Nutrition Metabolism and Cardiovascular Diseases最新文献

{"title":"The trajectories of free sugar intake and its main sources during childhood and cardiometabolic clusters at 13 years of age.","authors":"Sofia Sosa, Catarina Campos Silva, Milton Severo, Carla Lopes","doi":"10.1016/j.numecd.2026.105003","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.105003","url":null,"abstract":"<p><strong>Background and aim: </strong>The effect of free sugar (FS) intake trajectories in early life on later cardiometabolic health is unclear. To evaluate the association of FS intake trajectories (both total FS and primary food sources) on cardiometabolic risk clusters from childhood into adolescence.</p><p><strong>Methods and results: </strong>Participants (n = 3616) from the Generation XXI birth-cohort were assessed at ages 4, 7, 10, and 13. FS intake was assessed using food frequency questionnaires. Cardiometabolic outcomes (BMI, waist circumference, HOMA, lipids, blood pressure) were objectively measured. Gaussian mixture models identified FS trajectories and cardiometabolic risk clusters at 13y, and logistic regression models estimated their associations, adjusting for confounders and energy intake. Six FS intake trajectories were identified. Compared with the lowest FS trajectory, higher intake trajectories were positively associated with a less favorable cardiometabolic profile, with this association attenuated after adjustment for energy. Children with the highest FS intake at 4-years of age had significantly increased odds of a less favorable profile (Cluster 1, OR = 2.11,95%CI:1.04-4.22). The later the age peaks the maximum FS intake from sugar-sweetened beverages (SSBs), the lower the cardiometabolic risk (OR = 0.94,95%CI:0.87-1.02). For sweets, both a later trend reversal of minimum intake (OR = 1.09,95%CI:1.00-1.18) and a higher minimum intake (OR = 1.15,95%CI:1.05-1.25) were associated with a less favorable cardiometabolic profile, even after adjustments.</p><p><strong>Conclusion: </strong>Higher FS intake in early life and persistent intake during childhood, particularly from SSBs and sweets, is associated with a less favorable cardiometabolic profile in adolescence. This association was attenuated after adjustment for energy intake, suggesting that energy intake may partly explain the observed associations.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"105003"},"PeriodicalIF":3.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal validation of an original bias-reduced fat-free mass metabolic coefficient in inpatients with obesity.","authors":"Giuseppe Mazzola, Simone Perna, Clelia Russo, Valentina Nerbi, Veronica Piccinni, Sara Carovelli, Carlo Cattaneo, Michela Seniga, Luca Matteo Schiavi, Eleonora Patta, Mariangela Rondanelli","doi":"10.1016/j.numecd.2026.105000","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.105000","url":null,"abstract":"<p><strong>Background and aims: </strong>In obese patients subjects, conventional resting energy expenditure (REE) normalization using the REE/fat-free mass (FFM) ratio is confounded by the metabolic contribution of adipose tissue, introducing an anthropometric bias across varying levels of adiposity. This study validates a new corrected metabolic coefficient (K_FFM) designed to neutralize this bias and evaluates its longitudinal responsiveness and clinical reliability during a 8-week multidisciplinary rehabilitation intervention.</p><p><strong>Method and results: </strong>Longitudinal study of 167 patients subjects with Class I-III obesity undergoing an 8-week residential program. REE and body composition were assessed by indirect calorimetry and DXA. KFFM was calculated by adjusting REE for fat mass. Bias was evaluated by Pearson correlation; longitudinal changes by Linear Mixed Models; metabolic convergence by Brown-Forsythe test and bootstrapping (5000 iterations). MDC was set at 2.30 kJ/kg/day. Allometric modeling confirmed a non-linear REE-FFM relationship with an exponent of β = 0.82 (p = 0.0007). The K_FFM achieved complete bias neutralization (r = 0.098,p = 0.21), whereas the traditional REE/FFM ratio remained significantly correlated with adiposity (r = 0.25,p = 0.001). Longitudinal analysis revealed a significant overall metabolic shift (p = 0.0009), with a highly significant reduction in K_FFM specifically for Class III obesity (from 118.11 to 109.95 kJ/kg FFM/day; p = 0.0004). Furthermore, 91.02% of patients subjects exhibited changes exceeding the minimum detectable change (MDC = 2.30 kJ/kg/day), confirming true physiological signals. Bootstrap analysis confirmed the stability of inter-individual variance (95% CI: -14.74 to 7.08).</p><p><strong>Conclusions: </strong>K_FFM could be a bias-reduced, robust metric for REE normalization in obesity, showing stable inter-individual variability and sensitivity to clinically meaningful bioenergetic changes beyond traditional ratio-based methods.