Lecithin Increases Plasma Free Choline and Decreases Hepatic Steatosis in Long-Term Total Parenteral Nutrition Patients A. L. BUCHMAN, M. DUBIN, D. JENDEN, ET AL Gastroenterology 102:1363-1370, 1992

Several investigators, including the authors, have demonstrated that patients receiving long-term total parenteral nutrition (TPN) have low plasma choline levels.1-3 In the present study, 15 patients who were receiving home TPN were randomly chosen from a group of long-term TPN patients found to have low levels of plasma free choline on initial screening.3The patients received TPN for 7.0 ± 1.1 years (range, 1.5 to 12.5 years). Their TPN consisted of 2 to 3 liters of 15% to 25% dextrose solution with 3.5% to 4.25% amino acids, electrolytes, trace elements, and vitamins. Patients received 20.1 ± 2.2 kcal/kg per day actual body weight. Parenteral lipid supplied was 22 ± 5% of daily intravenous caloric intake (Intralipid 20%, Kabi-Vitrum, Alameda, CA).Patients received either lecithin supplementation (20 g/12 hours in 2.5 tablespoons of soybean oil-based liquid) or placebo (2.5 tablespoons of oil) for 6 weeks in a double-blind fashion. Patients were evaluated at baseline and at 2 and 6 weeks. Laboratory meas...