40 | id == 40
40 | category_id == 11
40 | category_order == 8
40 | category_name == Metabolic Health
40 | category_color == #C47AC0
40 | slug == fatty-liver-PEMT
40 | title == Genetic Factors of Fatty Liver (PEMT)
40 | meta_description == One PEMT variant plays a major role in liver health. Click to check your genes and get tailored tips.
40 | summary == <p><strong>Your liver depends on PEMT&nbsp;to get rid of excess fat and stay healthy. One variant suppresses&nbsp;the PEMT gene and correlates with fatty liver.&nbsp;Read on to learn more about the genetics of fatty liver.</strong></p>
40 | overall_score_text == Liver Score (based on PEMT gene)
40 | image == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/background/Genetic-Hacks-To-Prevent-Fatty-Liver-PEMT_JPG.jpg
40 | author_id == 9
40 | author_name == Aleksa Ristic
40 | author_title == MS (Pharmacy)
40 | author_order == 45
40 | author_photo == https://sd-selfdecode-assets-prod.s3.amazonaws.com/blog/author-photo/Aleksa.jpg
40 | author_intro == <p><strong>Aleksa received his MS in Pharmacy from the University of Belgrade, his master thesis focusing on protein sources in plant-based diets.</strong>&nbsp;&nbsp;</p>    <p>Aleksa is passionate about herbal pharmacy, nutrition, and functional medicine. He found a way to merge his two biggest passions&mdash;writing and health&mdash;and use them for noble purposes. His mission is to bridge the gap between science and everyday life, helping readers improve their health and feel better.</p>
40 | reviewer_id == 1
40 | reviewer_name == Jasmine Foster
40 | reviewer_title == BSc, BEd
40 | medical_reviewer_id == 11
40 | medical_reviewer_name == Puya Yazdi
40 | medical_reviewer_title == MD
40 | publish_date == 2019
40 | publish_date == 9
40 | publish_date == 9
40 | avg_rating == 4.888888888888889
40 | tags_id == 131
40 | tags_name == Choline
40 | tags_id == 133
40 | tags_name == Estrogen
40 | tags_id == 128
40 | tags_name == Fatty Liver
40 | tags_id == 129
40 | tags_name == NAFLD
40 | tags_id == 130
40 | tags_name == PEMT Gene
40 | tags_id == 132
40 | tags_name == Phosphatidylcholine
40 | permissions_favorite == False
40 | permissions_rate == False
40 | content_article == <h2><span style="font-weight: 400;">The PEMT Gene</span></h2> <p><a href="../../gene/pemt/"><span style="font-weight: 400;">PEMT</span></a><span style="font-weight: 400;"> encodes an enzyme (Phosphatidylethanolamine N-methyltransferase) which produces phosphatidylcholine (PC) in the liver. It converts phosphatidylethanolamine (PE) into PC by three-step </span><a href="https://selfhacked.com/blog/what-is-methylation-and-how-does-it-affect-our-health/"><span style="font-weight: 400;">methylation</span></a><span style="font-weight: 400;">, with the help of S-adenosylmethionine (SAM-e) [</span><a href="https://www.ncbi.nlm.nih.gov/gene/10400"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">This pathway is the only source of choline in the absence of food sources. It has played a critical evolutionary role by supplying choline and PC during periods of starvation [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/24184426"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/15536089"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">PEMT is mainly expressed in the liver and accounts for 30% of liver PC production. Choline and PC are essential for [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/10514439/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/10514439/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782876/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">]:</span></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Cell membranes</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Signaling</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Fat transport and metabolism</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Brain health</span></li> </ul> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">PEMT produces phosphatidylcholine (PC) in the liver via methylation. It supplies choline and PC in the absence of food sources of choline, thus maintaining cell structure, fat metabolism, and brain health.</span></p> <h2><span style="font-weight: 400;">Choline, PEMT, and Fatty Liver</span></h2> <p><span style="font-weight: 400;"><a title="PEMT pathway: the production of PC in the liver" href="https://www.sciencedirect.com/science/article/pii/S0005273613003799#f0020" target="_blank" rel="noopener"><img src="https://ars.els-cdn.com/content/image/1-s2.0-S0005273613003799-gr3.jpg" alt="PEMT-choline-fatty-liver" width="500" height="377" /></a></span></p> <p><span style="font-weight: 400;">Phosphatidylcholine (PC) helps break down fats in the liver and send them to other parts of the body. A lack of PC, due to choline deficiency or low PEMT activity, can cause fat to accumulate in the liver [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/15975496"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/3343237/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Mice without PEMT quickly develop fatty liver when fed a </span><a href="http://selfhacked.com/blog/low-carb-diet-vs-high-carb-diet/"><span style="font-weight: 400;">high-fat diet</span></a><span style="font-weight: 400;">, indicating a vital role of this enzyme in liver health [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/24368431"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p>*8868307856338897*</p> <p><span style="font-weight: 400;">In a meta-analysis of six clinical trials with over 3,500 participants, one PEMT variant was associated with non-alcoholic fatty liver disease (NAFLD). In these trials, people with a &ldquo;T&rdquo; allele on </span><a href="../../snp/rs7946/"><span style="font-weight: 400;">rs7946</span></a><span style="font-weight: 400;"> had 55% higher rates of NAFLD compared to those without [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/26636496"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">The connection is particularly strong in people of East Asian ancestry. Luckily, the "T" allele is much less common in this population [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/26636496"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">In a small study of European descendants, the &ldquo;T&rdquo; allele at rs7946 was more common among NAFLD patients, but another trial failed to confirm this. The authors hypothesized that the PEMT variant could worsen the effects of risk factors, such as overeating and a sedentary lifestyle [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1256033/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/27063264/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">The &ldquo;T&rdquo; allele on rs7946 may be associated with higher rates of fatty liver. This variant is significant among people from East Asia, and it may worsen the effects of overeating and sedentary lifestyle.