URINARY EXCRETION OF CHOLINE METABOLITES FOLLOWING CHOLINE ADMINISTRATION IN NORMALS AND PATIENTS WITH HEPATOBILIARY DISEASES 1

Abstract

For the determination of choline a procedure was adopted using precipitation by Reinecke salt. Procedures were also developed for the determination of trimethylamine and trimethylamine oxide in the urine based on either Reinecke salt precipitation or the Folin-Ciocalteau reaction. Studies were made on the urine of four normal persons and 22 patients with hepatobiliary diseases before and after oral administration of 2-8g. of choline base. Choline was not found in the urines of normal persons nor patients with hepatobiliary diseases under basal conditions. After oral admn. of choline very small amounts, if any, of choline were excreted, as a rule not exceeding 0.3% of the amount of choline administered. Under basal conditions small amts. of trimethylamines were found in the urine. Within 24 hrs. about two-thirds of the choline N ingested was excreted in normal individuals as trimethylamine and its oxide. Incubated stool dilutions transformed choline to trimethylamine. Inhibition of the intestinal flora by aureomycin and sulfathalidine greatly depressed the urinary trimethylamine excretion. This indicates that the urinary trimethylamines result from bacterial transformation of choline in the intestine. The greater part of therapeutically administered choline is, therefore, changed in the liver into a product without lipotropic activity. Admn. of can sugar with choline delayed urinary trimethylamine excretion while intake of starch depressed it. In liver diseases the urinary trimethylamines elimination after choline admn. is delayed or decreased. Ingested trimethylamine in these patients is readily excreted. These findings suggest an altered action of intestinal bacteria in liver diseases.