Serum bile acid patterns are associated with the presence of NAFLD in twins, and dose‐dependent changes with increase in fibrosis stage in patients with biopsy‐proven NAFLD

Summary Background The fasting‐state serum bile acid profile in nonalcoholic fatty liver disease (NAFLD) has been reported to differ when nonalcoholic steatohepatitis is compared to nonalcoholic fatty liver. However, there are few data comparing changes in NAFLD vs non‐NAFLD, or whether the bile acid profile differs according to the degree of fibrosis. Aim To examine the serum bile acid profile across the entire spectrum of NAFLD. Methods We performed a cross‐sectional analysis of two complementary cohorts: a Twin and Family cohort of 156 participants, and a biopsy‐proven‐NAFLD cohort of 156 participants with fasting bile acid profiling using liquid chromatography/mass spectrometry. Results In the Twin and Family cohort (mean age 46.3 years and body mass index (BMI) 26.6 kg/m2), 36 (23%) participants had NAFLD (magnetic resonance imaging proton density fat fraction ≥ 5%). Higher chenodeoxycholyl conjugates (9.0% vs 6.5%, P = 0.019) and lower glycohyocholate (1.2% vs 3.6%, P