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"105000"},"PeriodicalIF":3.9,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher estimated cardiorespiratory fitness levels were associated with lower risk of cardiometabolic multimorbidity: a retrospective cohort study from CHARLS.","authors":"Lina Zhu, Yetong Wu, Yangzong Yu, Yake Lou, Dongmei Zhou, Shaoshen Wang","doi":"10.1016/j.numecd.2026.105001","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.105001","url":null,"abstract":"<p><strong>Background and aims: </strong>Cardiometabolic multimorbidity (CMM) is significantly associated with an increased risk of all-cause mortality. However, evidence on the relationship between cardiorespiratory fitness (CRF) and CMM remains limited, particularly in Chinese populations.</p><p><strong>Methods and results: </strong>Data were derived from the China Health and Retirement Longitudinal Study. A total of 5,255 participants aged ≥45 years with up to 9 years of follow-up were included. Sex-specific body mass index (BMI)-based models were used to evaluate estimated CRF (eCRF). Skeletal muscle mass was assessed using appendicular skeletal muscle mass (ASM) and appendicular skeletal muscle mass index (ASMI). During the 9-year follow-up, 441 (8.4%) participants developed CMM. Kaplan-Meier survival analysis demonstrated that higher eCRF levels were associated with a lower cumulative risk of CMM. Multivariable Cox proportional hazards regression analysis revealed that after full adjustment for confounders, each 1-MET (1 mL kg^-1·min^-1) increase in eCRF was associated with an 18.9% (5.8%) reduction in the risk of CMM. In quartile analysis of eCRF, compared with the lowest quartile (Q1), the risk of CMM was 25.5% lower in Q2, 46.5% lower in Q3, and 61.0% lower in Q4. The fully adjusted RCS analysis indicated a linear relationship between eCRF and CMM risk. Mediation analysis suggested that skeletal muscle mass statistically mediated the association between eCRF and CMM, with mediated proportions of 22.69% for ASM and 40.54% for ASMI.</p><p><strong>Conclusion: </strong>Higher eCRF was associated with a reduced risk of CMM, and this association may be partially mediated by skeletal muscle mass.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"105001"},"PeriodicalIF":3.9,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Cardiovascular disease incidence among aging patients with rheumatoid arthritis: results from the Canadian Longitudinal Study on Aging (CLSA)\" [Nutr Metab Cardiovasc Dis 12 (2026) 104845].","authors":"Yasaman Hajiesmaeili, Osvaldo Espin Garcia, M Reza Azarpazhooh, Saverio Stranges, Lillian Barra","doi":"10.1016/j.numecd.2026.104957","DOIUrl":"10.1016/j.numecd.2026.104957","url":null,"abstract":"","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104957"},"PeriodicalIF":3.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of tirzepatide and semaglutide on clinical and metabolic outcomes in patients with heart failure with preserved ejection fraction and obesity: a systematic review and meta-analysis.","authors":"Ahmed J AlAraibi, Fatema Naser Shakeeb, Tasneem Alqatta, Abu-Baker Sharafeldin, Laura Dempsey, Alexandra E Butler","doi":"10.1016/j.numecd.2026.104994","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104994","url":null,"abstract":"<p><strong>Background and aims: </strong>Heart failure with preserved ejection fraction (HFpEF) with obesity remains a therapeutic challenge with limited options. Glucagon-like peptide-1 (GLP-1) receptor agonists and dual incretin agonists may improve health status, functional capacity, and metabolic parameters. We evaluated the efficacy and safety of semaglutide and tirzepatide in this population.</p><p><strong>Methods and results: </strong>We searched PubMed, Embase, CENTRAL, and ClinicalTrials.gov from inception to June 2025. Mean differences (continuous outcomes) and risk ratios (worsening heart-failure events) were pooled using random-effects models; other outcomes were synthesised narratively. Four studies met the HFpEF-specific criteria (three randomized trials and one observational cohort); the primary analysis was restricted to the three randomized trials (n = 1876), with SELECT and FLOW retained as indirect supportive evidence. Semaglutide or tirzepatide improved KCCQ-CSS (+7.39 points; 95% CI 5.43-9.35) and 6-min walk distance (+17.18 m; 11.82-22.54), and reduced worsening heart-failure events (risk ratio 0.45; 0.31-0.66). Body weight decreased by -7.73% (-10.70 to -4.76; I² = 93%). Findings were robust in sensitivity analysis; secondary outcomes showed consistent CRP and HbA1c reductions; gastrointestinal intolerance was the most common adverse event.</p><p><strong>Conclusions: </strong>Semaglutide and tirzepatide were associated with improvements in health status, functional capacity, and body weight, and fewer worsening heart-failure events, in HFpEF with obesity, with an acceptable safety profile. They may have an adjunctive role, although larger, longer-term dedicated outcome trials are needed.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104994"},"PeriodicalIF":3.