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Choline intake in a large cohort of patients with nonalcoholic fatty liver disease.
Am J Clin Nutr 2012; 95(4):892-900AJ

Abstract

BACKGROUND

There is significant histologic and biochemical overlap between nonalcoholic fatty liver disease (NAFLD) and steatohepatitis associated with choline deficiency.

OBJECTIVE

We sought to determine whether subjects with biopsy-proven NAFLD and evidence of an inadequate intake of choline had more severe histologic features.

DESIGN

We performed a cross-sectional analysis of 664 subjects enrolled in the multicenter, prospective Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) with baseline data on diet composition (from a recall-based food-frequency questionnaire) within 6 mo of a liver biopsy. Food questionnaires were analyzed with proprietary software to estimate daily intakes of choline. Liver biopsies were centrally read, and consensus was scored with the NASH CRN-developed scoring system. Because choline needs vary by age, sex, and menopausal status, participants were segregated into corresponding categories (children 9-13 y old, males ≥14 y old, premenopausal women ≥19 y old, and postmenopausal women) on the basis of the Institute of Medicine's definition of adequate intake (AI) for choline. Deficient intake was defined as <50% AI.

RESULTS

Postmenopausal women with deficient choline intake had worse fibrosis (P = 0.002) once factors associated with NAFLD (age, race-ethnicity, obesity, elevated triglycerides, diabetes, alcohol use, and steroid use) were considered in multiple ordinal logistic regression models. Choline intake was not identified as a contributor to disease severity in children, men, or premenopausal women.

CONCLUSION

Decreased choline intake is significantly associated with increased fibrosis in postmenopausal women with NAFLD. The Pioglitazone vs Vitamin E vs Placebo for Treatment of Non-Diabetic Patients With Nonalcoholic Steatohepatitis trial was registered at clinicaltrials.gov as NCT00063622, and the Treatment of Nonalcoholic Fatty Liver Disease in Children trial was registered at clinicaltrials.gov as NCT00063635.

Authors+Show Affiliations

Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins School of Medicine, Baltimore, MD, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

22338037

Citation

Guerrerio, Anthony L., et al. "Choline Intake in a Large Cohort of Patients With Nonalcoholic Fatty Liver Disease." The American Journal of Clinical Nutrition, vol. 95, no. 4, 2012, pp. 892-900.
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(4):892-900.
Guerrerio, A. L., Colvin, R. M., Schwartz, A. K., Molleston, J. P., Murray, K. F., Diehl, A., ... Scheimann, A. O. (2012). Choline intake in a large cohort of patients with nonalcoholic fatty liver disease. The American Journal of Clinical Nutrition, 95(4), pp. 892-900. doi:10.3945/ajcn.111.020156.
Guerrerio AL, et al. Choline Intake in a Large Cohort of Patients With Nonalcoholic Fatty Liver Disease. Am J Clin Nutr. 2012;95(4):892-900. PubMed PMID: 22338037.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Choline intake in a large cohort of patients with nonalcoholic fatty liver disease. AU - Guerrerio,Anthony L, AU - Colvin,Ryan M, AU - Schwartz,Amy K, AU - Molleston,Jean P, AU - Murray,Karen F, AU - Diehl,AnnaMae, AU - Mohan,Parvathi, AU - Schwimmer,Jeffrey B, AU - Lavine,Joel E, AU - Torbenson,Michael S, AU - Scheimann,Ann O, Y1 - 2012/02/15/ PY - 2012/2/17/entrez PY - 2012/2/18/pubmed PY - 2012/5/9/medline SP - 892 EP - 900 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 95 IS - 4 N2 - BACKGROUND: There is significant histologic and biochemical overlap between nonalcoholic fatty liver disease (NAFLD) and steatohepatitis associated with choline deficiency. OBJECTIVE: We sought to determine whether subjects with biopsy-proven NAFLD and evidence of an inadequate intake of choline had more severe histologic features. DESIGN: We performed a cross-sectional analysis of 664 subjects enrolled in the multicenter, prospective Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) with baseline data on diet composition (from a recall-based food-frequency questionnaire) within 6 mo of a liver biopsy. Food questionnaires were analyzed with proprietary software to estimate daily intakes of choline. Liver biopsies were centrally read, and consensus was scored with the NASH CRN-developed scoring system. Because choline needs vary by age, sex, and menopausal status, participants were segregated into corresponding categories (children 9-13 y old, males ≥14 y old, premenopausal women ≥19 y old, and postmenopausal women) on the basis of the Institute of Medicine's definition of adequate intake (AI) for choline. Deficient intake was defined as <50% AI. RESULTS: Postmenopausal women with deficient choline intake had worse fibrosis (P = 0.002) once factors associated with NAFLD (age, race-ethnicity, obesity, elevated triglycerides, diabetes, alcohol use, and steroid use) were considered in multiple ordinal logistic regression models. Choline intake was not identified as a contributor to disease severity in children, men, or premenopausal women. CONCLUSION: Decreased choline intake is significantly associated with increased fibrosis in postmenopausal women with NAFLD. The Pioglitazone vs Vitamin E vs Placebo for Treatment of Non-Diabetic Patients With Nonalcoholic Steatohepatitis trial was registered at clinicaltrials.gov as NCT00063622, and the Treatment of Nonalcoholic Fatty Liver Disease in Children trial was registered at clinicaltrials.gov as NCT00063635. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/22338037/Choline_intake_in_a_large_cohort_of_patients_with_nonalcoholic_fatty_liver_disease_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.111.020156 DB - PRIME DP - Unbound Medicine ER -