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In db/db mice, CK treatment increases secondary BAs, such as lithocholic acid (LCA) and deoxycholic acid (DCA) through changes in the gut microbiota, especially the Ruminococcaceae family, and up-regulation of cytochrome P450 family 7 subfamily B member 1 ( Cyp7b1 ) and cytochrome P450 family 27 subfamily A member 1 ( Cyp27a1 ) and down-regulation of cytochrome P450 family 8 subfamily B member 1 ( Cyp8b1 ), which changes BA biosynthesis from the classical pathway to the alternative pathway

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As BMI rose, hepatic insulin sensitivity was often reduced, whereas brain inflammation was more likely to increase