Genetic variation in NR1H4 encoding the bile acid receptor FXR determines fasting glucose and free fatty acid levels in humans

J Clin Endocrinol Metab. 2013 Jul;98(7):E1224-9. doi: 10.1210/jc.2013-1177. Epub 2013 May 2.


Context: Bile acid signaling via farnesoid X receptor (FXR) regulates glucose and lipid levels, fat mass, and hepatic steatosis in animal models.

Objective: To understand the role of FXR in human metabolism, we investigated associations of common single-nucleotide polymorphisms (SNPs) in the FXR-encoding gene NR1H4 with glucose and lipid metabolism, body fat mass, and liver fat content.

Design: We genotyped 2166 healthy German subjects for 7 tagging SNPs within NR1H4 (rs35735, rs1030454, rs11110415, rs11610264, rs17030285, rs4764980, and rs11110390) covering 100% of common genetic variation (minor allele frequency > 10%).

Outcome measures: Subjects were metabolically characterized by an oral glucose tolerance test. In subgroups, hyperinsulinemic-euglycemic clamp and liver fat quantification by (1)H-magnetic resonance spectroscopy were performed.

Results: SNP rs4764980 was significantly associated with fasting glycemia (P = .0043) and nominally associated with fasting and postglucose load free fatty acid (FFA) levels (P = .01). Upon interrogation of publicly available Meta-Analyses of Glucose and Insulin-related traits Consortium data, the association of rs4764980 with fasting glycemia was replicated (Meta-Analyses of Glucose and Insulin-related traits Consortium, P = .005). Additionally, SNP rs11110390 showed significant associations with fasting (P = .0054) and postload (P = .0051) FFA levels. For none of the investigated SNPs, associations with insulin secretion or sensitivity, body fat mass, or liver fat content were detected.

Conclusions: We conclude that FXR contributes to fasting glucose and FFA levels in humans independent of unhealthy body fat accumulation. The receptor represents an interesting target to influence lipid and glucose metabolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / metabolism
  • Adipose Tissue / pathology
  • Adiposity
  • Adult
  • Bile Acids and Salts / metabolism
  • Blood Glucose / analysis*
  • Body Mass Index
  • Fasting
  • Fatty Acids, Nonesterified / blood*
  • Female
  • Gene Frequency
  • Genome-Wide Association Study
  • Germany
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / etiology
  • Hyperglycemia / genetics*
  • Hyperglycemia / metabolism
  • Hyperlipidemias / blood
  • Hyperlipidemias / etiology
  • Hyperlipidemias / genetics*
  • Hyperlipidemias / metabolism
  • Insulin Resistance
  • Lipid Metabolism
  • Liver / metabolism
  • Male
  • Overweight / pathology
  • Overweight / physiopathology
  • Polymorphism, Single Nucleotide*
  • Receptors, Cytoplasmic and Nuclear / genetics*
  • Receptors, Cytoplasmic and Nuclear / metabolism


  • Bile Acids and Salts
  • Blood Glucose
  • Fatty Acids, Nonesterified
  • Receptors, Cytoplasmic and Nuclear
  • farnesoid X-activated receptor