Fecal excretions of hydroxy fatty acid and bile acid in diabetic diarrheal patients.

Thirteen normal subjects, 5 diarrheal controls (Group I) and 13 diabetics without peripheral neuropathy (Group II) were compared with 7 diabetic patients (Group III) with respect to fecal excretions of bile acids and hydroxy fatty acids for pathogenesis of diabetic diarrhea. The mean fecal excretions of bile acids per day were 304.9 mg for the normal controls, 297.8 mg for Group I, and 382.4 mg for Group II, while those of Group III were significantly higher (958.2 mg, p < 0.01) than the foregoing groups, and nearly three times as much as the controls. As to the fecal fatty acid excretion, there were no significant differences observed among these groups. The percentages of fecal hydroxy fatty acids were not significantly different in normal subjects (1.5%), Group I (2.0%), and Group II (1.2%). In contrast, the percentage of hydroxy fatty acid for Group III was greatly (p < 0.01) increased (13.2%). From the above results, the percentage of hydroxy fatty acid in diabetic diarrheal patients was high, suggesting that there is bacterial overgrowth. Meanwhile, the fecal bile acid level was increased about three times, indicative of poor absorption of bile acid from mild to moderate degree. Therefore, it is considered improbable that fecal hydroxy fatty acids and bile acids are the cause of diabetic diarrhea.