title: Breast milk choline contents are associated with inflammatory status of breastfeeding women.
abstract: BACKGROUND
  Choline is an important component of human breast milk and its content varies considerably among breastfeeding women and lactation periods.
  
  
  OBJECTIVE
  The aim of this study was to assess the relationship between breast milk choline contents and inflammatory status in breastfeeding women.
  
  
  METHODS
  Breast milk choline compounds and serum C-reactive protein (CRP) concentrations were determined in breastfeeding women at 1 to 3 (n = 53) or 22 to 180 (n = 54) days postpartum, expressing colostrum or mature milk, respectively.
  
  
  RESULTS
  Median concentrations of free choline, phosphocholine, glycerophosphocholine, phospholipid-bound choline, and total choline were 71, 38, 96, 194, and 407 µmol/L or 93, 351, 958, 186, and 1532 µmol/L in colostrum or mature milk, respectively. Median serum CRP concentrations were 4.13 mg/L and 0.33 mg/L at 1 to 3 days and 22 to 180 days postpartum, respectively. At 1 to 3 days postpartum, milk free choline, phosphocholine, glycerophosphocholine, and total choline as well as serum CRP concentrations were significantly higher in breastfeeding women who delivered by cesarean section than those who delivered via the vaginal route. Serum CRP concentration was positively correlated with colostrum free choline (r = 0.703; P < .001), phosphocholine (r = 0.759; P < .001), glycerophosphocholine (r = 0.706; P < .001), and total choline (r = 0.693; P < .001), whereas it was negatively correlated (r = -0.442; P < .001) with colostrum phospholipid-bound choline. Serum CRP was also negatively correlated with mature milk free choline (r = -0.278; P < .05), but no correlation was found between serum CRP and other choline compounds in mature milk.
  
  
  CONCLUSIONS
  These data show that the concentrations of milk choline compounds are associated with inflammatory status of breastfeeding women, particularly during the first few days after delivery.
authors.affiliation: 1Department of Biochemistry, Uludag University Medical School, Bursa, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Ozarda
authors.forename: Mehmet
authors.initials: M
authors.lastname: Cansev
authors.forename: Ismail H
authors.initials: IH
authors.lastname: Ulus
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000009:adverse effects / Q000378:metabolism*; D002794:Choline / Q000009:adverse effects / Q000378:metabolism*; D003126:Colostrum / Q000378:metabolism*; D005260:Female; D006801:Humans; D008895:Milk, Human / Q000378:metabolism*; D010446:Peptide Fragments / Q000009:adverse effects / Q000378:metabolism*; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy
chemical_list: C079903:C-reactive protein (164-173); D010446:Peptide Fragments; D002097:C-Reactive Protein; D002794:Choline
keywords: C-reactive protein; breastfeeding; free choline; glycerophosphocholine; human breast milk; phosphocholine