Nutrition Metabolism and Cardiovascular Diseases最新文献

{"title":"Impact of residual cholesterol and inflammatory risk on short-term prognosis among coronary artery bypass graft patients with concomitant carotid artery stenosis.","authors":"Xinmin Liu, Weijing Wang, Sen Zhang, Yajun Ma, Qilin Zhou, Yuye Ning, Fei Xu, Shujuan Li","doi":"10.1016/j.numecd.2026.104882","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104882","url":null,"abstract":"<p><strong>Background and aims: </strong>To investigate the association between residual cholesterol and inflammatory risk and postoperative outcomes in patients with carotid artery stenosis (CAS) undergoing coronary artery bypass grafting (CABG).</p><p><strong>Methods and results: </strong>This retrospective study included 1064 patients with CAS undergoing CABG. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C) levels: residual cholesterol and inflammatory risk (RCIR), residual inflammatory risk (RIR), residual cholesterol risk (RCR), and no residual risk (NRR). The primary endpoint was 30-day postoperative major adverse cardiac and cerebrovascular events (MACCEs), defined as a composite of all-cause mortality, myocardial infarction, and stroke. Multivariable logistic regression analyses were performed. After multivariable adjustment, RCIR were significantly related to an increased risk of postoperative MACCEs compared with NRR (adjusted OR, 2.330; 95% CI, 1.232-4.408; P = 0.009), driven primarily by a higher risk of postoperative stroke (adjusted OR, 4.055; 95% CI, 1.224-13.429; P = 0.022). A significant interaction was observed between RCIR and bilateral carotid artery stenosis (P for interaction = 0.015), with RCIR group conferring a markedly increased risk of MACCEs compared with the NRR group among patients with bilateral stenosis.</p><p><strong>Conclusions: </strong>Residual cholesterol and inflammatory risk were independently associated with adverse postoperative outcomes in patients with CAS undergoing CABG, primarily driven by postoperative stroke. A potentially stronger association among patients with bilateral carotid artery stenosis was observed, but this finding should be interpreted as exploratory and requires further validation.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104882"},"PeriodicalIF":3.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762798","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":"Dietary carbohydrate quality and fiber-rich food intake are associated with heart failure stages: the CARDIA study.","authors":"So-Yun Yi, Lyn M Steffen, Weihua Guan, Daniel Duprez, Kamakshi Lakshminarayan, James M Shikany, Ankeet S Bhatt, Cora E Lewis, David R Jacobs","doi":"10.1016/j.numecd.2026.104879","DOIUrl":"10.1016/j.numecd.2026.104879","url":null,"abstract":"","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104879"},"PeriodicalIF":3.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of new anthropometric equations to estimate fat mass in young adult men and women.","authors":"Francesco Campa, Raquel Vaquero-Cristóbal, Nicolas Baglietto, Malek Mecherques-Carini, Alessandro Sampieri, Giuseppe Cerullo, Mario Albaladejo-Saura, Antonio Paoli, Francisco Esparza-Ros","doi":"10.1016/j.numecd.2026.104868","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104868","url":null,"abstract":"<p><strong>Background and aim: </strong>Anthropometric equations are widely used to estimate fat mass (FM). This study aimed firstly to develop and validate new anthropometric equations for estimating FM using dual-energy X-ray absorptiometry (DXA) as reference method in apparently healthy young adults. Then, we aimed to compare their accuracy with previously published two-component-based models.</p><p><strong>Methods and results: </strong>Five hundred fifteen adults (60% men, 40% women; age 24.2 ± 6.0 years, range 18-45; BMI 23.6 ± 3.1 kg m^-2, range 16.2-36.0) underwent standardized anthropometric assessment according to International Society for the Advancement of Kinanthropometry (ISAK) guidelines, including measurement of eight skinfolds, and whole-body DXA. Participants were randomly divided into a development sample (n = 344) and an independent validation sample (n = 171). Two multiple-regression models were developed: a comprehensive equation based on all eight skinfolds and a simplified equation based on a four-skinfold protocol. Model performance was evaluated using R², standard error of estimate (SEE), mean absolute error (MAE), root mean square error (RMSE), and Bland-Altman analysis. In validation, the 8-skinfold and 4-skinfold equations explained 82% and 80% of the variance in DXA-derived FM, respectively, with low prediction error (MAE 2.23-2.37 kg; RMSE ≤3.03 kg) and no significant bias versus DXA (p > 0.25). In contrast, all previously published equations showed significant bias (p < 0.001), consistently underestimating FM.