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Total flavonoids of Astragalus Ameliorated Bile Acid Metabolism Dysfunction in Diabetes Mellitus

Evid Based Complement Alternat Med.

Astragalus Radix is one of the common traditional Chinese medicines used to treat diabetes. However, the underlying mechanism is not fully understood.

Flavones are a class of active components that have been reported to exert various activities. Existing evidence suggests that flavones from Astragalus Radix may be pivotal in modulating progression of diabetes.

In this study, total flavones from Astragalus Radix (TFA) were studied to observe its effects on metabolism of bile acids both in vivo and in vitro. C57BL/6J mice were treated with STZ and high-fat feeding to construct diabetic model, and HepG2 cell line was applied to investigate the influence of TFA on liver cells.

We found a serious disturbance of bile acids and lipid metabolism in diabetic mice, and oral administration or cell incubation with TFA significantly reduced the production of total cholesterol (TCHO), total triglyceride, glutamic oxalacetic transaminase (AST), glutamic-pyruvic transaminase (ALT), and low-density lipoprotein (LDL-C), while it increased the level of high-density lipoprotein (HDL-C). The expression of glucose transporter 2 (GLUT2) and cholesterol 7α-hydroxylase (CYP7A1) was significantly upregulated on TFA treatment, and FXR and TGR5 play pivotal role in modulating bile acid and lipid metabolism.

This study supplied a novel understanding towards the mechanism of Astragalus Radix on controlling diabetes.

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Bile acid metabolism and the pathogenesis of type 2 diabetes

Curr Diab Rep.

T2D is a growing health problem world-wide, but the currently available strategies for therapy and prevention are insufficient. Recent observations indicate that bile acid homeostasis is altered in T2D. Bile acids are metabolic regulators that act as signaling molecules through receptor-dependent and -independent pathways. The most prominent signaling molecules mediating bile acid signaling are the nuclear receptor FXR and the membrane receptor TGR5. Both are implicated in the regulation of lipid, glucose and energy metabolism. Dysregulation of these pathways might contribute to the development of T2D and associated metabolic complications. Interestingly, data from studies with bile acids or bile acid sequestrants indicate that the manipulation of bile acid homeostasis might be an attractive approach for T2D therapy. In this review, we summarize the mechanisms of bile-acid-mediated metabolic control that might be of relevance in the pathogenesis of T2D.
Keywords: Animals, Bile Acids and Salts, metabolism, Diabetes Mellitus, Type 2, metabolism, physiopathology, Dyslipidemias, metabolism, physiopathology, Humans, Obesity, metabolism, physiopathology

Keywords: Bile acids, T2D, FXR, TGR5, bile acid sequestrants, obesity, dyslipidemia, NAFL

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Understanding Bile Acid Signaling in Diabetes: From Pathophysiology to Therapeutic Targets

Diabetes and metabolism Journal

Diabetes and obesity have reached an epidemic status worldwide. Diabetes increases the risk for cardiovascular disease and non-alcoholic fatty liver disease.

Primary bile acids are synthesized in hepatocytes and are transformed to secondary bile acids in the intestine by gut bacteria. Bile acids are nutrient sensors and metabolic integrators that regulate lipid, glucose, and energy homeostasis by activating nuclear farnesoid X receptor and membrane Takeda G protein-coupled receptor 5.

Bile acids control gut bacteria overgrowth, species population, and protect the integrity of the intestinal barrier. Gut bacteria, in turn, control circulating bile acid composition and pool size.

Dysregulation of bile acid homeostasis and dysbiosis causes diabetes and obesity.

Targeting bile acid signaling and the gut microbiome have therapeutic potential for treating diabetes, obesity, and non-alcoholic fatty liver disease.

Keywords: Bile acids and salts, Gastrointestinal microbiome, Non-alcoholic fatty liver disease, Receptors, cytoplasmic and nuclear, Receptors, G-protein-coupled

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Study suggests hot flashes could be precursor to diabetes

Medical Xpress

Hot flashes, undoubtedly the most common symptom of menopause, are not just uncomfortable and inconvenient, but numerous studies demonstrate they may increase the risk of serious health problems, including heart disease. A new study suggests that hot flashes (especially when accompanied by night sweats) also may increase the risk of developing diabetes.

As reported in “Vasomotor symptom characteristics: are they risk factors for incident diabetes?” data was analyzed from the more than 150,000 postmenopausal women who participated in the Women’s Health Initiative (WHI) to confirm that the occurrence of hot flashes was associated with an elevated diabetes risk. Of the total population studied, 33% of the women had experienced hot flashes. Any incidence of hot flashes was associated with an 18% increased diabetes risk, and this risk continued to climb on the basis of the severity and duration of the hot flashes. Moreover, diabetes risk was the most pronounced for women reporting any type of night sweats but only if the onset of hot flashes occurred late in the menopause transition.

Diabetes is a serious health risk currently affecting 15% of women aged 55 years and older. Its incidence is expected to more than double by 2050. Compared with men with diabetes, women with diabetes have a higher risk of being hospitalized for or dying from diabetes and its complications, which makes the timely identification and management of diabetes through lifestyle intervention or medical management critical.

This study showed that, after adjustment for obesity and race, women with more severe night sweats, with or without hot flashes, still had a higher risk of diabetes,” says Dr. JoAnn Pinkerton, NAMS executive director. “Menopause is a perfect time to encourage behaviour changes that reduce menopause symptoms, as well as the risk of diabetes and heart disease. Suggestions include getting regular exercise and adequate sleep, avoiding excess alcohol, stopping smoking, and eating a heart-healthy diet. For symptomatic women, hormone therapy started near menopause improves menopause symptoms and reduces the risk of diabetes.”

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Sandra Ishkanes
Functional Medicine Practitioner
BSc MA DipION

sandra@gynecologic.dream.press
Brighton, UK

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