Unveiling Role of Serum Total Bile Acid in Diabetic Osteopathy, the Unexplored Complication of Diabetes

As a signaling molecule and modulator of glucose and lipid metabolism, the role played by bile acid in regulating bone health in Type 2 Diabetes Mellitus needs evaluation on the basis of previous observations of interrelation of diabetes with osteoporosis and association of bile acid with bone metabolism. 46 Type 2 diabetics and 46 non-diabetic control admitted to orthopedic IPD for surgical treatment were included in the study. They were evaluated for Lumbar Bone mineral density (BMD), serum total bile acid, bone turnover markers PIPN and CTX, along with vitamin D, serum calcium and phosphate after submission of written consent. Association of total bile acid with glycemic status and bone tumor marker was assessed by regression analysis. Correlation of bile acid with BMD, CTX, and P1PN was assessed by spearman correlation test using IBM SPSS software (26 version). Diabetics revealed significantly low BMD and low bone turnover markers with elevated serum total bile acid. Bile acid registered a significant positive association with glycemic parameters and marked negative relation with BMD and bone tumor markers. Persistent relation was also noticed with CTX and vitamin D even after confounded with glycemic status. As a metabolic regulator, Bile acid exhibited an impact on bone health in Type 2 diabetics increasing the risk for fragility fracture. Detailed metabolic profile evaluation as well as its integrated role with gut microbiota, needs to be explored for more insight into its molecular mechanism and future therapeutic implications.