title: Mechanisms of triglyceride metabolism in patients with bile acid diarrhea.
abstract: Bile acids (BAs) are essential for the absorption of lipids. BA synthesis is inhibited through intestinal farnesoid X receptor (FXR) activity. BA sequestration is known to influence BA metabolism and control serum lipid concentrations. Animal data has demonstrated a regulatory role for the FXR in triglyceride metabolism. FXR inhibits hepatic lipogenesis by inhibiting the expression of sterol regulatory element binding protein 1c via small heterodimer primer activity. Conversely, FXR promotes free fatty acids oxidation by inducing the expression of peroxisome proliferator-activated receptor α. FXR can reduce the expression of microsomal triglyceride transfer protein, which regulates the assembly of very low-density lipoproteins (VLDL). FXR activation in turn promotes the clearance of circulating triglycerides by inducing apolipoprotein C-II, very low-density lipoproteins receptor (VLDL-R) and the expression of Syndecan-1 together with the repression of apolipoprotein C-III, which increases lipoprotein lipase activity. There is currently minimal clinical data on triglyceride metabolism in patients with bile acid diarrhoea (BAD). Emerging data suggests that a third of patients with BAD have hypertriglyceridemia. Further research is required to establish the risk of hypertriglyceridaemia in patients with BAD and elicit the mechanisms behind this, allowing for targeted treatment.
authors: Nidhi Midhu Sagar, Michael McFarlane, School of Medicine, University of Warwick, Coventry CV4 7AL, United Kingdom.
authors: Nidhi Midhu
authors: NM
authors: Sagar
authors: Nidhi Midhu Sagar, Michael McFarlane, School of Medicine, University of Warwick, Coventry CV4 7AL, United Kingdom.
authors: Michael
authors: M
authors: McFarlane
authors: Nidhi Midhu Sagar, Michael McFarlane, School of Medicine, University of Warwick, Coventry CV4 7AL, United Kingdom.
authors: Chuka
authors: C
authors: Nwokolo
authors: Nidhi Midhu Sagar, Michael McFarlane, School of Medicine, University of Warwick, Coventry CV4 7AL, United Kingdom.
authors: Karna Dev
authors: KD
authors: Bardhan
authors: Nidhi Midhu Sagar, Michael McFarlane, School of Medicine, University of Warwick, Coventry CV4 7AL, United Kingdom.
authors: Ramesh Pulendran
authors: RP
authors: Arasaradnam
mesh_terms: D001647:Bile Acids and Salts / Q000378:metabolism*; D003967:Diarrhea / Q000378:metabolism*; D005346:Fibroblast Growth Factors / Q000097:blood; D006801:Humans; D018160:Receptors, Cytoplasmic and Nuclear / Q000502:physiology; D014280:Triglycerides / Q000378:metabolism*; D000099150:Receptor, Farnesoid X-Activated
chemical_list: D001647:Bile Acids and Salts; D005346:Fibroblast Growth Factors; D018160:Receptors, Cytoplasmic and Nuclear; D014280:Triglycerides; D000099150:Receptor, Farnesoid X-Activated; C117476:FGF19 protein, human
keywords: Bile acid diarrhea; Bile acids; Farnesoid X receptor; Triglycerides