Bile acids associate with glucose metabolism, but do not predict conversion from impaired fasting glucose to diabetes

Oscar Chávez-Talavera (1) , Matthieu Wargny (2) , Matthieu Pichelin (2) , Amandine Descat (3, 4) , Emmanuelle Vallez (1) , Mostafa Kouach (4) , Edith Bigot-Corbel (5) , Marielle Joliveau (2) , Jean-François Goossens (4) , Cédric Le May (2) , Samy Hadjadj (2) , Remy Hanf (6) , Anne Tailleux (1) , Bart Staels (1) , Bertrand Cariou (2)

1 RNMCD - Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011
2 ITX - ITX - unité de recherche de l'institut du thorax
3 Université de Lille
4 GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365
5 CRCINA-ÉQUIPE 16 - Molecular Mechanisms of Chronic Inflammation in Hematological Diseases
6 Genfit SA [Loos, France]

Objective: Bile acids (BAs) are signaling molecules controlling lipid and glucose metabolism. Since BA alterations are associated with obesity and insulin resistance, plasma BAs have been considered candidates to predict type 2 diabetes (T2D) risk. We aimed to determine (1) the association of BAs with glucose homeostasis parameters and (2) their predictive association with the risk of conversion from prediabetes to new-onset diabetes (NOD) in a prospective cohort study. Design: 205 patients with impaired fasting glucose (IFG) were followed each year during 5 years in the IT-DIAB cohort study. Twenty-one BA species and 7α-hydroxy-4-cholesten-3-one (C4), a marker of BA synthesis, were quantified by LC/MS-MS in plasma from fasted patients at baseline. Correlations between plasma BA species and metabolic parameters at baseline were assessed by Spearman's coefficients and the association between BAs and NOD was determined using Cox proportional-hazards models. Results: Among the analyzed BA species, total hyocholic acid (HCA) and the total HCA/total chenodeoxycholic acid (CDCA) ratio, reflecting hepatic BA 6α-hydroxylation activity, negatively correlated with BMI and HOMA-IR. The total HCA/total CDCA ratio also correlated negatively with HbA1C. Conversion from IFG to NOD occurred in 33.7% of the participants during the follow-up. Plasma BA species were not independently associated with the conversion to NOD after adjustment with classical T2D risk factors. Conclusions: Fasting plasma BAs are not useful clinical biomarkers for predicting NOD in patients with IFG. However, an unexpected association between 6α-hydroxylated BAs and glucose parameters was found, suggesting a role for this specific BA pathway in metabolic homeostasis. IT-DIAB study registry number: NCT01218061.

Mots clés: C4; Bile acids; HOMA-IR; Prediabetes; Impaired fasting glucose; New onset diabetes; Hyocholic acid; C4

Domaines: Sciences du Vivant [q-bio]

Oscar Chávez-Talavera, Matthieu Wargny, Matthieu Pichelin, Amandine Descat, Emmanuelle Vallez, et al.. Bile acids associate with glucose metabolism, but do not predict conversion from impaired fasting glucose to diabetes. Metabolism, 2020, 103, pp.154042. ⟨10.1016/j.metabol.2019.154042⟩. ⟨inserm-02869470⟩