TABLE 3.

Clinical measures in humans fed diets with various choline contents¹

Test and dietary phase	Subjects with signs of organ dysfunction (n = 33)	Subjects with no signs of organ dysfunction (n = 18)
Ratio of liver fat to spleen fat
550 mg choline	1.9 ± 0.1	1.4 ± 0.1
<50 mg choline	2.6 ± 0.22	1.4 ± 0.1
Repletion	2.1 ± 0.2	NA
Serum AST (U/L)
550 mg choline	29 ± 3	22 ± 2
<50 mg choline	43 ± 63	20 ± 1
Repletion	26 ± 1	NA
Serum ALT (U/L)
550 mg choline	34 ± 4	25 ± 2
<50 mg choline	35 ± 3	22 ± 2
Repletion	33 ± 3	NA
Serum GGT (U/L)
550 mg choline	23 ± 1.2	22 ± 1.3
<50 mg choline	24 ± 1.9	22 ± 1.6
Repletion	24 ± 1.7	NA
Serum total bilirubin (mg/dL)
550 mg choline	0.5 ± 0.04	0.5 ± 0.07
<50 mg choline	0.5 ± 0.04	0.6 ± 0.07
Repletion	0.6 ± 0.05	NA
Serum LD (U/L)
550 mg choline	444 ± 14	414 ± 23
<50 mg choline	485 ± 183	395 ± 22
Repletion	433 ± 17	NA
Serum albumin (mg/dL)
550 mg choline	3.9 ± 0.09	3.9 ± 0.11
<50 mg choline	3.8 ± 0.09	3.9 ± 0.09
Repletion	3.8 ± 0.07	NA
Serum amylase (U/L)
550 mg choline	56 ± 3.8	72 ± 6.0
<50 mg choline	51 ± 3.74	67 ± 5.8
Repletion	57 ± 5.4	NA
Serum AP (U/L)
550 mg choline	76 ± 2.7	63 ± 2.8
<50 mg choline	81 ± 2.75	67 ± 3.13
Repletion	81 ± 3.1	NA
PTT (s)
550 mg choline	28 ± 0.5	31 ± 0.9
<50 mg choline	28 ± 0.5	31 ± 0.9
Repletion	28 ± 0.6	NA
Serum total cholesterol (mg/dL)
550 mg choline	174 ± 7	159 ± 10
<50 mg choline	175 ± 8	159 ± 10
Repletion	180 ± 9	NA
Serum LDL (mg/dL)
550 mg choline	90 ± 5	94 ± 10
<50 mg choline	93 ± 6	91 ± 8
Repletion	101 ± 7	NA
Serum HDL (mg/dL)
550 mg choline	52 ± 1.7	51 ± 2.9
<50 mg choline	52 ± 2.0	48 ± 2.53
Repletion	51 ± 2.0	NA
Serum CPK (U/L)
550 mg choline	187 ± 60	132 ± 36
<50 mg choline	803 ± 302	89 ± 12
Repletion	98 ± 11	NA
Serum uric acid (mg/dL)
550 mg choline	4.5 ± 0.15	4.1 ± 0.23
<50 mg choline	5.4 ± 0.202	5.0 ± 0.262
Repletion	5.4 ± 0.184	NA
Serum blood urea nitrogen (mg/dL)
550 mg choline	9.7 ± 0.48	7.8 ± 0.49
<50 mg choline	8.9 ± 0.48	7.7 ± 0.35
Repletion	10 ± 0.66	NA
Serum creatinine (mg/dL)
550 mg choline	0.9 ± 0.03	0.8 ± 0.03
<50 mg choline	0.8 ± 0.03	0.8 ± 0.04
Repletion	0.8 ± 0.03	NA

¹All values are x̄ ± SE. The subjects were fed a baseline diet providing 550 mg choline · 70 kg body wt⁻¹ · d⁻¹ for 10 d. If the subjects did not manifest organ dysfunction during this diet, they were advanced to a choline-depletion diet (<50 mg choline · 70 kg body wt⁻¹ · d⁻¹) until they developed signs of organ dysfunction or for ≤42 d. The subjects who developed organ dysfunction were fed choline-repletion diets until signs of organ dysfunction were reversed. Data from subjects (n = 51) who were offered the low-choline diet are included; data from 6 subjects who were depleted during the 550-mg choline baseline diet are shown in Table 2. Laboratory measures were performed at the end of each dietary phase. For some time points, n was smaller than indicated because of missing data (see text). Statistical significance was conducted by using F tests to determine differences obtained by fitting unified linear mixed-effects models to the data (n = 51) in appropriate scales. For all biomarkers except HDL, the interactions of diet and depletion with subgroup (men, premenopausal women, and postmenopausal women) were not statistically significant at the α = 0.05 level. For HDL, with the use of a closed testing procedure (31) for testing multiple hypotheses, one interaction was detected; we rejected the null hypothesis that pre- and postmenopausal women are not different with respect to the difference between those who experience choline deficiency—related organ dysfunction and those who do not (P ≤ 0.05). CPK, creatine phosphokinase; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, γ-glutamyl transferase; AP, alkaline phosphatase; LD, lactate dehydrogenase; PTT, partial thromboplastin time; NA, not available.

²⁻⁵ Significantly different from 550 mg choline:

²P < 0.0001

³P < 0.05

⁴P < 0.01

⁵P < 0.001.