Negative Correlation of Serum Total Bile Acid with Albuminuria in Patients with Type-2 Diabetes Mellitus: A Cross-Sectional Study

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Background: Diabetic nephropathy remains one of the most common microvascular complications of type-2 diabetes mellitus (T2DM) and is a major cause of chronic kidney disease worldwide. Albuminuria is an early marker of renal damage in diabetic individuals. Recent research suggests that bile acids act as metabolic signaling molecules that regulate glucose metabolism, inflammation, and insulin sensitivity. However, their association with diabetic kidney disease remains inadequately explored. Objective: To evaluate the relationship between serum total bile acid levels and albuminuria in patients with type2 diabetes mellitus. Materials and Methods: This cross-sectional study was conducted at Patna Medical College, Patna, Bihar, India over a period of eight months (February 2025–October 2025). A total of 80 patients with diagnosed T2DM were enrolled. Serum total bile acid levels were measured using enzymatic assays, and urinary albumin excretion was assessed using the albumin-creatinine ratio (ACR). Patients were categorized into normoalbuminuria, microalbuminuria, and macroalbuminuria groups. Statistical analysis was performed using Pearson correlation and ANOVA tests. Results: The mean serum bile acid level was significantly lower in patients with higher albuminuria levels (p < 0.01). A significant negative correlation was observed between serum total bile acid levels and urinary albumin excretion (r = −0.42, p = 0.002). Conclusion: Serum total bile acid levels show a significant inverse relationship with albuminuria in patients with T2DM. Lower bile acid levels may be associated with worsening renal involvement in diabetic patients.