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Results from this study suggest that hepatic fat export in periparturient dairy cows is improved by choline supplementation during the transition period and this may potentially decrease the risk for metabolic disorders in the periparturient dairy cow. [7] Choline is also known to be involved in the synthesis of carnitine, cell membrane phospholipids, and the neurotransmitter acetylcholine

The proposed mechanism involves NNMT inhibition increasing the SAM:SAH ratio and NAD+ precursor availability, activating sirtuin-mediated metabolic programs