</span></p> <h3><span style="font-weight: 400;">Should You Worry About Fatty Liver?</span></h3> <p><span style="font-weight: 400;">Given that NAFLD affects 20-30% of people in the Western world, the short answer is "yes." Obesity, diabetes, and other metabolic disorders increase the risk of this condition [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/27063264/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">You may not notice any symptoms in the early stages, so it's essential to check your liver enzymes and do an ultrasound exam if you or your doctor suspect any changes.</span></p> <h2><span style="font-weight: 400;">PEMT Variants and Fatty Liver &mdash; How It Works</span></h2> <p><span style="font-weight: 400;">Phosphatidylcholine (PC) helps produce </span><a href="https://selfhacked.com/blog/vldl-cholesterol-levels/"><span style="font-weight: 400;">VLDL</span></a><span style="font-weight: 400;">, which exports fat from the liver into the bloodstream. Additionally, PC suppresses the formation of </span><a href="https://www.selfhacked.com/blog/triglycerides/"><span style="font-weight: 400;">triglycerides</span></a><span style="font-weight: 400;"> in the liver and accelerates fat burning [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12193594/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12466019/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/11773510/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/15975496"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Carriers of the &ldquo;T&rdquo; allele at rs7946 may have reduced PEMT function. This would imply lower PC production and quicker liver fat buildup. In one lab test, the &ldquo;TT&rdquo; genotype resulted in a 30% loss of PEMT function. This mechanism has yet to be proven in better-designed trials [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1256033/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <h3><span style="font-weight: 400;">The Role of Estrogen</span></h3> <p><span style="font-weight: 400;">Men and postmenopausal women have higher rates of NAFLD compared with younger women. That&rsquo;s likely because estrogen stimulates PEMT expression and activity, supplying adequate amounts of PC [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/12717867/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/29992886"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">In those who carry the rs7946-T variant, estrogen may make up for this effect and maintain normal PEMT activity.</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">The rs7946-T variant reduces PEMT function, which may cause lower PC levels and increased liver fat buildup. Estrogen can counteract this effect by boosting PEMT expression and activity.</span></p> <h2><span style="font-weight: 400;">Your PEMT Results for Fatty Liver</span></h2> <p><span style="font-weight: 400;">*8868307856338897*</span></p> <p><strong>Primary SNP: </strong><a href="../../gene/pemt/"><strong>PEMT</strong></a> <a href="../../snp/rs7946/"><strong>rs7946</strong></a></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;C&rsquo; = Normal PEMT activity, doesn&rsquo;t correlate with fatty liver</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">&lsquo;T&rsquo; = Reduced PEMT activity, may correlate with fatty liver</span></li> </ul> <p><strong>Population Frequency:</strong></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">50% of European descendants have the &ldquo;TT&rdquo; genotype</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">4% of East-Asian descendants have the &ldquo;TT&rdquo; genotype</span></li> </ul> <p>*2151922414785063*</p> <h2><span style="font-weight: 400;">Recommendations to Improve Liver Health</span></h2> <p><span style="font-weight: 400;">Does this variation mean you're doomed to develop fatty liver? Absolutely not! Here's what you can do to support your PEMT and improve liver health.</span></p> <p><span style="font-weight: 400;">Remember to talk to your doctor before making any significant changes to your diet, exercise regimen, or supplements. This post is for informational purposes only.</span></p> <p><span style="font-weight: 400;">*2329806181473659*</span></p> <h3><span style="font-weight: 400;">Lifestyle</span></h3> <p><span style="font-weight: 400;">Chronic excessive alcohol consumption can wreak havoc on your liver. It causes fatty liver, inflammation, and scarring [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513682/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321494/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Suppressed PEMT may be one of the reasons drinking causes liver fat buildup. Alcohol also reduces PEMT activity indirectly by lowering the levels of S-adenosylmethionine [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/11192332"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Try to limit alcohol consumption or avoid it completely.</span></p> <h3><span style="font-weight: 400;">Diet</span></h3> <p><span style="font-weight: 400;">If low PEMT activity impairs phosphatidylcholine (PC) and choline production, getting enough choline from food should compensate for this effect. The liver will then produce PC via the CDP-choline pathway, which depends on adequate choline supply [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/24184426"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Enzymes in the CDP-choline pathway were 60% more active in PEMT-deficient mice. Choline supplementation improved their liver function and prevented fat buildup [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/24184426"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC24232/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/24368431"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Adequate choline intake is associated with lower rates of fatty liver [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/26636496"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230213/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1276051/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1574369/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Adult