Choline Supplementation in Cystic Fibrosis-The Metabolic and Clinical Impact.
Nutrients
; 11(3)2019 Mar 18.
Article
en En
| MEDLINE
| ID: mdl-30889905
ABSTRACT
BACKGROUND:
Choline is essential for the synthesis of liver phosphatidylcholine (PC), parenchymal maintenance, bile formation, and lipoprotein assembly to secrete triglycerides. In choline deficiency, the liver accretes choline/PC at the expense of lung tissue, thereby impairing pulmonary PC homoeostasis. In cystic fibrosis (CF), exocrine pancreas insufficiency results in impaired cleavage of bile PC and subsequent fecal choline loss. In these patients, the plasma choline concentration is low and correlates with lung function. We therefore investigated the effect of choline supplementation on plasma choline/PC concentration and metabolism, lung function, and liver fat.METHODS:
10 adult male CF patients were recruited (11/2014â»1/2016), and orally supplemented with 3 × 1 g choline chloride for 84 (84â»91) days. Pre-/post-supplementation, patients were spiked with 3.6 mg/kg [methyl-D9]choline chloride to assess choline/PC metabolism. Mass spectrometry, spirometry, and hepatic nuclear resonance spectrometry served for analysis.RESULTS:
Supplementation increased plasma choline from 4.8 (4.1â»6.2) µmol/L to 10.5 (8.5â»15.5) µmol/L at d84 (p < 0.01). Whereas plasma PC concentration remained unchanged, D9-labeled PC was decreased (12.2 [10.5â»18.3] µmol/L vs. 17.7 [15.5â»22.4] µmol/L, p < 0.01), indicating D9-tracer dilution due to higher choline pools. Supplementation increased Forced Expiratory Volume in 1 second percent of predicted (ppFEV1) from 70.0 (50.9â»74.8)% to 78.3 (60.1â»83.9)% (p < 0.05), and decreased liver fat from 1.58 (0.37â»8.82)% to 0.84 (0.56â»1.17)% (p < 0.01). Plasma choline returned to baseline concentration within 60 h.CONCLUSIONS:
Choline supplementation normalized plasma choline concentration and increased choline-containing PC precursor pools in adult CF patients. Improved lung function and decreased liver fat suggest that in CF correcting choline deficiency is clinically important. Choline supplementation of CF patients should be further investigated in randomized, placebo-controlled trials.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_doencas_nao_transmissiveis
Asunto principal:
Volumen Espiratorio Forzado
/
Colina
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Deficiencia de Colina
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Fibrosis Quística
/
Metabolismo de los Lípidos
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Hígado
/
Pulmón
Tipo de estudio:
Clinical_trials
/
Etiology_studies
Límite:
Adolescent
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Adult
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Nutrients
Año:
2019
Tipo del documento:
Article
País de afiliación:
Alemania