Background: Bile acids (BAs) play an important role in releasing incretin hormones via the enteroendocrine L-cell surface TGR5 receptors. The aim of this study was to investigate the difference in BA concentration at baseline and in response to a meal stimulus between type 2 diabetes mellitus (T2DM) and a matched normoglycaemic group. Materials and methods: A cross-sectional study of 12 patients with known T2DM and 12 matched normoglycaemic controls compared BA fractions after an overnight fast and following a standard meal. Results: The T2DM group had higher baseline glucose (P < 0.001), but baseline total BA, total glycine conjugated BAs (GCBA) and total taurine conjugated BA (TCBA) were similar between both groups. The T2DM group compared to the normoglycaemic group had a higher post-prandial peak change in total BAs 4.28 (3.51-5.38) mmol/L vs. 0.88 (0.60-1.57) mmol/L (P < 0.001) and peak total GCBA 2.77 (1.07-4.19) mmol/L vs. 0.94 (0.34-1.15) mmol/L (P < 0.0001), but similar peak total TCBA 0.36 (0.02-0.76) mmol/L vs. 0.08 (0.04-0.22) mmol/L (P¼0.91). Conclusion: The post-prandial bile acid response is elevated in obese patients with T2DM compared to matched normoglycaemic individuals.
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