Journal
CURRENT OPINION IN LIPIDOLOGY
Volume 30, Issue 3, Pages 244-254Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOL.0000000000000597
Keywords
bile acids; insulin resistance; metabolic syndrome; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; obesity; type 2 diabetes
Funding
- Agence Nationale pour la Recherche [ANR-10-LABX-46, ANR-10-INBS-08]
- Societe Francophone du diabete
- French Ministry of Research
- ERC [694717]
- European Research Council (ERC) [694717] Funding Source: European Research Council (ERC)
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Purpose of review The purpose of this review is to discuss the influence of obesity, insulin resistance, type 2 diabetes (T2D), and nonalcoholic fatty liver disease (NAFLD) on bile acid metabolism and to analyze whether these findings reinforce current beliefs about the role of bile acids in the pathophysiology of these diseases. Recent findings Discordant results on plasma bile acid alterations in NAFLD patients have been reported. Obesity, insulin resistance, and T2D, common comorbidities of NAFLD, have been associated with bile acid changes, but the individual bile acid species variations differ between studies (summarized in this review), perhaps because of clinicobiological differences between the studied patient populations and the heterogeneity of statistical analyses applied. Summary The regulatory role of bile acids in metabolic and cellular homeostasis renders bile acids attractive candidates as players in the pathophysiology of NAFLD. However, considering the complex relationship between NAFLD, obesity, insulin resistance and T2D, it is difficult to establish clear and independent associations between bile acid alterations and these individual diseases. Though bile acid alterations may not drive NAFLD progression, signaling pathways activated by bile acids remain potent therapeutic targets for its treatment. Further studies with appropriate matching or adjustment for potential confounding factors are necessary to determine which pathophysiological conditions drive the alterations in bile acid metabolism.
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