Humans eating diets deficient in the essential nutrient choline can develop organ dysfunction. We hypothesized that common single nucleotide polymorphisms (SNPs) in genes involved in choline metabolism influence the dietary requirement of this nutrient. Fifty-seven humans were fed a low choline diet until they developed organ dysfunction or for up to 42 days. We tested DNA SNPs for allelic association with susceptibility to developing organ dysfunction associated with choline deficiency. We identified an SNP in the promoter region of the phosphatidylethanolamine Nmethyltransferase gene (PEMT; −744 G→C; rs12325817) for which 18 of 23 carriers of the C allele (78%) developed organ dysfunction when fed a low choline diet (odds ratio 25, P=0.002). The first of two SNPs in the coding region of the choline dehydrogenase gene (CHDH; +318 A→C; rs9001) had a protective effect on susceptibility to choline deficiency, while a second CHDH variant (+432 G→T; rs12676) was associated with increased susceptibility to choline deficiency. A SNP in the PEMT coding region (+5465 G→A; rs7946) and a betaine:homocysteine methyl-transferase (BHMT) SNP (+742 G→A; rs3733890) were not associated with susceptibility to choline deficiency. Identification of common polymorphisms that affect dietary requirements for choline could enable us to identify individuals for whom we need to assure adequate dietary choline intake.-da Costa, K.-A., Kozyreva, O. G., Song, J., Galanko, J. A., Fischer, L. M., Zeisel, S. H. Common genetic polymorphisms affect the human requirement for the nutrient choline.Keywords choline deficiency; phosphatidylethanolamine N-methyltransferase; PEMT; choline dehydrogenase; CHDH; betaine:homocysteine methyltransferase; BHMT; genetic polymorphism Choline is an essential nutrient needed for structural integrity and signaling functions of cell membranes, methyl group metabolism, and neurotransmitter synthesis (1). Humans eating diets deficient in choline develop fatty liver, liver damage, and muscle damage (2-4). These effects occur, in part, because a specific lack of phosphatidylcholine limits the export of excess triglyceride from liver (5,6) and induces apoptosis and subsequent leakage of enzymes (e.g., AST, ALT, and CPK) from tissues of liver and muscle (3,7,8
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript pregnancy in humans was associated with a 4-fold increased risk of having a baby with a neural tube defect (9). In addition, offering pregnant rodents diets deficient in choline resulted in perturbed brain development in their fetuses (10-13).We do not understand all of the factors that influence the dietary requirement for choline in humans, but we know that the requirement is modified by dietary availability of other methyl donors (1) and by endogenous de novo biosynthesis of choline moiety (14). (Fig. 1) The methylation of homocysteine can be accomplished by using a methyl group derived from onecarbon metabolism or by using a methyl group derived from choline. When choline is used...