</p><p><strong>Conclusions: </strong>DXA-referenced equations derived from standardized ISAK anthropometry demonstrated improved agreement and lower systematic bias compared with traditional two-component-based models.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104868"},"PeriodicalIF":3.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714272","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":"Association between the uric acid-to-albumin ratio and mortality in hyperuricemia: a nationwide cohort study.","authors":"Jun Tang, Xiaoli Li, Shiyan Mo, Wenji Chen, Lina Fan, Xiaofei Liu","doi":"10.1016/j.numecd.2026.104876","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104876","url":null,"abstract":"<p><strong>Background and aims: </strong>The prognostic value of uric acid-to-albumin ratio (UAR) for mortality among patients with hyperuricemia remains unclear. This study aimed to investigate its association with all-cause and cardiovascular mortality.</p><p><strong>Methods and results: </strong>We analyzed data from 6437 hyperuricemic patients in NHANES (2007-2018), linked to the National Death Index. Associations between UAR and mortality were assessed using multivariable Cox proportional hazards models and restricted cubic splines (RCS). Subgroup interaction and mediation analyses were performed. During a mean follow-up of 78.61 ± 42.45 months, 982 all-cause deaths and 279 cardiovascular deaths occurred. After multivariable adjustment, participants in the highest UAR quartile had significantly higher risks of all-cause mortality (HR = 2.07, 95% CI: 1.60-2.67; P < 0.0001) and cardiovascular mortality (HR = 1.69, 95% CI: 1.05-2.72; P = 0.0311). Compared with serum uric acid (SUA) alone, UAR showed stronger associations with both outcomes. RCS analysis showed a significant linear association between UAR and all-cause mortality (overall P < 0.001), while an L-shaped association was observed for cardiovascular mortality, with a threshold of 1.66 mg/g (P for non-linearity = 0.010). The associations were stronger in males (P for interaction = 0.0184) and smokers (P for interaction = 0.0173). Mediation analysis indicated that eGFR mediated 9.26% and 12.61% of the associations with all-cause and cardiovascular mortality, respectively.</p><p><strong>Conclusion: </strong>UAR is independently associated with all-cause and cardiovascular mortality among patients with hyperuricemia and may serve as a composite index for cardiovascular risk stratification.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104876"},"PeriodicalIF":3.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680543","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":"Association between fasting substrate utilization and adipose tissue distribution.","authors":"Andrea Foppiani, Federica Sileo, Francesca Menichetti, Silvia Gallosti, Ramona De Amicis, Alessandro Leone, Laila Vignati, Simona Bertoli, Alberto Battezzati","doi":"10.1016/j.numecd.2026.104877","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104877","url":null,"abstract":"<p><strong>Background and aim: </strong>Metabolic flexibility is crucial for health. While reduced fatty acid utilization often correlates with obesity, its relationship with specific fat depots in non-obese individuals remains unclear. This study investigated the association between fasting substrate utilization, measured via respiratory exchange ratio (RER), and abdominal fat distribution (visceral and subcutaneous) across BMI categories.</p><p><strong>Methods and results: </strong>In a retrospective study of 15,022 participants, fasting RER was measured via indirect calorimetry. Participants were categorized by metabolic phenotype: Predominant Fat Oxidation (RER <0.775) or Predominant Glucose Oxidation (RER >0.925). Visceral (VAT) and subcutaneous adipose tissue (SAT) were assessed via ultrasound, adjusting for age, sex, and menopause. In underweight/normal weight individuals, predominant glucose oxidation correlated with significantly higher VAT (adjusted difference = 0.40 cm; p < 0.001) and lower SAT (adjusted difference = -0.16 cm; p = 0.039) compared to predominant fat oxidation. A similar trend persisted in overweight participants but was attenuated in obesity, where predominant glucose oxidation was associated with lower overall body fat.