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Associations between serum bile acid profile and mortality in patients with coronary artery disease: a cohort study
Yupeng Zeng1, Qing Li1, Xinyuan Jin1
1Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong Province, China.
Insights
Higher levels of specific bile acids, including cholic acid (CA) and chenodeoxycholic acid (CDCA), are linked to reduced mortality risk in patients with coronary artery disease (CAD). These findings highlight bile acids
Area of Science:
- Metabolomics and Cardiovascular Research
- Cholesterol Metabolism and Disease
- Biomarkers in Atherosclerosis
Background:
- Bile acids, cholesterol metabolites, regulate glucose, lipid, and immune functions.
- Limited research exists on the association between circulating bile acids and coronary artery disease (CAD).
Purpose of the Study:
- To investigate the relationship between serum bile acid profiles and mortality in patients diagnosed with CAD.
Main Methods:
- Serum concentrations of 15 bile acids were measured in 1730 CAD patients.
- Ultra-high-performance liquid chromatography-tandem mass spectrometry was employed.
- Cox proportional hazards regression models assessed associations with mortality risks.
Main Results:
- Follow-up of 9.2 years revealed 405 all-cause and 261 cardiovascular deaths.
- Higher serum concentrations of cholic acid (CA), chenodeoxycholic acid (CDCA), deoxycholic acid (DCA), and hyodeoxycholic acid (HDCA) correlated with reduced cardiovascular and all-cause mortality.
- Interactions between bile acids and clinical factors (BMI, CAD type, diabetes, age) were significant.
Conclusions:
- Elevated serum levels of specific unconjugated bile acids (CA, CDCA, DCA, HDCA) are associated with decreased mortality in CAD patients.
- These bile acids may serve as potential prognostic biomarkers for cardiovascular disease outcomes.
Background:
Bile acids, metabolic products of cholesterol, play a crucial regulatory role in glucose, lipid metabolism, and immune homeostasis. However, few studies have focused on the relationship between circulating bile acid concentrations and coronary artery disease (CAD).
Objectives:
This study aimed to explore the relationship between serum bile acid profiles and mortality risk in patients with CAD.
Methods:
We measured the concentrations of 15 serum bile acids in 1730 patients with CAD from the Guangdong Coronary Artery Disease Cohort study using ultrahigh-performance liquid chromatography-tandem mass spectrometry. Cox proportional hazards regression models were used to estimate the associations between bile acid concentrations and cardiovascular/all-cause mortality risks.
Results:
During the median 9.2-y follow-up, 405 all-cause and 261 cardiovascular deaths occurred. Serum cholic acid (CA), chenodeoxycholic acid (CDCA), deoxycholic acid (DCA), and hyodeoxycholic acid (HDCA) concentrations were significantly associated with lower risks of cardiovascular mortality, with hazard ratios (HRs) ranging from 0.40 to 0.55 [95% confidence intervals (CIs) ranging between 0.28 and 0.78] for Q4 compared with Q1 and HRs ranging from 0.64 to 0.85 (95% CIs ranging between 0.54 and 0.93) per SD increment. These bile acids were also inversely associated with risk of all-cause mortality, with HRs ranging from 0.57 to 0.67 (95% CIs ranging between 0.42 and 0.88) for Q4 compared with Q1 and HRs ranging from 0.81 to 0.88 (95% CIs ranging between 0.70 and 0.94) per SD increment. Significant interactions were observed for CA with body mass index, CDCA with CAD type, DCA with a history of diabetes, and HDCA with age, suggesting that these bile acid-mortality associations could be modified by specific clinical factors.
Conclusions:
Our findings suggest that higher serum concentrations of unconjugated bile acids, specifically CA, CDCA, DCA, and HDCA, are significantly associated with lower cardiovascular disease and all-cause mortality risks in patients with CAD.
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