Die Bedeutung von Cholin für die Entwicklung von Säuglingen und Kindern

Cholin ist ein essenzieller Nährstoff mit wachstumsproportionalem Bedarf. Eine zu geringe Zufuhr, eine gestörte Wiederaufnahme bzw. fäkale Verluste durch Darmerkrankungen und bakterieller Abbau kann bei Kindern zu einem Cholinmangel führen, ebenso wie ein erhöhter Fettgehalt der Leber (Steatose). Bei Säuglingen liegt die Cholinzufuhr durch Formula häufig unter der durch Muttermilch und hat eine unphysiologische Zusammensetzung.

Publication History

Article published online:
01 December 2022

• Literatur

• 1 Zeisel SH.. Choline: critical role during fetal development and dietary requirements in adults. Annu Rev Nutr 2006; 26: 229-250 DOI: 10.1146/annurev.nutr.26.061505.111156.
• 2 Bernhard W, Poets CF, Franz AR.. Choline and choline-related nutrients in regular and preterm infant growth. Eur J Nutr 2019; 58: 931-945 DOI: 10.1007/s00394-018-1834-7.
• 3 Fischer LM, da Costa KA, Kwock L. et al. Sex and menopausal status influence human dietary requirements for the nutrient choline. Am J Clin Nutr 2007; 85: 1275-1285 DOI: 10.1093/ajcn/85.5.1275.
• 4 Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B₆, Folate, Vitamin B₁₂, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998. PMID: 23193625
• 5 EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Dietary Reference Values for choline. EFSA Journal 2016; 14: 4484 DOI: 10.2903/j.efsa.2016.4484.
• 6 Smolders L, de Wit NJW, Balvers MGJ. et al. Natural choline from egg yolk phospholipids is more efficiently absorbed compared with choline bitartrate; outcomes of a randomized trial in healthy adults. Nutrients 2019; 11: 2758 DOI: 10.3390/nu11112758.
• 7 Bernhard W, Raith M, Shunova A. et al. Choline kinetics in neonatal liver, brain and lung – Lessons from a rodent model for neonatal care. Nutrients 2022; 14: 720 DOI: 10.3390/nu14030720.
• 8 Böckmann KA, Franz AR, Minarski M. et al. Differential metabolism of choline supplements in adult volunteers. Eur J Nutr 2022; 61: 219-230 DOI: 10.1007/s00394-021-02637-6.
• 9 Cho C, Aardema NDJ, Bunnell ML. et al. Free choline, but not phosphatidylcholine, elevates circulating trimethylamine-N-oxide and this response is modified by the gut microbiota composition in healthy men. Curr Dev Nutr 2020; 4: 379 DOI: 10.1093/cdn/nzaa045_012.
• 10 v. Bergmann G, Schwiegk H.. Krankheiten der Leber und Gallenwege. In: Schwiegk., Jores A, Hrsg. Lehrbuch der Inneren Medizin.. Berlin, Heidelberg: Springer; 1949: 882-1003 DOI: 10.1007/978-3-642-87317-1_10
• 11 Zeisel SH.. Dietary choline deficiency causes DNA strand breaks and alters epigenetic marks on DNA and histones. Mutat Re 2012; 733: 34-38 DOI: 10.1016/j.mrfmmm.2011.10.008.
• 12 Chen AH, Innis SM, Davidson AG, James SJ.. Phosphatidylcholine and lysophosphatidylcholine excretion is increased in children with cystic fibrosis and is associated with plasma homocysteine, S-adenosylhomocysteine, and S-adenosylmethionine. Am J Clin Nutr 2005; 81: 686-691
• 13 Li Z, Agellon LB, Vance DE.. The role of phosphatidylethanolamine methyltransferase in a mouse model of intrahepatic cholestasis. Biochim Biophys Acta 2011; 1811: 278-283
• 14 da Costa KA, Kozyreva OG, Song J. et al. Common genetic polymorphisms affect the human requirement for the nutrient choline. FASEB J 2006; 20: 1336-1344
