Association between circulating bile acid alterations and nonalcoholic steatohepatitis independent of obesity and diabetes mellitus

Autor:	Dong Hyeon Lee, Bo Kyung Koo, Geum-Sook Hwang, Min Kyung Lee, Seo Young Jang, Mee Soo Chang, Taekyeong Yoo, Sae Kyung Joo, Murim Choi, Youngae Jung, Yong Jin Jung, Heeyeon Lee, Dain Kim, Jeong Hwan Park, Sang Won Kang, Won Kim
Rok vydání:	2021
Předmět:	medicine.medical_specialty medicine.drug_class digestive system Bile Acids and Salts Non-alcoholic Fatty Liver Disease Diabetes mellitus Internal medicine Nonalcoholic fatty liver disease Diabetes Mellitus medicine Metabolome Humans Obesity Hepatology Bile acid business.industry Fatty liver nutritional and metabolic diseases medicine.disease digestive system diseases Endocrinology Liver CYP8B1 business Body mass index
Zdroj:	Liver International. 41:2892-2902
ISSN:	1478-3231 1478-3223
Popis:	Background and aims Bile acid (BA) dysregulation is related to not only metabolic diseases but also nonalcoholic fatty liver disease (NAFLD). We investigated whether circulating BA levels are altered according to the histological severity of NAFLD independent of metabolic derangements. Methods Global metabolic profiling and targeted BA analysis using sera collected from biopsy-proven no-NAFLD (n = 67), nonalcoholic fatty liver (NAFL) (n = 99), and nonalcoholic steatohepatitis (NASH, n = 75) subjects were performed sequentially. Circulating metabolome analysis integrated with the hepatic transcriptome was performed to elucidate the mechanistic basis of altered circulating BA profiles after stratification by obesity (body mass index ≤ 25 kg/m2 ). Circulating BA alterations were also validated in an independent validation cohort (29 no-NAFLD, 70 NAFL and 37 NASH). Results Global profiling analysis showed that BA was the metabolite significantly altered in NASH compared to NAFL. Targeted BA analysis demonstrated that glyco-/tauro-conjugated primary BAs were commonly increased in nonobese and obese NASH, while unconjugated primary BAs increased only in nonobese NASH. These characteristic primary BA level changes were maintained even after stratification according to diabetes status and were replicated in the independent validation cohort. Compared to nonobese NAFL patients, nonobese NASH patients exhibited upregulated hepatic expression of CYP8B1. Conclusions BA metabolism is dysregulated as the histological severity of NAFLD worsens, independent of obesity and diabetes status; dysregulation is more prominent in nonobese NAFLD patients. Metabolome-driven omics approach provides new insight into our understanding of altered BA metabolism associated with individual phenotypes of NAFLD.
Databáze:	OpenAIRE
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