Gut bacterial bile salt hydrolase activity correlates with cardiovascular risk: a case-control study

Background. Serum cholesterol may be regulated by bile acid metabolism in the gut that depends on bacterial bile salt hydrolase (BSH) activity. There are limiting data regarding the clear effect of BSH on host lipid metabolism and cardiovascular risk (CVR). The investigation aimed to assess the relationship between the gut bacterial BSH relative activity (RA) and serum cholesterol with CVR levels. Materials and methods. The investigation was conducted as a case-control study and included 26 almost healthy participants (a control group) and 77 patients with dyslipidemia and without anamnesis of major cardiovascular events (a case group). The total RA of gut BSH, lipid profile, and CVR level according to 5 risk scores were assessed. Results. The RA of BSH was higher in healthy adults comparing to participants with dyslipidemia (p < 0.001). There were found moderate negative correlation between RA of gut bacterial BSH and total cholesterol (TC) (–0.38) and moderate correlation with low-density lipoproteins (LDL) (–0.36) with linear relationship that is defined by equation: LDL = –5.33 • RA of BSH + 4.479. It was revealed that with increasing of RA of gut bacterial BSH, the risk of dyslipidemia decreased (р