men need 550 mg of choline daily, while women need 425 mg. The best food sources include [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579689/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">,</span><a href="https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/"><span style="font-weight: 400;"> R</span></a><span style="font-weight: 400;">]:</span></p> <ul> <li style="font-weight: 400;"><span style="font-weight: 400;">Beef liver</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Eggs</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Chicken</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Codfish</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Shiitake mushrooms</span></li> </ul> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">If PEMT can&rsquo;t produce enough PC, it's essential to get enough choline from food. The best sources include beef liver, eggs, chicken, codfish, and shiitake mushrooms.</span></p> <h3><span style="font-weight: 400;">Supplements</span></h3> <h4><span style="font-weight: 400;">Choline</span></h4> <p><span style="font-weight: 400;">Different supplement forms of choline can increase dietary intake and compensate for low PEMT activity. These include:</span></p> <ul> <li style="font-weight: 400;"><a href="https://selfhacked.com/blog/health-benefits-phosphatidylcholine/"><span style="font-weight: 400;">Phosphatidylcholine</span></a><span style="font-weight: 400;"> (PC)</span></li> <li style="font-weight: 400;"><a href="https://www.selfhacked.com/blog/top-18-scientific-health-benefits-choline-cdp-choline-alpha-gpc/"><span style="font-weight: 400;">Citicoline</span></a><span style="font-weight: 400;"> (CDP-choline)</span></li> <li style="font-weight: 400;"><a href="https://selfhacked.com/blog/alpha-gpc/"><span style="font-weight: 400;">Alpha-GPC</span></a></li> <li style="font-weight: 400;"><a href="https://selfhacked.com/blog/lecithin/"><span style="font-weight: 400;">Lecithin</span></a><span style="font-weight: 400;">&nbsp;</span></li> </ul> <h4><span style="font-weight: 400;">Plant-Derived Estrogens</span></h4> <p><span style="font-weight: 400;">Certain plant-derived substances mildly stimulate estrogen receptors; they may compensate for the lack of PEMT-boosting estrogen, but this mechanism requires further investigation [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/29992886"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/23161396"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><a href="https://selfhacked.com/blog/top-15-scientific-health-benefits-of-resveratrol-with-references/"><span style="font-weight: 400;">Resveratrol</span></a><span style="font-weight: 400;"> is a potent antioxidant from grape skin, which can stimulate estrogen receptors and support the liver [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017646/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28446/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/24302567"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].&nbsp;</span></p> <p><span style="font-weight: 400;">In a small clinical trial, 6-month supplementation with resveratrol significantly reduced liver fat [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566048/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><a href="https://selfhacked.com/blog/green-tea/"><span style="font-weight: 400;">EGCG</span></a><span style="font-weight: 400;"> from green tea may also support estrogen functions in the liver (via estrogen receptor alpha) and thus increase PEMT activity [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214133/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981607/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Different animal trials have found EGCG beneficial for fatty liver. Green tea extract reduced liver enzymes in 80 NAFLD patients [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120134/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763469/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">These supplements are more popular among postmenopausal women, but anyone may find them useful. They are safe and don&rsquo;t cause hormonal imbalance when taken at recommended doses [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390141/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/19786161"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400; background-color: #e8ebfc; border-left: 2px solid #4569fa; display: block; padding: 20px;">Some plant compounds&mdash;such as resveratrol and EGCG&mdash;may compensate for low estrogen, increase PEMT activity, and improve liver health.</span></p> <h4><span style="font-weight: 400;">SAM-e</span></h4> <p><span style="font-weight: 400;">When PEMT makes phosphatidylcholine, it takes methyl groups from S-adenosylmethionine or </span><a href="https://selfhacked.com/blog/s-adenosyl-l-methionine/"><span style="font-weight: 400;">SAM-e</span></a><span style="font-weight: 400;">. Thus, more SAM-e = active PEMT [</span><a href="https://www.ncbi.nlm.nih.gov/pubmed/22877991"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">, </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/2910850"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">SAM-e boosts </span><a href="http://selfhacked.com/blog/30-scientifically-proven-health-benefits-glutathione/"><span style="font-weight: 400;">glutathione</span></a><span style="font-weight: 400;"> and, according to different clinical trials, may help with chronic liver disease [</span><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4361566/"><span style="font-weight: 400;">R</span></a><span style="font-weight: 400;">].</span></p> <p><span style="font-weight: 400;">Keep in mind that the above supplements aren't approved by the FDA to prevent or treat any medical condition.</span></p>
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40 | content_learn_more_8868307856338897_text == Your PEMT variant reduces enzyme activity and correlates with slightly higher rates of fatty liver. If you’re exposed to other risk factors and suspect any liver changes, increase your choline intake and consider taking supplements that may boost your PEMT. Keep reading for more details.
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rsIDs = rs7946
rsStatus = rs7946,PEMT,chr17,17506246,C,T,,,25,11,HET
