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Choline supplementation for preterm infants: metabolism of four Deuterium-labeled choline compounds

Katrin A Böckmann1, Wolfgang Bernhard2, Michaela Minarski2

  • 1Department of Neonatology, Faculty of Medicine, Eberhard Karls University, Calwer Straße 7, 72076, Tuebingen, Germany. katrin.boeckmann@med.uni-tuebingen.de.

European Journal of Nutrition
|December 2, 2022
PubMed

Insights

Choline supplementation in preterm infants is crucial. Different forms of deuterated choline were compared, with D9-POPC showing a unique metabolic shift towards phosphatidylcholine (PC) and potential for enhanced poly-unsaturated fatty acid (PUFA) delivery.

Area of Science:

  • Biochemistry
  • Neonatology
  • Nutritional Science

Background:

  • Choline is essential for preterm infant development, involved in cell membrane formation (phosphatidylcholine - PC), fatty acid transport (PUFA-PC), and methylation (betaine).
  • Inadequate choline supply in preterm infants may lead to developmental issues.
  • This study investigated the kinetics of various deuterated choline forms in enterally fed preterm infants.

Purpose of the Study:

  • To compare the kinetics of deuterated choline (D9-choline), D9-betaine, and D9-phosphatidylcholine (D9-PC) after administration of different D9-choline components.
  • To evaluate the metabolic fate of D9-choline chloride, D9-glycerophosphorylcholine (D9-GPC), and D9-1-palmitoyl-2-oleoyl-PC (D9-POPC) in preterm infants.
  • To inform optimal choline supplementation strategies for preterm infants.

Main Methods:

  • A prospective study involving 32 enterally fed preterm infants (gestational age 28 0/7–32 0/7 weeks).
  • Infants received a single enteral dose of a D9-choline equivalent as D9-choline chloride, D9-GPC, or D9-POPC.
  • Plasma concentrations of D9-choline, D9-betaine, and D9-PC were analyzed using tandem mass spectrometry at 1, 12, 24, and 60 hours post-administration.

Main Results:

  • D9-Choline chloride, D9-GPC, and D9-phosphoryl-choline similarly increased plasma D9-choline and D9-betaine levels.
  • D9-POPC administration did not result in detectable plasma D9-choline but led to the highest plasma D9-PC concentrations.
  • Fatty-acyl remodeling of D9-POPC was observed, with a predominance of linoleic acid in D9-PC, suggesting preferential incorporation of poly-unsaturated fatty acids (PUFAs).

Conclusions:

  • D9-Choline chloride, D9-GPC, and D9-phosphoryl-choline are effective in increasing plasma D9-choline and D9-betaine.
  • D9-POPC uniquely shifts choline metabolism towards D9-PC formation and may facilitate PUFA delivery.
  • Combined supplementation strategies, potentially including GPC and (PO)PC, could optimize choline and PUFA supply in preterm infants.
Abstract

Keywords:
CholineDeuteriumPreterm infantStable isotope labelingSupplementation

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