Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
Nutr J. 2024 Mar 2;23(1):28. doi: 10.1186/s12937-024-00928-2.
The relationship between circulating bile acids (BAs) and kidney function among patients with type 2 diabetes is unclear. We aimed to investigate the associations of circulating concentrations of BAs, particularly individual BA subtypes, with chronic kidney disease (CKD) in patients of newly diagnosed type 2 diabetes.
In this cross-sectional study, we included 1234 newly diagnosed type 2 diabetes who participated in an ongoing prospective study, the Dongfeng-Tongji cohort. Circulating primary and secondary unconjugated BAs and their taurine- or glycine-conjugates were measured using ultraperformance liquid chromatography-tandem mass spectrometry. CKD was defined as eGFR < 60 ml/min per 1.73 m. Logistic regression model was used to compute odds ratio (OR) and 95% confidence interval (CI).
After adjusting for multiple testing, higher levels of total primary BAs (OR per standard deviation [SD] increment: 0.78; 95% CI: 0.65-0.92), cholate (OR per SD: 0.78; 95% CI: 0.66-0.92), chenodeoxycholate (OR per SD: 0.81; 95% CI: 0.69-0.96), glycocholate (OR per SD: 0.81; 95% CI: 0.68-0.96), and glycochenodeoxycholate (OR per SD: 0.82; 95% CI: 0.69-0.97) were associated with a lower likelihood of having CKD in patients with newly diagnosed type 2 diabetes. No significant relationships between secondary BAs and odds of CKD were observed.
Our findings showed that higher concentrations of circulating unconjugated primary BAs and their glycine-conjugates, but not taurine-conjugates or secondary BAs, were associated with lower odds of having CKD in patients with type 2 diabetes.
2 型糖尿病患者循环胆汁酸（BAs）与肾功能之间的关系尚不清楚。我们旨在研究循环 BAs 浓度，尤其是个体 BA 亚型，与新诊断的 2 型糖尿病患者慢性肾脏病（CKD）之间的相关性。
在这项横断面研究中，我们纳入了 1234 名参加正在进行的前瞻性研究——东风-同济队列的新诊断的 2 型糖尿病患者。使用超高效液相色谱-串联质谱法测量循环初级和次级未结合的 BA 及其牛磺酸或甘氨酸结合物。CKD 的定义为 eGFR＜60 ml/min/1.73 m。使用逻辑回归模型计算比值比（OR）和 95%置信区间（CI）。
在校正多重检验后，总初级 BA 水平升高（每标准差[SD]增量的 OR：0.78；95%CI：0.65-0.92）、胆酸（OR per SD：0.78；95%CI：0.66-0.92）、鹅脱氧胆酸（OR per SD：0.81；95%CI：0.69-0.96）、甘氨胆酸（OR per SD：0.81；95%CI：0.68-0.96）和甘氨鹅脱氧胆酸（OR per SD：0.82；95%CI：0.69-0.97）与新诊断的 2 型糖尿病患者发生 CKD 的可能性降低相关。次级 BAs 与 CKD 几率之间没有显著的相关性。
我们的研究结果表明，循环未结合的初级 BAs 及其甘氨酸结合物浓度较高，而不是牛磺酸结合物或次级 BAs，与 2 型糖尿病患者发生 CKD 的几率降低相关。
