The association between primary bile acids and metabolically unhealthy obesity
Authors' conclusion
Serum individual PBAs and total PBAs were significantly elevated in MUO compared with MHO. Higher PBA levels were associated with adverse metabolic parameters and an increased proportion of MUO. This study characterizes the distinct BA profiles across obesity phenotypes and highlights the associations between PBAs and MUO.
Study context
- Population
- Individuals with normal weight, metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO) (discovery cohort); validation cohort of 104 MHO and 104 MUO matched for age, sex and BMIdiscovery cohort
- Participants
- 261 / 80 / 120
- Exposure
- MUO vs MHO vs normal weight
- Normal-weightn = 261reference
- MHOn = 80
- MUOn = 120
- Outcome
- Serum bile acid profiles
Methodological detailsdiscovery and validation cohorts, validation cohort matched for age, sex and BMI
- Discovery and validation cohorts
- Validation cohort matched for age, sex and BMI
Main finding
As reported in the abstract
Serum primary bile acids (PBAs)
- Individual primary bile acids (PBAs) (cholic, glycocholic, chenodeoxycholic acid) and total PBA markedly increased in MUO vs both normal-weight and MHO
- Total secondary bile acids decreased in both obesity phenotypes vs normal-weight; no difference between MUO and MHO
- Among individuals with obesity, individual or total PBA levels positively correlated with WHR, HOMA-IR, HbA1c and TG
- Higher total PBA level associated with increased proportion of MUO
- Replicated in the validation cohort
Observational data: associations, not effects.
Original publication
The association between primary bile acids and metabolically unhealthy obesity. Diabetes Metab. Published 16 April 2026. doi:10.
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