Prediagnostic alterations in circulating bile acid profiles in the development of hepatocellular carcinoma
Document Type
Article
Publication Date
4-15-2022
Abstract
Bile acids (BAs) play different roles in cancer development. Some are carcinogenic and BA signaling is also involved in various metabolic, inflammatory and immune-related processes. The liver is the primary site of BA synthesis. Liver dysfunction and microbiome compositional changes, such as during hepatocellular carcinoma (HCC) development, may modulate BA metabolism increasing concentration of carcinogenic BAs. Observations from prospective cohorts are sparse. We conducted a study (233 HCC case-control pairs) nested within a large observational prospective cohort with blood samples taken at recruitment when healthy with follow-up over time for later cancer development. A targeted metabolomics method was used to quantify 17 BAs (primary/secondary/tertiary; conjugated/unconjugated) in prediagnostic plasma. Odd ratios (OR) for HCC risk associations were calculated by multivariable conditional logistic regression models. Positive HCC risk associations were observed for the molar sum of all BAs (ORdoubling = 2.30, 95% confidence intervals CI]: 1.76-3.00), and choline- and taurine-conjugated BAs. Relative concentrations of BAs showed positive HCC risk associations for glycoholic acid and most taurine-conjugated BAs. We observe an association between increased HCC risk and higher levels of major circulating BAs, from several years prior to tumor diagnosis and after multivariable adjustment for confounders and liver functionality. Increase in BA concentration is accompanied by a shift in BA profile toward higher proportions of taurine-conjugated BAs, indicating early alterations of BA metabolism with HCC development. Future studies are needed to assess BA profiles for improved stratification of patients at high HCC risk and to determine whether supplementation with certain BAs may ameliorate liver dysfunction.
Keywords
Bile acid metabolism, Biomarkers, Cancer prevention, Hepatocellular carcinoma, Obesity
Divisions
fac_med
Funders
French National Cancer Institute (L'Institut National du Cancer; INCa) [Grant No: 2009-139 & 2014-1-RT-02-CIRC-1],IARC,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London,Danish Cancer Society,Ligue Contre le Cancer (France),Institut Gustave Roussy (France),Mutuelle Generale de l'Education Nationale (France),Institut National de la Sante et de la Recherche Medicale (Inserm),German Cancer Aid, German Cancer Research Center (DKFZ),German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE),Federal Ministry of Education & Research (BMBF),Fondazione AIRC per la ricerca sul cancro,Compagnia di San Paolo,Netherlands Government,Cancer Research UK [Grant No: 14136 & C8221/A29017],UK Research & Innovation (UKRI) [Grant No: 1000143 ],Medical Research Council UK (MRC) [Grant No: MR/M012190/1]
Publication Title
International Journal of Cancer
Volume
150
Issue
8
Publisher
Wiley
Publisher Location
111 RIVER ST, HOBOKEN 07030-5774, NJ USA