studies

1050A AASLD ABSTRACTS HEPATOLOGY, October, 2015
1726
Bile acid metabolism is altered in adolescents with type
1 diabetes
Zoehrer Evelyn 1 , Melanie Heckmann 1 , Elke Fröhlich-Reiterer 1 , Hildegard
Jasser-Nitsche 1 , Günter Fauler 2 , Hubert Scharnagl 2 , Tatjana
Stojakovic 2 , Jörg Jahnel 1 ; 1 Department of Paediatrics and
Adolescent Medicine, Medical University Graz, Graz, Austria;
2 Clinical Institute of Medical and Chemical Laboratory Diagnostics,
Medical University Graz, Graz, Austria
Objective: High levels of bile acids (BA) stimulate insulin release
and therefore decrease serum glucose levels via the TGR5/
GLP1 pathway; vice versa, high glucose levels can upregulate
BA synthesis from cholesterol by stimulating transcription of the
rate-limiting enzyme Cyp7a1. Type 1 diabetes (T1D) leads to
hyperglycemia due to lack of endogenous insulin. We hypothesized
that in children and adolescents with T1D BA levels
vary coordinately with HbA1c, a longtime marker of glycemic
control. Design: Concentrations of glucose, HbA1c, and serum
total BA (tBA) were measured in 86 fasted children and adolescents
with T1D (age 11 - 20 years) under insulin therapy.
Patients were divided into three groups: Group 1: low HbA1c
(< 59 mmol/mol; n=21); Group 2: medium HbA1c (59 – 75
mmol/mol; n=49) and Group 3: high HbA1c (> 75 mmol/
mol; n=16). TBA values were compared with normal values
for adolescents (n=98; Jahnel et al. 2015, CCLM). Using 10
μl of serum we determined by high-performance liquid chromatography
– high-resolution mass spectrometry a BA profile
including 15 unconjugated and taurine (T)- or glycine (G)-conjugated
BA; summed, the values for these analytes yield the
tBA value. Results: In Group 1, with low HbA1c values, mean
tBA values lay below reference values with 3.1 mmol/l ± 2.4
mmol/l (3.7 mmol/l ± 1.9 mmol/l). In Group 2, with normal
HbA1c values, mean tBA values were significantly lower than
in Group 1 and lay below normal ranges with 2.3 mmol/l ±
1.8 mmol/l (p