Serum bile acid response to oral glucose is attenuated in patients with early type 2 diabetes and correlates with 2h plasma glucose in individuals without diabetes.

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2022

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Wang, X.
Chen, C.
Xie, C.
Huang, W.
Young, R.L.
Jones, K.L.
Horowitz, M.
Rayner, C.K.
Sun, Z.
Wu, T.

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Diabetes, Obesity and Metabolism, 2022; 24(6):1134-1142

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Xuyi Wang, Chang Chen, Cong Xie, Weikun Huang, Richard L. Young, Karen L. Jones, Michael Horowitz, Christopher K. Rayner, Zilin Sun, Tongzhi Wu

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Abstract

Aim: To determine the serum bile acid (BA) response to 75-g oral glucose in individuals without diabetes, and whether this is attenuated in patients with ‘early’ type 2 diabetes (T2D) and related to the glycaemic response at 2 hours in either group. Methods: Forty newly diagnosed, treatment-naïve Han Chinese T2D subjects and 40 age-, gender-, and body mass index-matched controls without T2D ingested a 75-g glucose drink after an overnight fast. Plasma glucose and serum concentrations of total and individual BAs, fibroblast growth factor-19 (FGF-19), total glucagon-like peptide-1 (GLP-1), and insulin, were measured before and 2 hours after oral glucose. Results: Fasting total BA levels were higher in T2D than control subjects (P < .05). At 2 hours, the BA profile exhibited a shift from baseline in both groups, with increases in conjugated BAs and/or decreases in unconjugated BAs. There were increases in total BA and FGF-19 levels in control (both P < .05), but not T2D, subjects. Plasma glucose concentrations at 2 hours related inversely to serum total BA levels in control subjects (r = –0.42, P = .006). Total GLP-1 and the insulin/glucose ratio were increased at 2 hours in both groups, and the magnitude of the increase was greater in control subjects. Conclusions: The serum BA response to a 75-g oral glucose load is attenuated in patients with ‘early’ T2D, as is the secretion of FGF-19 and GLP-1, while in individuals without T2D it correlates with 2-hour plasma glucose levels. These observations support a role for BAs in the regulation of postprandial glucose metabolism.

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© 2022 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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