Effect of Taurine Supplementation on Fat and Bile Acid Absorption in Patients with Cystic Fibrosis

Abstract

Eleven children with cystic fibrosis (CF) and pancreatic insufficiency were given supplementation with taurine (30–40 mg/kg/day) for 2 months, while taking their usual dosage of enzymatic therapy. One patient dropped out of the study because she developed severe constipation. In the other 10 patients, urinary taurine excretion (88 ± 30.1 mg/m²s.a./24 h) was similar to that of controls (86.2 ± 6 mg/m²s.a./24 h) before taurine and increased markedly after supplementation (618.2 ± 79.97 mg/m²s.a./24 h), indicating efficient intestinal absorption. Their coefficient of fat absorption was 81.2 ±2.3% and increased significantly after taurine (91.3 ±1.13%; p < 0.01); the area under the curve of plasma triglyceride postprandial levels (1 ± 0.1 mg × min/ml) also increased significantly after taurine (1.4 ± 0.3 mg × min/ml; p < 0.05), showing values very similar to those of controls. Conversely, no change was observed in the serum postprandial levels of glycocholic acid: the maximum postprandial peak before (1.2 ± 0.3 μmol/1) and after taurine (1 ± 0.1 μmol/1) remained significantly lower than in controls (2.4 ± 0.3 μmol/1); p < 0.01 and p < 0.001, respectively. Mean total fecal bile acid (BA) excretion was 10.24 ±2.15 mg/kg/day before taurine and 12.8 ± 4.27 mg/kg/day after taurine (normal pediatric values, 2.91 ± 1.1 mg/kg/day); however, in the individual patients we found a variable trend, four of them showing a net increase in fecal BA excretion. We conclude that taurine supplementation is confirmed as a useful form of adjuvant therapy in CF patients with severe pancreatic insufficiency, probably as a result of an improvement in the intraluminal phase of fat digestion. However, more work is necessary to define better its effect on BA metabolism in these patients.

Key Words:

• Bile acids
• cystic fibrosis
• fat absorption
• taurine