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of metabolically healthy and unhealthy obesity by circulating omics.","authors":"Giulia Pontali, Christian X Weichenberger, Johannes Rainer, Essi Hantikainen, Marilyn De Graeve, Fulvio Mattivi, Michael Kob, Markus Ralser, Peter P Pramstaller, Francisco S Domingues","doi":"10.1016/j.numecd.2026.104998","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104998","url":null,"abstract":"<p><strong>Background and aims: </strong>Individuals affected by obesity present different health trajectories and do not suffer from cardiometabolic complications all in the same way. There is a need to better understand obesity subtypes and to develop approaches for stratification. In this study we investigated metabolomic and proteomic signatures in serum and blood plasma samples discriminating metabolically healthy from unhealthy obesity.</p><p><strong>Methods and results: </strong>We investigated data from participants of the Cooperative Health Research in South Tyrol (CHRIS) study. Participants were grouped into metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) based on available health data. A total of 461 individuals were included in the analysis, with n = 130 MHO and n = 331 MUO. Random forest (RF) classifiers and linear regression models were used to discriminate metabolically healthy from unhealthy obesity and to identify molecular features characteristic of MHO/MUO. Regression models were used to assess associations between each relevant metabolite/protein and MHO/MUO phenotypes. Three plasma proteins and 12 circulating metabolites were identified as relevant predictors of MHO/MUO phenotypes. Among them, Apolipoprotein C-III (APOC3) was the most important predictor in the RF models. Causal mediation analysis confirmed a direct effect of APOC3 on the MHO/MUO phenotypes, and identified triglyceride levels as a mediator of APOC3.</p><p><strong>Conclusion: </strong>APOC3 was identified as a novel predictor for obesity stratification, highlighting the importance of this apolipoprotein in relation to metabolic health in obesity.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104998"},"PeriodicalIF":3.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De novo lipogenesis in relation to cardiometabolic outcomes and the influence of carbohydrate quality in post-myocardial infarction patients from the Alpha Omega Cohort.","authors":"Luc Heerkens, Fränzel J B van Duijnhoven, Kamalita Pertiwi, Johanna M Geleijnse","doi":"10.1016/j.numecd.2026.104997","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104997","url":null,"abstract":"<p><strong>Background and aims: </strong>Fatty liver disease (FLD) and impaired kidney function are associated with higher cardiovascular disease (CVD) mortality in CVD patients, despite using cardiovascular medication. In CVD-free populations, de novo lipogenesis (DNL) has been linked to these outcomes, but its role in CVD patients remains unclear. We examined associations between DNL and cardiometabolic outcomes in CVD patients, and explored mediation by DNL in the relation between carbohydrate quality and cardiometabolic outcomes.</p><p><strong>Methods and results: </strong>Data from 4305 CVD patients from the Alpha Omega Cohort were analyzed. DNL was assessed using the lipogenic index (circulating palmitic acid/linoleic acid). Carbohydrate intakes were assessed with a food frequency questionnaire. Linear regressions estimated associations for annual change in estimated glomerular filtration rate, and Cox proportional hazards for prevalent FLD and CVD mortality risk. Mediation analyses assessed whether the lipogenic index mediated associations between carbohydrate quality and cardiometabolic outcomes. A high lipogenic index (Q5 vs Q1) was associated with more annual kidney function decline (β: -0.84, 95% confidence interval [-1.37, -0.31]), higher FLD prevalence (Prevalence Ratio: 1.60 [1.34, 1.92]), and higher CVD mortality risk during 3-year (Hazard Ratio: 1.83 [1.06, 3.15]) and 15-year follow-up (HR 1.37 [1.12, 1.67]). Higher intake of total polysaccharides (per 10 en%), replacing sugars, was associated with reduced 15-year CVD mortality risk (HR: 0.83 [0.68, 0.96]), but this was not mediated by the lipogenic index.</p><p><strong>Conclusion: </strong>Elevated DNL was adversely linked to cardiometabolic outcomes in CVD patients. DNL did not mediate the association between carbohydrate quality and cardiometabolic outcomes.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104997"},"PeriodicalIF":3.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal outcomes in gestational diabetes mellitus: a retrospective cohort study stratified by fasting hyperglycemia phenotype.","authors":"Alessandro Roberto Dodesini, Elena Ciriello, Anna Corsi, Martina Cristodoro, Cristiana Scaranna, Francesca Invernizzi, Rosalia Bellante, Roberto Trevisan","doi":"10.1016/j.numecd.2026.104996","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104996","url":null,"abstract":"<p><strong>Background and aim: </strong>Gestational diabetes mellitus (GDM) encompasses distinct metabolic phenotypes. While post-load glucose spikes reflect peripheral insulin resistance, impaired fasting glucose (IFG) reflects hepatic insulin resistance. This study aims to characterize GDM phenotypes stratified by baseline fasting glucose status and evaluate their maternal and neonatal outcomes within a standardized management pathway.