Circulating bile acids concentration is predictive of coronary artery disease in human

Abstract

Synthetized by the liver and metabolized by the gut microbiota, BA are involved in metabolic liver diseases that are associated with cardiovascular disorders. Animal models of atheroma documented a powerful anti-atherosclerotic effect of bile acids (BA). This prospective study examined whether variations in circulating BA are predictive of coronary artery disease (CAD) in human. Consecutive patients undergoing coronary angiography were enrolled. Circulating and fecal BA were measured by high pressure liquid chromatography and tandem mass spectrometry. Of 406 screened patients, 80 were prospectively included and divided in two groups with (n = 45) and without (n = 35) CAD. The mean serum concentration of total BA was twice lower in patients with, versus without CAD (P = 0.005). Adjusted for gender and age, this decrease was an independent predictor of CAD. In a subgroup of 17 patients, statin therapy doubled the serum BA concentration. Decreased serum concentrations of BA were predictors of CAD in humans. A subgroup analysis showed a possible correction by statins. With respect to the anti-atherosclerotic effect of BA in animal models, and their role in human lipid metabolism, this study describe a new metabolic disturbance associated to CAD in human.

Substantial Fat Loss in Physique Competitors Is Characterized by Increased Levels of Bile Acids, Very-Long Chain Fatty Acids, and Oxylipins

“…In the past, it has been suggested that moderate levels of BA (e.g., deoxycholic acid) concentrations may be optimal, whereas more extreme levels (low or high) may have deleterious effects. This is why some BAs have been associated with both beneficial and harmful metabolic alterations or health outcomes [ 35 , 36 , 37 , 38 , 39 , 40 ]. In the end, more studies are warranted to unravel the complex BA-related metabolic homeostasis, networks, their changes after different interventions, and associated health outcomes.…”

“…Interestingly, metabolic states of chronic malnutrition and thus low-energy availability have also been characterized by dysfunction of peroxisomal β-oxidation and the accumulation of VLCFAs [ 52 ]. Altogether, we suggest that in addition to reflecting cardiometabolically advantageous FFA profiles [ 35 , 37 , 38 , 39 , 40 ], the increased levels of VLCFAs may also act as a marker for metabolic adaptations, namely attenuated oxidative functions in mitochondria, associated with prolonged periods of low-energy availability and fat mass loss to very low levels.…”

The role of the gut microbiota in health and cardiovascular diseases

“…Given that BAs, as the main metabolites of cholesterol, exert a powerful effect on maintaining cholesterol homeostasis and anti-atherosclerotic activity, the impaired ability to excrete BAs becomes a risk factor for CAD [ 384 , 385 ]. Previous studies have found that patients with CAD have lower BAs fecal excretion than CAD-free individuals, indicating the protective effect of BAs excretion against CAD [ 386 , 387 ].…”

“…Previous studies have found that patients with CAD have lower BAs fecal excretion than CAD-free individuals, indicating the protective effect of BAs excretion against CAD [ 386 , 387 ]. Notably, recent studies have mentioned that decreased circulating concentrations of BAs are also predictors of CAD [ 385 , 388 ]. In a sizable cohort study of 7,438 patients with suspected CAD, researchers found that fasting serum total BA levels were highly related to the presence and severity of CAD [ 388 ].…”

Impact of the Gastrointestinal Tract Microbiota on Cardiovascular Health and Pathophysiology

“…However, a direct link between circulating microbe-modified bile acids and CVDs has not been established yet. 66…”