Serum Bile Acids Associated With Brain Hypometabolism in Patients Across the Alzheimer's Disease Continuum Publisher Pubmed



Shushtari A ; Shekari K ; Rashti Mohammad S ; Alizadeh S ; Allahverdloo M ; Sadeghi M ; Zargari Z ; Honarbakhsh Haghighi V ; Kadaei F ; Zarif Z ; Salimi Eranji F ; Ghahrieh F ; Shafie M ; Mayeli M
Source: Neuroscience Published:2025

Abstract

The present study compares the predictive performance of serum bile acids with that of conventional Cerebrospinal Fluid (CSF) biomarkers of brain hypometabolism in the Alzheimer's disease (AD) continuum using [18F]-Fluorodeoxyglucose Positron Emission Tomography ([18F]-FDG-PET). Data were extracted from the Alzheimer's Disease Neuroimaging Initiative (ADNI). CSF biomarker data, serum bile acid measurements, and [18F]-FDG-PET data were used. We studied 556 participants, including 185 cognitively normal (CN) individuals, 289 patients with mild cognitive impairment (MCI), and 82 patients with AD. Serum levels of Lithocholic acid and Glycolithocholic acid were significantly elevated in AD compared to MCI and CN participants. Overall, CSF biomarkers had lower predictive power compared to brain hypometabolism in distinguishing AD from other groups. Stronger correlations with brain glucose hypometabolism were observed for conventional CSF biomarkers compared to bile acids in MCI and AD patients. Regression analyses indicated that while certain bile acids predicted brain hypometabolism in CN subjects better than conventional biomarkers, their predictive performance underperformed CSF biomarkers in MCI and AD. Overall, FDG-PET remains more effective than conventional CSF biomarkers for staging the AD continuum. While bile acids show potential, their ability to predict brain glucose metabolism in the AD continuum has not yet surpassed that of established CSF biomarkers. © 2025 International Brain Research Organization (IBRO)