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Research Article| Volume 136, 155312, November 2022

Changes in circulating bile acid subtypes in response to weight-loss diets are associated with improvements in glycemic status and insulin resistance: The POUNDS Lost trial

  • Yoriko Heianza
    Correspondence
    Corresponding authors at: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 1724, New Orleans, LA 70112, United States of America.
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
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  • Xuan Wang
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
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  • Jennifer Rood
    Affiliations
    Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States of America
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  • Clary B. Clish
    Affiliations
    Metabolomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA, United States of America
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  • George A. Bray
    Affiliations
    Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States of America
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  • Frank M. Sacks
    Affiliations
    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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  • Lu Qi
    Correspondence
    Corresponding authors at: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 1724, New Orleans, LA 70112, United States of America.
    Affiliations
    Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America

    Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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Published:September 15, 2022DOI:https://doi.org/10.1016/j.metabol.2022.155312

      Highlights

      • Changes in various bile acid (BA) subtypes showed differential effects on improvements in glucose and insulin resistance.
      • Habitual dietary fat intakes modified the relations between changes in BA metabolism and improved glucose metabolism.
      • Changes in BA subtypes may be potential targets to achieve better outcomes during weight-loss dietary interventions.

      Abstract

      Objective

      Various primary and secondary bile acids (BAs) may play pivotal roles in glucose/insulin metabolism. We investigated whether changes in specific BA subtypes were associated with long-term changes in glucose and insulin sensitivity.

      Methods

      This study included 515 adults with overweight or obesity who participated in a 2-year intervention study of weight-loss diets with different macronutrient intakes. Circulating primary and secondary unconjugated BAs and their taurine-/glycine-conjugates were measured at baseline and 6 months after the interventions. We analyzed associations of changes in BA subtypes with two-year changes in fasting glucose, insulin, and insulin resistance (HOMA-IR).

      Results

      Greater decreases in primary and secondary BA subtypes induced by the interventions were significantly associated with greater reductions of fasting insulin and HOMA-IR at 6 months, showing various effects across the BA subtypes. The reductions of specific BA subtypes (chenodeoxycholate [CDCA], taurocholate [TCA], taurochenodeoxycholate [TCDCA], and taurodeoxycholate [TDCA]) were significantly related to improved glucose levels at 6 months. The initial (6-month) decreases in primary and secondary BA subtypes (glycochenodeoxycholate [GCDCA], TCDCA, and glycoursodeoxycholate [GUDCA]) were also significantly associated with long-term improvements in glucose and insulin metabolism over 2 years. We found significant interactions between dietary fat intake and changes in the BA subtypes for changes in glucose metabolism (Pinteraction < 0.05).

      Conclusions

      Weight-loss diet-induced changes in distinct subtypes of circulating BAs were associated with improved glucose metabolism and insulin sensitivity in adults with overweight or obesity. Dietary fat intake may modify the associations of changes in BA metabolism with glucose metabolism.

      Graphical abstract

      Abbreviations:

      BA (bile acid), BMI (body mass index), HOMA-IR (homeostasis model assessment-of-insulin resistance), POUNDS Lost (the Preventing Overweight Using Novel Dietary Strategies), MS (mass spectrometry), CA (cholate), CDCA (chenodeoxycholate), GCA (glycocholate), TCA (taurocholate), GCDCA (glycochenodeoxycholate), TCDCA (taurochenodeoxycholate), DCA (deoxycholate), LCA (lithocholate), UDCA (ursodeoxycholate), GDCA (glycodeoxycholate), TDCA (taurodeoxycholate), GLCA (glycolithocholate), GUDCA (glycoursodeoxycholate), THDCA (taurohyodeoxycholate), TUDCA (tauroursodeoxycholate), FDR (False Discovery Rate), FXR (farnesoid X receptor), TGR (takeda G protein-coupled receptor 5), GLP-1 (glucagon-like peptide-1)

      Keywords

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