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Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport
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Peripheral Vascular Disease and Carotid Artery Disease Are Associated with Decreased Bile Acid Excretion

Lior Charach1,2, Gideon Charach1,2, Eli Karniel1,2

  • 1Department of Internal Medicine B, Meir Medical Center, Kfar Saba 4428164, Israel.

Bioengineering (Basel, Switzerland)
|August 26, 2023
PubMed

Insights

Low bile acid excretion (BAE) is linked to increased cardiovascular and cerebrovascular disease risk. This study found low BAE is an independent risk factor for peripheral vascular disease (PVD) and predicts survival.

Area of Science:

  • Cardiovascular Science
  • Metabolic Disease Research
  • Gastroenterology

Background:

  • Low bile acid excretion (BAE) is a known risk factor for coronary artery disease (CAD) and cerebrovascular disease (stroke).
  • The association between BAE and peripheral vascular disease (PVD) and carotid artery disease (CA) remains less understood.
  • Atherosclerosis affects multiple vascular beds and impacts patient outcomes.

Purpose of the Study:

  • To investigate bile acid excretion (BAE) in patients with peripheral vascular disease (PVD) and carotid artery disease (CA).
  • To compare BAE levels in patients with atherosclerosis across different vascular beds.
  • To determine the relationship between BAE and long-term survival in a prospective cohort.

Main Methods:

  • Prospective study with 103 patients (66% male, mean age 60.9 years) over 22 years.
  • Fecal BAE measured via gas-liquid chromatography after a 4-day standard diet.
  • Regression analysis and Pearson correlations used to identify predictors of survival and relationships between BAE and other factors.

Main Results:

  • Low BAE (<262.4 mg/24 h) was associated with significantly lower 22-year survival (15%) compared to participants without atherosclerosis (>60% survival).
  • BAE was lower in patients with polyvascular atherosclerosis than in those with involvement of 1-3 vascular beds.
  • Advanced age, total BAE, and main BAE fractions were independent predictors of prolonged survival (p < 0.001).

Conclusions:

  • Low bile acid excretion (BAE) is a significant independent risk factor for peripheral vascular disease (PVD).
  • BAE levels correlate with the extent of atherosclerosis and predict long-term survival.
  • Measuring BAE may aid in assessing cardiovascular risk and patient prognosis.

Keywords:
atherosclerosisbile acidscarotid artery stenosislow bile acid excretionperipheral vascular disease

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