</p><p><strong>Conclusions: </strong>Higher fasting RER, indicating predominant glucose oxidation, was associated with adverse fat distribution (higher visceral, lower subcutaneous fat) in this cohort, particularly in normal-BMI individuals. Fasting RER warrants further investigation as a potential non-invasive indicator of metabolic risk and ectopic fat deposition prior to obesity development.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104877"},"PeriodicalIF":3.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702470","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 burden of cardiovascular-kidney-metabolic syndrome in high versus upper-middle-income countries: integrated analysis of trends, inequality, and risk factors.","authors":"Chenggong Ma, Zhongling Dai, Bingqing Xiao, Liyao Fu, Shi Tai","doi":"10.1016/j.numecd.2026.104867","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104867","url":null,"abstract":"<p><strong>Background and aim: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome links vascular, renal, and metabolic dysfunction, but its long-term burden transition and inequality patterns across development settings remain unclear. We compared trends, demographic drivers, inequalities, efficiency gaps, and risk-factor signatures of CKM-related burden in high-income countries (HICs) and upper-middle-income countries (UMICs) from 1990 to 2023, with projections to 2038.</p><p><strong>Methods and results: </strong>Using Global Burden of Disease 2023 estimates, we analyzed seven CKM-related components across 127 countries and territories, including 74 HICs and 53 UMICs. Outcomes included deaths, disability-adjusted life years (DALYs), incidence, prevalence, and age-standardized rates by sex and age. Analyses combined trend, decomposition, forecasting, inequality, frontier, and Random Forest-SHAP risk-attribution methods. From 1990 to 2023, age-standardized DALY rates declined for ischemic heart disease by 57.06% in HICs and 33.07% in UMICs, and for stroke by 57.73% and 61.70%, respectively. Diabetes burden increased in both strata, whereas chronic kidney disease diverged, with age-standardized DALY rates increasing by 23.48% in HICs but decreasing by 16.64% in UMICs. Despite declining standardized vascular rates, UMICs experienced rising absolute ischemic heart disease burden, with DALYs increasing by 77.00% and deaths by 109.14%. Inequality and risk profiles differed by setting: the chronic kidney disease age-standardized DALY concentration index was -0.363 in HICs versus -0.233 in UMICs, and the diabetes population-attributable fraction for high body-mass index was 54.7% versus 26.6%.</p><p><strong>Conclusions: </strong>CKM prevention should be stratified: HICs need metabolic-renal and equity-focused chronic care, while UMICs need vascular protection, early metabolic prevention, tobacco control, and clean household energy transitions.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104867"},"PeriodicalIF":3.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680559","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":"A metabolomics-based EAT-Lancet diet score and type 2 diabetes: Interaction with genetic, lifestyle, and environmental factors.","authors":"Zixuan Zhang, Guangrui Yang, Shuxiao Shi, Jingxuan Wang, Victor W Zhong, Yi Chen, Xihao Du","doi":"10.1016/j.numecd.2026.104874","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104874","url":null,"abstract":"<p><strong>Background and aims: </strong>Diet is a major modifiable determinant of type 2 diabetes (T2D), but conventional dietary assessments may inadequately capture interindividual metabolic responses to diet. We aimed to derive a metabolomics-based EAT-Lancet diet score, compare its association with T2D with that of a questionnaire-based score, and evaluate the effect modification by major T2D risk factors.