q000150:complications; D018805:Sepsis / Q000150:complications; D012725:Sexual Behavior; D014947:Wounds and Injuries / Q000150:complications
D002794:Choline