Negative correlation of serum total bile acid with albuminuria in patients with Type 2 Diabetes Mellitus: A cross-sectional study.

Pratap Kumar  Dash; Madhusmita  Panda; Duryodhan  Sahoo

doi:10.51168/sjhrafrica.v6i9.2125

Authors

Pratap Kumar Dash Additional Director, Department of Medicine, PGIMER, Bhubaneswar, Odisha, India
Madhusmita Panda, Professor & HOD, Department of Anatomy, FM Medical College, Balasore, Odisha, India
Duryodhan Sahoo Assistant Professor, Department of Biochemistry, Dharanidhar Medical College & Hospital, Keonjhar, Odisha, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2125

Keywords:

Type 2 Diabetes Mellitus, Albuminuria, Total Bile Acid, Diabetic Nephropathy, Biomarkers, FXR signaling

Abstract

Background
Type 2 diabetes mellitus (T2DM) is a leading cause of diabetic nephropathy, in which albuminuria serves as a key marker of renal damage. Bile acids are increasingly recognized as metabolic signaling molecules with potential roles in glucose and lipid regulation. This study examined the association between serum total bile acid (TBA) levels and albuminuria in patients with T2DM.

Methods
A single-center, cross-sectional study was conducted from January 2023 to December 2023 at Dharanidhar Medical College and Hospital (DDMCH), Keonjhar. One hundred adults with confirmed T2DM were enrolled. Clinical and biochemical data, including fasting serum total bile acid levels and first-morning urine albumin-to-creatinine ratio (UACR), were collected. Pearson’s correlation coefficient assessed the relationship between TBA and log-transformed UACR, and multivariable linear regression was performed to control for confounders such as age, HbA1c, and duration of diabetes.

Results
The cohort comprised 55 men and 45 women (mean age 58.5 years). A significant negative correlation was observed between serum TBA and log-transformed UACR (r = −0.55, p < 0.001). Mean serum TBA levels progressively decreased with increasing albuminuria: 5.7±1.5 µmol/L in normoalbuminuria, 3.9±1.2 µmol/L in microalbuminuria, and 2.4±0.8 µmol/L in macroalbuminuria. This association remained significant after adjusting for confounding variables (p < 0.01).

Conclusion

Serum total bile acid may represent a novel and easily accessible biomarker for assessing renal health and risk stratification in patients with T2DM. The results point to bile acids' possible protective function in the development of diabetic nephropathy.

Recommendations

This study provides a strong rationale for further large-scale, prospective research to confirm this relationship and explore the therapeutic potential of bile acid modulation.

Author Biographies

Pratap Kumar Dash, Additional Director, Department of Medicine, PGIMER, Bhubaneswar, Odisha, India

serves as Additional Director in the Department of Medicine at the Postgraduate Institute of Medical Education and Research (PGIMER), Bhubaneswar, Odisha. His research interests include diabetic complications, metabolic disorders, and clinical epidemiology.

Madhusmita Panda,, Professor & HOD, Department of Anatomy, FM Medical College, Balasore, Odisha, India

is Professor and Head of the Department of Anatomy at FM Medical College, Balasore, Odisha. She has extensive experience in human anatomical research and medical education, with a particular interest in metabolic and renal pathophysiology.

Duryodhan Sahoo, Assistant Professor, Department of Biochemistry, Dharanidhar Medical College & Hospital, Keonjhar, Odisha, India

is an Assistant Professor in the Department of Biochemistry at Dharanidhar Medical College & Hospital, Keonjhar, Odisha. His primary research areas include clinical biochemistry, diabetes-related biomarkers, and translational metabolic research.

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