Higher circulating bile acid concentrations in obese patients with type 2 diabetes

Abstract

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.

Temporal changes in bile acid levels and 12α-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes

“…14,38 T2DM is associated with altered BA metabolism. 9,25,39,40 Total BAs in obese persons with T2DM are reported to be higher compared with normoglycemic obese controls during fasting and postprandially; 9,39,40 some studies showed that this was driven by an increase in either glycine and/or taurine-conjugated BAs. 39,40 Another study showed that plasma CA and CDCA were inversely associated with insulin sensitivity.…”

Postprandial Plasma Concentrations of Individual Bile Acids and FGF-19 in Patients With Type 2 Diabetes

“…Indeed, postprandial hyperglycemia -an early defect seen in impaired glucose tolerance (IGT) and T2D -is a major contributor to HbA1c and even recognized as an independent risk factor for cardiovascular disease (18,19); a link that may also prove important considering the emerging evidence suggesting a role of bile acids in cardioprotection (20). Substantial rearrangements of bile acid metabolism in T2D patients are well established, including changes in pool size, pool composition, synthesis rate and postprandial plasma concentrations (21)(22)(23)(24)(25)(26)(27). We show that postprandial concentrations of secondary bile acids were higher in T2D patients vs. NGT.…”

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

“…The findings of this study may not generalize to patients outside the BMI and age restriction in our study, and probably of more importance, to patients with type 2 diabetes or severe metabolic disease. Previous studies have shown different bile acid profiles and responses in subjects with type 2 diabetes compared to non-diabetic subjects both before and after bariatric surgery [11,45].…”