Choline

Question 1

What are the biochemical functions of choline?

Answer 1

Since choline is the precursor for acetylcholine, phospholipids, and betaine, it is essential for cell membrane integrity, methyl metabolism, cholinergic neurotransmission, transmembrane signaling, and the transport and metabolism of lipid cholesterol.

Question 2

What condition/situation can lead to choline deficiency?

Answer 2

Pt on choline free long-term PN.
b) Conditions that can increase choline demand are pregnancy, lactation, and hyper metabolic states - if supply is low, choline deficiency may occur.

Question 3

What disease/conditions can result from choline deficiency?

B) What conditions are associated with choline deficiency?

Answer 3

There is growing evidence that choline deficiency may contribute to PN-induce liver dysfunction, hepatic steatosis and eventually liver failure.
Impairment of verbal and visual memory in choline deficient PN pt- may be related to acetylcholine, a neurotransmitter.
B) Liver disease, atherosclerosis, cancer, and possibly neurological disorders ( eg neural tube defects, Alzheimer’s dementia, memory).

Question 4

What liver related lab could reflect a choline deficiency especially in pt on a choline free PN formulation?

Answer 4

Elevated alanine aminotransferase (ALT) (an intracellular enzyme involved in a.a and CHO metabolims), which reflects liver damage.

Question 5

What are good sources of choline? What are the DRI?

Answer 5

a) Milk, liver, eggs and peanuts

b) 550/400mg/day for 14-18 M/F and 550/425 for all other groups M/F respectively.