</p><p><strong>Methods and results: </strong>This retrospective cohort study analyzed 1216 women with singleton pregnancies diagnosed with GDM using IADPSG criteria (2014-2022). Patients were stratified into Group 1 (IFG, fasting glucose ≥92 mg/dL, n = 741) and Group 2 (Normal Fasting Glucose [NFG], n = 475). All patients received standardized care including medical nutrition therapy and insulin when required. The IFG group had a significantly higher prevalence of pre-gestational obesity (30.4% vs 12.2%, p < 0.0001) and required insulin therapy four times more frequently (32.2% vs 8.8%, p < 0.0001). After multivariable adjustment, the IFG phenotype remained a robust independent predictor for large-for-gestational-age (LGA) infants (adjusted OR 1.82, 95% CI 1.21-2.74, p = 0.004) and labor induction (adjusted OR 1.44, 95% CI 1.11-1.86, p = 0.0016). No statistically significant differences were observed between groups regarding acute neonatal complications, including hypoglycemia (5.9% vs 6.1%, p = 0.88) and respiratory distress (8.6% vs 6.9%, p = 0.28).</p><p><strong>Conclusions: </strong>Fasting hyperglycemia identifies a high-risk GDM phenotype characterized by elevated baseline metabolic risks, higher insulin requirements, and increased rates of obstetric interventions and LGA infants. Within a standardized management setting, acute neonatal metabolic complications did not differ between groups. Baseline fasting glucose serves as an effective stratification tool to target intensive prenatal surveillance.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104996"},"PeriodicalIF":3.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the liver in CKM syndrome: from metabolic risk to organ damage.","authors":"Yasser Fouad, Mohammed Eslam","doi":"10.1016/j.numecd.2026.104995","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104995","url":null,"abstract":"","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104995"},"PeriodicalIF":3.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D and probiotic/synbiotic co-supplementation in cardiometabolic disorders: a systematic review and meta-analysis targeting the gut-immune-metabolic axis.","authors":"Luisa Malaguarnera, Sofia Surdo, Vincenzo Sortino, Salvatore Piro, Maria Stella Valle, Lucia Malaguarnera","doi":"10.1016/j.numecd.2026.104990","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104990","url":null,"abstract":"<p><strong>Background and aim: </strong>Vitamin D deficiency and gut microbiota dysregulation are both implicated in the pathophysiology of cardiometabolic disorders. The aim was to systematically evaluate and quantitatively synthesize the effects of vitamin D combined with probiotic or synbiotic supplementation on cardiometabolic outcomes in adults.</p><p><strong>Methods and results: </strong>A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was conducted from inception to March 2026. Randomized controlled trials investigating combined vitamin D and probiotic or synbiotic interventions in adults with cardiometabolic conditions were included. Primary outcomes comprised glycemic parameters (fasting glucose, insulin, HOMA-IR), lipid profile, and anthropometric measures. Secondary outcomes included inflammatory and metabolic biomarkers. When at least three studies reported comparable outcomes, pooled analyses were performed using a random-effects model. Seven randomized controlled trials, including 470 participants, met the inclusion criteria. Interventions were administered as both capsule-based supplements and food-based formulations, particularly vitamin D-fortified probiotic dairy products. Pooled analyses demonstrated a significant reduction in fasting insulin concentrations, whereas HOMA-IR, fasting glucose, lipid profile, anthropometric parameters, and circulating 25(OH)D concentrations were not significantly affected. Most pooled analyses showed low or no statistical heterogeneity, although substantial between-study heterogeneity was observed for circulating 25(OH)D concentrations.</p><p><strong>Conclusions: </strong>Combined vitamin D and probiotic or synbiotic supplementation is associated with modest improvements in selected cardiometabolic parameters, particularly insulin resistance. These findings support a potential interaction between vitamin D signaling and gut microbiota; however, the current evidence remains limited and heterogeneous. Larger, well-designed randomized controlled trials are needed to confirm these effects and clarify underlying mechanisms.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104990"},"PeriodicalIF":3.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}