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Higher plasma deoxycholic acid and related bile acid species are significantly associated with symptomatic hand osteoarthritis.
A new multi-omics study suggests that dysregulated bile acid metabolism—particularly elevated deoxycholic acid (DCA)—may contribute to the development and severity of symptomatic hand osteoarthritis (SHOA), highlighting a potential gut microbiome–bile acid pathway in osteoarthritis pathogenesis.
Jiatian Li and other researchers analyzed data from the Xiangya Osteoarthritis (XO) study to investigate the link between plasma bile acids and SHOA. The discovery cohort included 1,359 volunteers (mean age of 63.1 ± 9.0 years, 58.4% women). The prevalence of SHOA was 5.2%, and all participants were Asian. Using logistic regression models, investigators found that higher levels of DCA and DCA-related bile acid species were substantially associated with both the presence and severity of SHOA.
Specifically, DCA species were linked to increased SHOA risk (odds ratio [OR] 1.75), while DCA itself showed a stronger association (OR 2.14). These findings were successfully replicated in an independent validation cohort of 142 subjects, confirming the link between bile acid metabolism and SHOA. To explore potential biological mechanisms, the researchers integrated gut microbiome data from a previous XO Study analysis. Multi-omics analysis revealed prominent correlations between DCA, DCA species, the DCA/total bile acid ratio, and gut microbial taxa previously associated with SHOA.
The findings suggest that gut microbiota may influence bile acid metabolism and contribute to osteoarthritis development through the gut–joint axis. Further gene-based meta-analyses identified significant associations between hand osteoarthritis and genes encoding bile acid receptors, including the Farnesoid X receptor and the pregnane X receptor. These receptors are central regulators of bile acid signaling, inflammation, and metabolic homeostasis, suggesting that host genetics may interact with gut microbiota–derived metabolites to influence osteoarthritis risk.
Overall, the study highlights elevated DCA as a potential metabolic biomarker for SHOA and suggests that interactions between bile acids, gut microbiota, and bile acid receptor genes may play a key role in disease development. These outcomes open novel avenues for microbiome-targeted therapies and precision medicine strategies in osteoarthritis care.
Arthritis & Rheumatology
Bile acids metabolism in symptomatic hand osteoarthritis
Jiatian Li et al.
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