Klatt Kevin C, McDougall Melissa Q, Malysheva Olga V, Taesuwan Siraphat, Loinard-González Aura Alex P, Nevins Julie E H, Beckman Kara, Bhawal Ruchika, Anderson Elizabeth, Zhang Sheng, Bender Erica, Jackson Kristina H, King D Janette, Dyer Roger A, Devapatla Srisatish, Vidavalur Ramesh, Brenna J Thomas, Caudill Marie A
Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
Children's Nutrition Research Center, Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA.
Am J Clin Nutr. 2022 Sep 2;116(3):820-832. doi: 10.1093/ajcn/nqac147.
Dietary methyl donors (e.g., choline) support the activity of the phosphatidylethanolamine N-methyltransferase (PEMT) pathway, which generates phosphatidylcholine (PC) molecules enriched in DHA that are exported from the liver and made available to extrahepatic tissues.
This study investigated the effect of prenatal choline supplementation on biomarkers of DHA status among pregnant participants consuming supplemental DHA.
Pregnant participants (n = 30) were randomly assigned to receive supplemental choline intakes of 550 mg/d [500 mg/d d0-choline + 50 mg/d deuterium-labeled choline (d9-choline); intervention] or 25 mg/d (25 mg/d d9-choline; control) from gestational week (GW) 12-16 until delivery. All participants received a daily 200-mg DHA supplement and consumed self-selected diets. Fasting blood samples were obtained at baseline, GW 20-24, and GW 28-32; maternal/cord blood was obtained at delivery. Mixed-effects linear models were used to assess the impact of prenatal choline supplementation on maternal and newborn DHA status.
Choline supplementation (550 vs. 25 mg/d) did not achieve a statistically significant intervention × time interaction for RBC PC-DHA (P = 0.11); a significant interaction was observed for plasma PC-DHA and RBC total DHA, with choline supplementation yielding higher levels (+32-38% and +8-11%, respectively) at GW 28-32 (P < 0.05) and delivery (P < 0.005). A main effect of choline supplementation on plasma total DHA was also observed (P = 0.018); its interaction with time was not significant (P = 0.068). Compared with controls, the intervention group exhibited higher (P = 0.007; main effect) plasma enrichment of d3-PC (d3-PC/total PC). Moreover, the ratio of d3-PC to d9-PC was higher (+50-67%; P < 0.001) in the choline intervention arm (vs. control) at GW 20-24, GW 28-32, and delivery.
Prenatal choline supplementation improves hepatic DHA export and biomarkers of DHA status by bolstering methyl group supply for PEMT activity among pregnant participants consuming supplemental DHA. This trial is registered at www.clinicaltrials.gov as NCT03194659.
膳食甲基供体（如胆碱）支持磷脂酰乙醇胺N-甲基转移酶（PEMT）途径的活性，该途径生成富含DHA的磷脂酰胆碱（PC）分子，这些分子从肝脏输出并可供肝外组织利用。
本研究调查了产前补充胆碱对服用补充剂DHA的孕妇中DHA状态生物标志物的影响。
将30名孕妇随机分为两组，从妊娠第12 - 16周直至分娩，分别接受550毫克/天的补充胆碱摄入量[500毫克/天的普通胆碱 + 50毫克/天的氘标记胆碱（d9-胆碱）；干预组]或25毫克/天（25毫克/天的d9-胆碱；对照组）。所有参与者每天服用200毫克DHA补充剂并食用自选饮食。在基线、妊娠第20 - 24周和妊娠第28 - 32周采集空腹血样；分娩时采集母血/脐带血。使用混合效应线性模型评估产前补充胆碱对母婴DHA状态的影响。
补充胆碱（550毫克/天与25毫克/天）对红细胞PC-DHA未达到统计学显著的干预×时间交互作用（P = 0.11）；在血浆PC-DHA和红细胞总DHA方面观察到显著交互作用，补充胆碱在妊娠第28 - 32周（P < 0.05）和分娩时（P < 0.005）产生更高水平（分别提高32 - 38%和8 - 11%）。还观察到补充胆碱对血浆总DHA的主效应（P = 0.018）；其与时间的交互作用不显著（P = 0.068）。与对照组相比，干预组血浆d3-PC（d3-PC/总PC）的富集程度更高（P = 0.007；主效应）。此外，在妊娠第20 - 24周、妊娠第28 - 32周和分娩时，胆碱干预组（与对照组相比）的d3-PC与d9-PC的比率更高（提高50 - 67%；P < 0.001）。
产前补充胆碱可通过增加甲基供应以支持PEMT活性，从而改善服用补充剂DHA的孕妇的肝脏DHA输出和DHA状态生物标志物。本试验已在www.clinicaltrials.gov注册，注册号为NCT03194659。
