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Nutrients
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27 June 2023

Reply to Abenavoli et al. Comment on “Clayton-Chubb et al. Understanding NAFLD: From Case Identification to Interventions, Outcomes, and Future Perspectives. Nutrients 2023, 15, 687”

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1
Department of Gastroenterology, The Alfred Hospital, Melbourne, VIC 3004, Australia
2
Central Clinical School, Monash University, Melbourne, VIC 3004, Australia
3
Department of Gastroenterology, Eastern Health, Box Hill, VIC 3128, Australia
4
Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia
This article belongs to the Special Issue Liver Disease, Lifestyle and Cardiovascular Risk
Thank you for your interesting comment [1] on our recent article [2]. The use of phosphatidylcholine as a potential nutraceutical therapeutic in NAFLD makes theoretical sense—choline deficiency is associated with hepatic steatogenesis [3,4], and phosphatidylcholine is an important component of cell membranes with relative deficiency also associated with hepatic steatogenesis [4].
While a discussion of all currently studied nutraceuticals was beyond the scope of our article, we agree that the evaluation of the potential therapeutic role of phosphatidylcholine in NAFLD over a longer term has some merit. However, we would also counsel to proceed with caution and to carefully monitor the safety of its administration given that some studies on dietary intake have linked phosphatidylcholine intake to increased all-cause and cardiovascular mortality [5]—which is of particular concern in the NAFLD population.
Thank you again for your interest in our article.

Author Contributions

Conceptualization, D.C.-C. and S.K.R.; writing—original draft preparation, D.C.-C. and S.K.R.; writing—review and editing, D.C.-C., W.K., A.M., J.S.L., A.H. and S.K.R.; supervision, S.K.R. All authors have read and agreed to the published version of the manuscript.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Abenavoli, L.; La Torre, G.; Milic, N. Comment on Clayton-Chubb et al. Understanding NAFLD: From Case Identification to Interventions, Outcomes, and Future Perspectives. Nutrients 2023, 15, 687. Nutrients 2023, 15, 2907. [Google Scholar] [CrossRef]
  2. Clayton-Chubb, D.; Kemp, W.; Majeed, A.; Lubel, J.S.; Hodge, A.; Roberts, S.K. Understanding NAFLD: From Case Identification to Interventions, Outcomes, and Future Perspectives. Nutrients 2023, 15, 687. [Google Scholar] [CrossRef]
  3. Mitra, A.; Ahn, J. Liver Disease in Patients on Total Parenteral Nutrition. Clin. Liver Dis. 2017, 21, 687–695. [Google Scholar] [CrossRef] [PubMed]
  4. Osipova, D.; Kokoreva, K.; Lazebnik, L.; Golovanova, E.; Pavlov, C.; Dukhanin, A.; Orlova, S.; Starostin, K. Regression of Liver Steatosis Following Phosphatidylcholine Administration: A Review of Molecular and Metabolic Pathways Involved. Front. Pharmacol. 2022, 13, 797923. [Google Scholar] [CrossRef]
  5. Zheng, Y.; Li, Y.; Rimm, E.B.; Hu, F.B.; Albert, C.M.; Rexrode, K.M.; Manson, J.E.; Qi, L. Dietary phosphatidylcholine and risk of all-cause and cardiovascular-specific mortality among US women and men. Am. J. Clin. Nutr. 2016, 104, 173–180. [Google Scholar] [CrossRef]
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