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

Xunxun Feng,Qianyun Guo,Guangyao Zhai,Jiaqi Yang,Yujie Zhou,Yang Liu

doi:10.3389/fendo.2021.754006

Xunxun Feng, Qianyun Guo + Show 4 more

Open Access

https://doi.org/10.3389/fendo.2021.754006

Copy DOI

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.

Highlights

As metabolic molecules, bile acids (BAs) promote the absorption of fat-soluble nutrients, but they regulate many metabolic processes, including the homeostasis of glucose and lipids
Multivariate regression analysis suggested that low total serum BA (TBA) level was positively associated with the occurrence of coronary artery disease (CAD) combined with type 2 diabetes mellitus (T2DM) (OR: 1.451; 95%confidence intervals (CI): 1.141–1.847)
In the total population and in the T2DM subgroup, alanine amino transferase (ALT) and aspartate amino transferase (AST) levels were significantly lower in the non-CAD group than in the CAD group, whereas total bilirubin (TBIL) was significantly higher in the CAD group

Summary

Introduction

Bile acids (BAs) promote the absorption of fat-soluble nutrients, but they regulate many metabolic processes, including the homeostasis of glucose and lipids. Bile acids (BAs) are endogenous metabolites synthesized from cholesterols in the liver and can be modified by intestinal microbes. Since they are important metabolic and signal transducers in the body, they may play an important role in regulating lipid and carbohydrate metabolism, as well as in shaping the composition of intestinal microbiota [1]. Recent studies have reported an important link between BAs in cholesterol metabolism and autophagic activity, suggesting that BAs may be closely related to atherosclerosis [3]. Coronary artery disease (CAD) may involve general metabolic disorders. Differences in small molecule metabolites may reflect underlying CAD and serve as biomarkers during CAD progression [4]

Objectives

Methods

Results

Conclusion