Myocardial Infarction and Coronary Artery Disease in Menopausal Women With Type 2 Diabetes Mellitus Negatively Correlate With Total Serum Bile Acids

Abstract

BackgroundAs metabolic molecules, bile acids (BAs) not only promote the absorption of fat-soluble nutrients, but they also regulate many metabolic processes, including the homeostasis of glucose and lipids. Although total serum BA (TBA) measurement is a readily available clinical test related to coronary artery disease (CAD), myocardial infarction (MI), and type 2 diabetes mellitus (T2DM), the relationship between TBA and these pathological conditions remain unclear, and research on this topic is inconclusive.MethodsThis study enrolled 20,255 menopausal women aged over 50 years, including 6,421 T2DM patients. The study population was divided into different groups according to the median TBA level in order to explore the clinical characteristics of menopausal women with different TBA levels. Spline analyses, generalized additive model (GAM) model and regression analyses based on TBA level were used to explore the relationship between TBA and different diseases independently, including CAD and MI, or in combination with T2DM.ResultsBoth in the general population and in the T2DM subgroup, the TBA level was significantly lower in CAD patients than in non-CAD patients. Spline analyses indicated that within normal clinical range of TBA concentration (0–10 µmol/L), the presence of CAD and MI showed similar trends in total and T2DM population. Similarly, the GAM model indicated that within the 0–10 μmol/L clinical range, the predicted probability for CAD and MI alone and in combination with T2DM was negatively correlated with TBA concentration. Multivariate regression analysis suggested that low TBA level was positively associated with the occurrence of CAD combined with T2DM (OR: 1.451; 95%CI: 1.141–1.847).ConclusionsIn menopausal women, TBA may represent a valuable clinical serum marker with negative correlation for CAD and MI in patients with T2DM.

Serum Metabolomics Reveals Distinct Profiles during Ischemia and Reperfusion in a Porcine Model of Myocardial Ischemia–Reperfusion

“…Feng et al showed that, in a select group of patients. i.e., menopausal women with type 2 diabetes mellitus, myocardial infarction and coronary artery disease were negatively correlated with total serum bile acids [ 50 ]. Consistent with the above, Huang et al showed that increased admission serum total bile acids could be associated with decreased 3 month mortality in patients with acute ischemic stroke [ 51 ].…”

Metabolomic and transcriptomic studies of improvements in myocardial infarction due to Pycr1 deletion

“…As a metabolite, bile acids not only promote the absorption of fat‐soluble nutrients but also regulate many metabolic processes, including the homeostasis of glucose and lipids. A growing body of research suggests that bile acid signalling pathway activation reduces inflammation and improves heart function after infarction, and strategies to control bile acid metabolism and its associated signalling to improve the inflammatory response may be beneficial for patients with MI 31–35 . Recent studies of UDCA and its taurine conjugate taurine deoxycholic acid (TUDCA) have demonstrated the clinical potential of these compounds as anti‐apoptotic drugs in the treatment of acute MI 36 .…”

“…A growing body of research suggests that bile acid signalling pathway activation reduces inflammation and improves heart function after infarction, and strategies to control bile acid metabolism and its associated signalling to improve the inflammatory response may be beneficial for patients with MI. 31 , 32 , 33 , 34 , 35 Recent studies of UDCA and its taurine conjugate taurine deoxycholic acid (TUDCA) have demonstrated the clinical potential of these compounds as anti‐apoptotic drugs in the treatment of acute MI. 36 The metabolism of arginine is closely related to the metabolism of proline, and arginine is partially involved in the synthesis of proline.…”