</p><p><strong>Methods and results: </strong>We included 96,716 participants without T2D at baseline from the UK Biobank with circulating metabolomics data and at least two valid 24-h dietary assessments. A metabolomics-based EAT-Lancet diet was derived using elastic net regression linking dietary intake with circulating metabolites. Cox proportional hazards models assessed associations with incident T2D and compared results with a questionnaire-based diet. Interactions with key T2D risk factors were assessed on the multiplicative and additive scales. During a median follow-up of 14.2 years, 2798 participants developed T2D. The metabolomics-based EAT-Lancet diet showed a stronger inverse association with incident T2D (hazard ratio [HR] 0.75; 95% confidence interval [CI] [0.72, 0.77]) than the questionnaire-based (HR 0.90; 95% CI [0.87, 0.94]). Metabolites characterizing the diet were enriched in pathways related to carbohydrate, energy metabolism and amino acid metabolism. Additive interactions between metabolomics-based diet and genetic risk, BMI, smoking status, and air pollution exposure were observed (RERI 0.31-4.77; AP 13%-61%).</p><p><strong>Conclusions: </strong>A metabolomics-based EAT-Lancet diet was inversely associated with T2D risk and modified associations between major T2D risk factors and incident T2D. Integrating metabolomics into dietary assessment may enhance risk stratification and support precision nutrition strategies for T2D prevention.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104874"},"PeriodicalIF":3.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702317","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":"Management of patients with cardiovascular disease and overweight/obesity: expert opinion on semaglutide use.","authors":"Claudio Bilato, Roberto Baratta, Leonardo De Luca, Maurizio De Luca, Alessandro Fucili, Massimo Iacoviello, Paolo Sbraccia, Luca Busetto","doi":"10.1016/j.numecd.2026.104872","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104872","url":null,"abstract":"<p><strong>Aims: </strong>Overweight and obesity are major global health challenges and key drivers of cardiovascular disease (CVD), yet patients with established CVD and excess body weight remain systematically under-recognized and undertreated. This consensus paper, developed by an Italian multidisciplinary panel of cardiology, endocrinology and obesity experts, aims to characterize the clinical phenotype of CVD patients most likely to benefit from semaglutide therapy, identify barriers to its implementation, and propose patient-centered strategies to optimize treatment pathways.</p><p><strong>Data synthesis: </strong>The document reviews the pathophysiological relevance of adiposity in cardiovascular risk, and discusses the evolving diagnostic framework beyond body mass index (e.g., waist-to-height ratio). Evidence from SELECT trial is contextualized to support semaglutide as a disease-modifying therapy with benefits largely independent of weight loss. The expert panel highlights persistent barriers related to reimbursement, organizational limitations, cultural bias, and therapeutic inertia. To address these gaps, a flexible multidisciplinary care model is proposed, centered on systematic patient identification, shared follow-up responsibilities among cardiologists, general practitioners and obesity specialists, structured clinical pathways, and digital or automated tools to reduce missed opportunities for treatment. Emphasis is placed on consistent clinician education and patient empowerment as essential components for long-term adherence and cardiometabolic risk reduction.</p><p><strong>Conclusions: </strong>Integrating semaglutide into routine cardiovascular care requires a coordinated, patient-centered approach supported by specialty networking, aligned educational frameworks, and organizational tools to streamline identification, initiation, and monitoring. Implementing these strategies can strengthen secondary prevention, reduce therapeutic inertia, and ensure that patients with CVD and excess adiposity receive timely, evidence-based, and holistic management.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104872"},"PeriodicalIF":3.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473908","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":"Baseline, cumulative, and short-term changes in triglyceride-glucose-related obesity indices and incident cardiovascular disease in middle-aged and older Chinese adults: a prospective national cohort study.","authors":"Huizhen Liu, Ting Wang, Xiaoqin Zhou, Deying Kang","doi":"10.1016/j.numecd.2026.104873","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104873","url":null,"abstract":"<p><strong>Background and aim: </strong>The triglyceride-glucose (TyG) index combined with obesity indices (TyG-OIs) predicts the risk of cardiovascular disease (CVD). However, evidence regarding the cumulative exposure to TyG and TyG-OIs, their short-term changes, and their associations with CVD remains limited. This study aims to address these gaps.