Urine bile acids relate to glucose control in patients with type 2 diabetes mellitus and a body mass index below 30 kg/[m.sup.2]

• Published in: PloS one Vol. 9; no. 4
• Main Authors: Taylor, David R, Alaghband-Zadeh, Jamshid, Cross, Gemma F, Omar, Sohail, le Roux, Carel W, Vincent, Royce P
• Format: Journal Article
• Language: English
• Published: Public Library of Science 01.04.2014
• Subjects: Bile acids; Blood sugar; Care and treatment; Control; Diagnosis; Health aspects; Type 2 diabetes
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0093540

Bile acids are important endocrine signalling molecules, modulating glucose homeostasis through activation of cell surface and nuclear receptors. Bile acid metabolism is altered in type 2 diabetes mellitus; however, whether this is of pathogenic consequence is not fully established. In this study urinary bile acid excretion in individuals with type 2 diabetes and matched healthy volunteers was assessed. Urinary bile acid excretion in type 2 diabetes patients was considered in the context of prevailing glycaemia and the patient body mass index. Urine bile acids were measured by liquid chromatography-tandem mass spectrometry, allowing individual quantification of 15 bile acid species. Urinary bile acid excretion in patients with type 2 diabetes who were normal weight (BMI 18.5-24.9 kg/[m.sup.2]) and overweight (BMI 25- 29.9 kg/ [m.sup.2]) were elevated compared to healthy normal weight volunteers, both p < 0.0001. In obese (BMI$30 kg/[m.sup.2]) type 2 diabetes patients, urinary bile acid excretion was significantly lower than in the normal and overweight type 2 diabetes groups (both p < 0.01). Total bile acid excretion positively correlated with HbAlc in normal (rs = 0.85, p = <0.001) and overweight (rs = 0.61, p = 0.02) but not obese type 2 diabetes patients (rs= - 0.08, p = 0.73). The glycaemia-associated increases in urine bile acid excretion in normal weight and overweight type 2 diabetes seen in this study may represent compensatory increases in bile acid signalling to maintain glucose homeostasis. As such alterations appear blunted by obesity; further investigation of weight-dependent effects of bile acid signalling on type 2 diabetes pathogenesis is warranted.