Choline Supplementation With a Structured Lipid in Children With Cystic Fibrosis: A Randomized Placebo-Controlled
Joan I Schall1, Maria R Mascarenhas, Asim Maqbool
1*Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA ‡The Richard Stockton College of New Jersey NJ §Biostatistics and Data Management Core ||Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA ¶Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA #Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH **Avanti Polar Lipids, Inc, Alabaster, AL.
This study shows that a choline-rich supplement (LYM-X-SORB™) safely improved choline status, including muscle stores, in children with cystic fibrosis and pancreatic insufficiency. It also enhanced fat absorption, addressing a key deficiency.
Area of Science:
- Biochemistry
- Pediatric Nutrition
- Gastroenterology
Background:
- Choline depletion is a common issue in cystic fibrosis (CF) and pancreatic insufficiency, leading to potential liver, fatty acid, and muscle abnormalities.
- Standard enzyme treatments do not fully resolve choline deficiency in these patients.
- This study investigated a novel choline-rich structured lipid supplement for improving choline status.
Purpose of the Study:
- To evaluate the efficacy and safety of LYM-X-SORB™ (LXS), an easily absorbed choline-rich structured lipid.
- To determine if LXS can improve choline status in children with CF and pancreatic insufficiency.
- To assess the impact of LXS on fat absorption, growth, and body composition.
Main Methods:
- A 12-month double-blind, placebo-controlled trial involving 110 children with CF and pancreatic insufficiency.
- Assessment of dietary choline intake, plasma and fecal choline metabolites, and phospholipid profiles.
- Measurement of fat absorption, pulmonary function, growth, body composition, and safety parameters, including muscle and liver fat using magnetic resonance spectroscopy in a subgroup.
Main Results:
- The LXS group showed a threefold increase in dietary choline intake and significant improvements in plasma choline, betaine, and dimethylglycine levels compared to placebo.
- Plasma lysophosphatidylcholine and phosphatidylcholine increased, and fecal phospholipid ratios improved in the LXS group, correlating with a 6% increase in fat absorption.
- Children receiving LXS demonstrated increased calf muscle choline concentration, which was associated with improved plasma choline status. No significant safety concerns were identified.
Conclusions:
- LYM-X-SORB™ supplementation effectively improved choline intake, plasma choline status, and muscle choline stores in children with CF and pancreatic insufficiency.
- The choline-rich supplement was well-tolerated and accepted by participants.
- LXS demonstrated potential to improve fat absorption and choline status in this vulnerable pediatric population.
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