Serum total bile acids associate with risk of incident type 2 diabetes and longitudinal changes in glucose-related metabolic traits.

Abstract

BACKGROUND:

Bile acids have been found to be related to changes in gut microbiota and multiple metabolic disorders, including type 2 diabetes (T2D). We aimed to prospectively investigate associations of serum total bile acids (TBAs) with risk of incident T2D and longitudinal changes in glycemic traits.

METHODS:

A community-based study was conducted at baseline in 2010, including 4968 nondiabetic participants aged ≥40 years followed up for an average of 4.3 years. Incident T2D was defined by using the 1999 WHO criteria based on 75-g oral glucose tolerance tests. Multivariate Cox proportional hazards regression was used to examine the association of serum TBAs with incident T2D. Fasting plasma glucose (FPG), 2-hour postload plasma glucose (2-h PPG), and fasting serum insulin (FSI) were measured at baseline and follow-up.

RESULTS:

During 21 653.7 person-years of follow-up, 605 cases of incident diabetes were identified (incidence rate 2.8%). Comparing to quartile 1 of serum TBAs, quartile 2, 3, and 4 were significantly associated with a 14.2%, 15.0%, and 31.4% higher risk of incident T2D (P = .029). Each one unit of log-TBAs was associated with an increase of 0.034 mmol/L in FPG, 0.111 mmol/L in 2-h PPG, 0.023 in log-FSI, and 0.012 in log-HOMA-IR (homeostasis model assessment of insulin resistance) (all P ≤ .024). The association was attenuated after further adjustment for HOMA-IR. Mediation analysis showed that insulin resistance indicated by HOMA-IR might mediate 28.5% of indirect effect on the association of TBAs with T2D (P = .0004).

CONCLUSIONS:

Baseline serum TBAs were significantly associated with incident T2D and longitudinal changes in glycemic traits. Insulin resistance might partially mediate the association of TBAs and T2D.

• Authors: Wen Zhu, Shuangyuan Wang, Huajie Dai, Liping Xuan, Chanjuan Deng, Tiange Wang, Zhiyun Zhao, Mian Li, Jieli Lu, Yu Xu, Yuhong Chen, Weiqing Wang, Yufang Bi, Min Xu, Guang Ning
• Journal: Journal of diabetes (J Diabetes) Vol. 12 Issue 8 Pg. 616-625 (Aug 2020) ISSN: 1753-0407 [Electronic] Australia
• PMID: 32220107 (Publication Type: Journal Article)
• Copyright: © 2020 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Chemical References

• Bile Acids and Salts
• Blood Glucose

Topics

• Adult
• Aged
• Bile Acids and Salts (blood)
• Blood Glucose (metabolism)
• China (epidemiology)
• Diabetes Mellitus, Type 2 (blood, epidemiology, etiology, metabolism)
• Female
• Glucose Tolerance Test
• Humans
• Incidence
• Longitudinal Studies
• Male
• Middle Aged
• Prospective Studies
• Risk Factors