|Schanler, Richard - Rich|
Submitted to: Nutrition
Publication Type: Peer reviewed journal
Publication Acceptance Date: 1/1/2001
Publication Date: 1/1/2001
Citation: Buchman,A.L., Sohel,M., Moukarzel,A., Bryant,D., Schanler,R., Awal,M., Burns,P., Dorman,K., Belfort,M., Jenden,D.J., Killip,D., Roch,M. 2001. Plasma choline in normal newborns, infants, toddlers, and in very-low-birth-weight neonates requiring total parenteral nutrition. Nutrition. 17(1):18-21. Interpretive Summary: The aim of this study was to determine the normal values of plasma-free choline and phospholipid-bound choline in newborns, infants, and children, while receiving intravenous nutrition support in-hospital. We report the range of such values. We found that newborn values for plasma-free choline were higher than those of adults, but decline to adult values by 1 year. Low maternal values were associated with low newborn values. Low newborn values were unrelated to intrauterine growth. Phospholipid-bound choline values in newborns are lower than those of adults suggesting a use in membrane synthesis during growth.
Technical Abstract: Choline deficiency is associated with hepatic abnormalities in adult volunteers and patients administered total parenteral nutrition (TPN). Preliminary investigation has suggested that plasma-free choline concentration (PFCh) is greater in neonatal animals, including humans, than in adults. The aims of this study were to determine the normal PFCh and phospholipid-bound choline concentration (PPLBCh) for newborns, infants, and toddlers and to determine the change during TPN. We also sought to determine the degree of fetal choline extraction, the relation between maternal and newborn plasma choline concentrations, and the relation between plasma choline status and normal newborn length, weight, and gestational age. Blood samples were obtained from 104 full-term newborns in two centers (Ben Taub and Maimonides), 25 mothers, 21 normal infants aged 20.3+/-11.8 wk, 12 normal infants aged 62.4+/-3.9 wk, and 14 preterm infants (gestational AGE = 28.9+/-2.2 wk) who required TPN. We concluded that newborn PFCh is significantly greater than PFCh in adults but falls to adult levels within the first year of life. Low maternal PFCh may be associated with low newborn PFCh. Normal newborn plasma choline status has no bearing on intrauterine growth, although the role of maternal choline deficiency in underweight newborns is unknown. Newborn PPLCh is substantially below that of adults, which suggests its use in membrane synthesis during growth.