ANNALS EXPRESS: Bile acids and the metabolic syndrome.

Bile acids have important roles in the regulation of lipid, glucose and energy metabolism. Metabolic diseases linked to obesity, including type 2 diabetes mellitus and non-alcoholic fatty liver disease, are associated with dysregulation of bile acid homeostasis. Here basic chemistry and regulation of bile acids will be reviewed, as well as their metabolic effects. Changes in circulating bile acids associated with obesity and related diseases will be reviewed. Finally, pharmaceutical manipulation of bile acid homeostasis as therapy for metabolic diseases will be outlined. Key words Bile acids; metabolic syndrome; type 2 diabetes mellitus; non-alcoholic fatty liver disease; farnesoid X receptor (FXR); Takeda G-protein coupled receptor 5 (TGR5).