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. 2019 Aug 7;11(8):1823. doi: 10.3390/nu11081823

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© 2019 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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A simplified diagram of the metabolic fate of maternal dietary choline and its delivery to the developing fetus. In the liver, choline can be used to make phosphatidylcholine (PC) through the cytidine diphosphate (CDP)-choline pathway (CDP-PC), or it can be oxidized to betaine and serve as a source of methyl groups for PC synthesis via the de novo phosphatidylethanolamine N-methyltransferase (PEMT) pathway (PEMT-PC). Both pathways are upregulated during the third trimester of pregnancy, but PEMT-derived PC is preferentially partitioned to the developing fetus. CM, chylomicron; MET, methionine; PE, phosphatidylethanolamine; SAM, S-adenosylmethionine; VLDL, very low-density lipoprotein.