Invited Review Choline Deficiency During Parenteral Nutrition in Humans

Choline is necessary for normal functioning of the mammalian organism. It is a precursor for phospho-lipid biosynthesis from which cell membranes are formed. Rats ingesting choline-deficient diets have major alterations in methylation of many cell com-ponents, including cell membranes.1 Previous stud-ies have demonstrated that choline deficiency is associated with the development of hepatic steatosis in the guinea pig,2–5 rat,6–12 hamster,13 swine,14 chicken,15 duck,16 Japanese quail,17 dog,18 and rhe-sus monkey.19 It has been suggested that hepatocyte death may be related to choline or lecithin defi-ciency–induced membrane structural changes.20 This process may be promoted by the progressive accumulation of triglycerides causing hepatocyt