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Open Access 01-03-2021 | Nutrition | Original Contribution

Serum choline in extremely preterm infants declines with increasing parenteral nutrition

Authors: Anders K. Nilsson, Anders Pedersen, Daniel Malmodin, Anna-My Lund, Gunnel Hellgren, Chatarina Löfqvist, Ingrid Hansen Pupp, Ann Hellström

Published in: European Journal of Nutrition | Issue 2/2021

Abstract

Purpose

Choline is an essential nutrient for fetal and infant growth and development. Parenteral nutrition used in neonatal care lack free choline but contain small amounts of lipid-bound choline in the form of phosphatidylcholine (PC). Here, we examined the longitudinal development of serum free choline and metabolically related compounds betaine and methionine in extremely preterm infants and how the concentrations were affected by the proportion of parenteral fluids the infants received during the first 28 postnatal days (PNDs).

Methods

This prospective study included 87 infants born at gestational age (GA) < 28 weeks. Infant serum samples were collected PND 1, 7, 14, and 28, and at postmenstrual age (PMA) 32, 36, and 40 weeks. The serum concentrations of free choline, betaine, and methionine were determined by ¹H NMR spectroscopy.

Results

The median (25th–75th percentile) serum concentrations of free choline, betaine, and methionine were 33.7 (26.2–41.2), 71.2 (53.2–100.8), and 25.6 (16.4–35.3) µM, respectively, at PND 1. The choline concentration decreased rapidly between PND one and PND seven [18.4 (14.1–26.4) µM], and then increased over the next 90 days, though never reaching PND one levels. There was a negative correlation between a high intake of parenteral fluids and serum-free choline.

Conclusion

Circulating free choline in extremely preterm infants is negatively affected by the proportion of parenteral fluids administered.

Trial registration

ClinicalTrials.gov Identifier NCT02760472, April 29, 2016, retrospectively registered.

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Title: Serum choline in extremely preterm infants declines with increasing parenteral nutrition
Authors: Anders K. Nilsson
Anders Pedersen
Daniel Malmodin
Anna-My Lund
Gunnel Hellgren
Chatarina Löfqvist
Ingrid Hansen Pupp
Ann Hellström
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keyword: Nutrition
Published in: European Journal of Nutrition / Issue 2/2021
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-020-02312-2

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