• 15 Bernhard W, Böckmann K, Maas C. et al. Combined choline and DHA supplementation: a randomized controlled trial. Eur J Nutr 2020; 59: 729-739 DOI: 10.1007/s00394-019-01940-7.
• 16 Corbin KD, Abdelmalek MF, Spencer MD. et al. Genetic signatures in choline and 1-carbon metabolism are associated with the severity of hepatic steatosis. FASEB J 2013; 27: 1674-1689 DOI: 10.1096/fj.12-219097.
• 17 Waite KA, Cabilio NR, Vance DE.. Choline deficiency-induced liver damage is reversible in Pemt(-/-) mice. J Nutr 2002; 132: 68-71 DOI: 10.1093/jn/132.1.68.
• 18 Wan S, Kuipers F, Havinga R. et al. Impaired hepatic phosphatidylcholine synthesis leads to cholestasis in mice challenged with a high-fat diet. Hepatol Commun 2019; 3: 262-276 DOI: 10.1002/hep4.1302.
• 19 Bernhard W, Raith M, Koch V. et al. Plasma phospholipids indicate impaired fatty acid homeostasis in preterm infants. Eur J Nutr 2014; 53: 1533-1547 DOI: 10.1007/s00394-014-0658-3.
• 20 Bernhard W.. Choline in cystic fibrosis: relations to pancreas insufficiency, enterohepatic cycle, PEMT and intestinal microbiota. Eur J Nutr 2021; 60: 1737-1759 DOI: 10.1007/s00394-020-02358-2.
• 21 Li K, Wahlqvist ML, Li D.. Nutrition, one-carbon metabolism and neural tube defects: A review. Nutrients 2016; 8: 741 DOI: 10.3390/nu8110741.
• 22 Ideraabdullah FY, Zeisel SH.. Dietary modulation of the epigenome. Physiol Rev 2018; 98: 667-695 DOI: 10.1152/physrev.00010.2017.
• 23 Brosnan JT, da Silva RP, Brosnan ME.. The metabolic burden of creatine synthesis. Amino Acids 2011; 40: 1325-1331
• 24 Bernhard W, Shunova A, Machann J. et al. Resolution of severe hepatosteatosis in a cystic fibrosis patient with multifactorial choline deficiency: A case report. Nutrition 2021; 89: 111348 DOI: 10.1016/j.nut.2021.111348.
• 25 Bernhard W, Maas C, Shunova A. et al. Transport of long-chain polyunsaturated fatty acids in preterm infant plasma is dominated by phosphatidylcholine. Eur J Nutr 2018; 57: 2105-2112 DOI: 10.1007/s00394-017-1484-1.
• 26 Li Z, Agellon LB, Vance DE.. Choline redistribution during adaptation to choline deprivation. J Biol Chem 2007; 282: 10283-10289
• 27 Hollenbeck CB.. An introduction to the nutrition and metabolism of choline. Cent Nerv Syst Agents Med Chem 2012; 12: 100-113
• 28 Gobato AO, Vasques ACJ, Ribeiro AF. et al. Prevalence of hepatic steatosis among children and adolescents with cystic fibrosis and its association with nutritional status. Rev Paul Pediatr 2019; 37: 435-441 DOI: 10.1590/1984-0462/;2019;37;4;00007.
• 29 Duarte MA, Silva GA.. Hepatic steatosis in obese children and adolescents. J Pediatr (Rio J) 2011; 87: 150-156 DOI: 10.2223/JPED.2065.
• 30 Guerrerio AL, Colvin RM, Schwartz AK. et al. Choline intake in a large cohort of patients with nonalcoholic fatty liver disease. Am J Clin Nutr 2012; 95: 892-900 DOI: 10.3945/ajcn.111.020156.
• 31 Branca F, Ferrari M.. Impact of micronutrient deficiencies on growth: the stunting syndrome. Ann Nutr Metab 2002; 46: 8-17
• 32 Zeisel SH.. The fetal origins of memory: the role of dietary choline in optimal brain development. J Pediatr 2006; 149: 131-136
• 33 Shunova A, Böckmann KA, Minarski M. et al. Choline content of term and preterm infant formulae compared to expressed breast milk – How do we justify the discrepancies?. Nutrients 2020; 12: 3815 DOI: 10.3390/nu12123815.