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) µmol/L vs. 0.88 (0.60–1.57) µmol/L ( P < 0.001) and peak total GCBA 2.77 (1.07–4.19) µmol/L vs. 0.94 (0.34–1.15) µmol/L ( P < 0.0001), but similar peak total TCBA 0.36 (0.02–0.76) µmol/L vs. 0.08 (0.04–0.22) µmol/L ( P=0.91). Conclusion The post-prandial bile acid response is elevated in obese patients with T2DM compared to matched normoglycaemic individuals.