{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:21:13Z","timestamp":1793996473157,"version":"4.8.0"},"reference-count":76,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Chronic Disease"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition characterized by the accumulation of fat in the liver. Nutrition, particularly micronutrients, plays a crucial role in the development and progression of NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to assess the impact of choline supplementation on oxidative stress, inflammation, and clinical outcomes in patients with NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A randomized, controlled, single-blinded study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Eligible NAFLD patients were randomized to;\n                      <jats:italic>choline group<\/jats:italic>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200939), received conventional management plus phosphatidylcholine (PC) 2400\u2009mg\/day for 12\u2009weeks, or c\n                      <jats:italic>ontrol group<\/jats:italic>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940), received conventional management for 12 weeks, and 10 healthy volunteers were included. Anthropometric, clinical, and laboratory evaluations were performed at baseline and after treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      After 12\u2009weeks, choline group showed significant differences versus controls by improvement in controlled attenuation parameter (304 vs 332\u2009dB\/m,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and fibrosis score (5.3 vs 6.8\u2009kPa,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), reduction in thiobarbituric acid reactive substances levels (1.9 vs 3.8 nmol\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), a decline in leptin levels (1.3 vs 2.1\u2009ng\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and liver enzyme (alanine aminotransferase and aspartate aminotransferase),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 and 0.004 respectively). Also, the lipid profile improved by a significant decline in triglyceride levels in choline versus controls 133 versus 158,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Choline supplementation in NAFLD patients demonstrated a favorable impact on hepatic steatosis, oxidative stress, inflammatory markers, liver enzyme levels, and lipid profile. These findings suggest that choline may be a promising therapeutic option for NAFLD management. Further large-scale, long-term studies are warranted to investigate the clinical benefits of choline supplementation in NAFLD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>The study was registered at clinicaltrials.gov and given the ID number: NCT05200156.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20406223251358659","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T06:25:52Z","timestamp":1755498352000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["The impact of choline supplementation on oxidative stress and clinical outcomes among patients with non-alcoholic fatty liver disease: a randomized controlled study"],"prefix":"10.1177","volume":"16","author":[{"given":"Sylvia S.","family":"Sedhom","sequence":"first","affiliation":[{"name":"Pharmacology Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0250-1709","authenticated-orcid":false,"given":"Lamia M.","family":"El Wakeel","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, African Unity Abbasia, Organization of African Unity St, El-Qobba Bridge, El Weili, Cairo Governorate 11566, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman M. F.","family":"Barakat","sequence":"additional","affiliation":[{"name":"Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hend I.","family":"Shousha","sequence":"additional","affiliation":[{"name":"Endemic Medicine and Hepato Gastroenterology Department, Faculty of Medicine, Cairo University, Giza, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa A.","family":"Shamkh","sequence":"additional","affiliation":[{"name":"Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salwa H.","family":"Salama","sequence":"additional","affiliation":[{"name":"Pharmacology Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa Z.","family":"Zaky","sequence":"additional","affiliation":[{"name":"Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal A.","family":"El Kholy","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, African Unity Abbasia, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,17]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.04.031"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000004"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2023.155642"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.04.015"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173499"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000323"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.02.003"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v7.i10.1325"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/9547613"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/antiox10020174"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/145754"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0b013e32834e7b4b"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.1992.10718251"},{"key":"e_1_3_4_15_2","first-page":"1399","article-title":"Choline deficiency: a cause of hepatic steatosis during parenteral nutrition that can be reversed with intravenous choline supplementation","volume":"22","author":"Buchman AL","year":"1995","unstructured":"Buchman AL, Dubin MD, Moukarzel AA, et al. 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