</p><p><strong>Methods and results: </strong>Using data from the China Health and Retirement Longitudinal Study (CHARLS), which included 2510 participants and 340 incident CVD cases, we calculated seven indices-TyG alone and six TyG-related obesity indices (TyG-OIs)-at baseline (2011-2012) and at Wave 3 (2015). We assessed cumulative exposure using the area under the curve and evaluated short-term changes through K-means clustering. Logistic regression analysis was performed to examine associations. Baseline TyG-WC, TyG-WHtR, TyG-ABSI, and TyG-WWI were significantly associated with CVD. Cumulative exposure to all indices except TyG-BMI showed positive associations, with TyG-WHtR demonstrating the strongest effects (Q2 OR = 1.73, Q3 OR = 1.95, Q4 OR = 1.81). Short-term changes in TyG, TyG-WC, TyG-BMI, TyG-ABSI, and TyG-WWI remained significant. TyG-WC, TyG-ABSI, and TyG-WWI were consistently associated with CVD across all three exposure metrics.</p><p><strong>Conclusion: </strong>The association between TyG and TyG-OIs with CVD risk varies depending on the exposure metric used. TyG-WC, TyG-ABSI, and TyG-WWI consistently predict CVD risk across baseline, cumulative, and short-term measures. Repeated monitoring of fasting glucose, triglycerides, waist circumference, ABSI, and WWI may improve long-term CVD risk assessment.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104873"},"PeriodicalIF":3.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680593","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":"Metabolic profiles in hypertensive disorders of pregnancy and gestational diabetes: a prospective longitudinal study.","authors":"Lorenzo Annesi, Davide Agnoletti, Emiliana Angilletta, Alessandro Baracchi, Giusy Buccomino, Debora Cromi, Elisa Montaguti, Anastassiya Nassonova, Leonardo Pieri, Gianluigi Pilu, Francesca Rosi, Federico Ruscelli, Sara Scarduelli, Giuliana Simonazzi, Sofia Vincenzi, Claudio Borghi, Federica Piani","doi":"10.1016/j.numecd.2026.104871","DOIUrl":"https://doi.org/10.1016/j.numecd.2026.104871","url":null,"abstract":"<p><strong>Background and aims: </strong>Altered lipid and metabolic indices have been linked to cardiometabolic complications of pregnancy. However, longitudinal changes and differences across healthy pregnancies, gestational diabetes mellitus (GDM), and hypertensive disorders of pregnancy (HDP) remain incompletely defined. This study aimed to characterize metabolic trajectories across healthy pregnancies, GDM, and HDP.</p><p><strong>Methods and results: </strong>We studied 166 nulliparous women at 11-13 and 24-27 weeks' gestation. Laboratory profiling included uric acid, creatinine, HDL cholesterol, triglycerides (TG), transaminases, total bilirubin, high-sensitivity C-reactive protein, lipoprotein(a), and apolipoprotein B (ApoB). Group and temporal differences were assessed by ANOVA, and logistic regression evaluated associations with GDM and HDP. HDP tended to be associated with higher triglycerides at both timepoints and higher total cholesterol at the first timepoint, although not consistently in all adjusted models. HDL cholesterol at the second timepoint was inversely associated with GDM across all models. ApoB, lipoprotein(a) and LDL cholesterol were not associated with either HDP or GDM. The triglyceride-to-HDL ratio tended to be associated with HDP at both timepoints and with GDM at the second timepoint although these associations were not retained after adjustment. The ApoB/HDL ratio at the second timepoint and its increase over gestation, was consistently associated with GDM but not with HDP.</p><p><strong>Conclusion: </strong>GDM and HDP may be associated with insulin resistance, with GDM tending to be associated with lower HDL cholesterol and HDP with higher triglycerides. However, these differences were modest and not consistent across all models, underscoring the need for larger studies to validate these findings and define clinically actionable markers.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104871"},"PeriodicalIF":3.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800889","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}