Red Yeast Rice (Cholesterol)

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by elevated total bile acid (TBA) levels, leading to adverse maternal and fetal outcomes. While genetic factors contribute to ICP and bile acid metabolism, the underlying mechanisms remain incompletely understood, particularly in East Asian populations. We conducted a genome-wide association study (GWAS) in 13,357 pregnant women from a Chinese cohort to investigate genetic determinants of TBA levels and ICP. Meta-analysis was performed by combining our data with the Shenzhen cohort. Post-GWAS analyses included pathway enrichment, integrative analysis with liver single-cell RNA sequencing (scRNA-seq) data, and Mendelian randomization (MR). We identified genome-wide significant associations at CYP7A1 (rs4738680, p = 1.08 × 10-10) and SLC39A9 (rs17107007, p = 3.46 × 10-28) for TBA, and at SLC39A9 (rs17107007, p = 3.34 × 10-16) for ICP. Pathway analysis highlighted bile acid synthesis and metabolism pathways for TBA and immune-related pathways for ICP. Integrative scRNA-seq analysis revealed enrichment of TBA-associated genes in hepatocytes and ICP-associated genes in neutrophils. MR analysis suggested a potential causal effect of estrone on TBA levels. Our findings provide novel insights into the genetic architecture of TBA and ICP, emphasizing the roles of bile acid metabolism in hepatocytes and immune dysregulation in ICP pathogenesis. The identified genetic loci and pathways may inform future research on risk prediction and targeted therapies for ICP. © 2026 Wiley Periodicals LLC.

BACKGROUND: Postprandial triglyceride (TG) metabolism represents a dynamic dimension of lipid physiology that complements conventional fasting lipid assessment. Although low-density lipoprotein cholesterol (LDL-C) remains the primary therapeutic target in cardiovascular prevention, residual cardiovascular risk persists in many individuals despite apparently adequate fasting lipid control. Because most individuals spend the majority of their waking hours in a fed state, postprandial TG responses may provide clinically relevant insight into metabolic flexibility, dietary exposure, and the efficiency of TG-rich lipoprotein clearance. METHODS: This narrative review was conducted using a literature search guided by predefined themes, keywords, and databases, without following a formal systematic review protocol. Randomized controlled trials, observational studies, meta-analyses, and major reviews addressing postprandial lipid metabolism, dietary determinants, and cardiometabolic risk were included, with priority given to human studies. RESULTS: Postprandial TG responses are strongly influenced by dietary composition, eating patterns, and metabolic health. Individuals with insulin resistance, type 2 diabetes, obesity, and metabolic-associated steatotic liver disease (MASLD) frequently demonstrate exaggerated or prolonged postprandial lipemia even when fasting TG concentrations appear acceptable. While circulating TGs serve as practical clinical markers of postprandial lipid handling, cholesterol-enriched remnant lipoproteins more closely reflect atherogenic burden. Nutritional interventions, weight management, and physical activity consistently improve postprandial TG dynamics, whereas pharmacologic therapy provides additional benefit in selected high-risk patients. Non-fasting TG measurements may provide additional insight into postprandial lipid metabolism and residual cardiovascular risk, although standardized protocols and validated clinical thresholds remain to be established. CONCLUSIONS: Postprandial TG metabolism provides clinically meaningful information beyond fasting lipid measurements and represents a useful adjunct for refining residual cardiovascular ris

PURPOSE: Evidence regarding sources of heterogeneity in the efficacy of statins for primary prevention of cardiovascular disease (CVD) remains limited. This study aimed to identify trial-level factors contributing to such heterogeneity. METHODS: Relevant studies were systematically identified from a previous systematic review and through searches in PubMed, Embase, and Cochrane up to 20 January 2026. The protocol was registered in PROSPERO (CRD42024579932). Randomized controlled trials (RCTs) in adults without prior CVD that investigated statin treatment were included. Risk of bias was assessed using the Cochrane Risk of Bias tool. Meta-analyses were conducted to pool risk ratios (RRs) and 95% confidence intervals (CIs) for major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and cardiovascular death. Univariate meta-regression analyses were conducted to assess the impact of trial-level covariates on the effect sizes, expressed as the ratio of risk ratios (RRR). Within-study subgroup differences were meta-analyzed by pooling ratio of effect sizes. Meta-regression analyses were conducted using complete-case trial-level data. RESULTS: 25 RCTs (102,667 participants) were included. Compared to no statin treatment, statin treatment was associated with a reduced risk of MACE (RR, 0.73[95% CI, 0.67 to 0.80], P < 0.001), MI (RR, 0.68[95% CI, 0.60 to 0.77], P < 0.001), stroke (RR, 0.76[95% CI, 0.65 to 0.89], P = 0.001) and cardiovascular death (RR, 0.81[95% CI, 0.71 to 0.95], P = 0.008). Univariate meta-regression indicated that higher baseline total cholesterol (RRR, 1.29 [95% CI, 1.07 to 1.57], P = 0.008), higher low-density lipoprotein cholesterol (LDL-C) (RRR, 1.31 [95% CI, 1.07 to 1.62], P = 0.010), higher triglycerides (RRR, 1.81 [95% CI, 1.17 to 2.81], P = 0.008) and lower statin intensity (RRR, 0.74 [95% CI, 0.59 to 0.94], P = 0.015) were significantly associated with reduced efficacy of statins for stroke prevention at the trial level. CONCLUSIONS: Statin therapy demonstrated consistent efficacy in CVD prevention across diverse populations, except that baseline lipid profiles and statin intensity may represent exploratory, hypothesis-g

BACKGROUND: Prediabetes is a growing global health concern. Lifestyle modification is the cornerstone of management, yet scalable delivery strategies are needed. SMS text messaging is a promising mobile health approach for behavior change, but its effectiveness for metabolic outcomes in prediabetes remains uncertain. OBJECTIVE: This study aims to evaluate the effectiveness of text message-delivered lifestyle programs for BMI among adults with prediabetes and, secondarily, for weight, waist circumference, hemoglobin A1c (HbA1c), total cholesterol, and diabetes incidence. METHODS: We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-guided systematic review and meta-analysis of randomized controlled trials (searching the PubMed, MEDLINE, CINAHL, Embase, Web of Science, and the Cochrane Library databases; from April 2005 to March 2025). Three reviewers independently screened studies, extracted data, and assessed risk of bias (using the Cochrane Risk of Bias tool), and random-effects meta-analyses were performed. RESULTS: In total, 7 randomized controlled trials (n=4632) met the inclusion criteria. SMS text messaging did not significantly affect BMI compared with standard care (mean difference [MD] -0.17 kg/m², 95% CI -0.85 to 0.25; I²=32%). Secondary outcomes were similarly nonsignificant: weight (MD -0.46 kg, 95% CI -1.74 to 0.83; I²=27%); waist circumference (MD -0.36 cm, 95% CI -1.09 to 0.36; I²=13%); HbA1c (MD -0.05%, 95% CI -0.17 to 0.07; I²=89%); total cholesterol (standardized MD -0.00, 95% CI -0.06 to 0.06; I²=0%); and diabetes incidence (odds ratio 0.84, 95% CI 0.63-1.12, I²=51%; n=3515 across 3 trials). Estimates were small and, for several outcomes, notably HbA1c and diabetes incidence, were imprecise and heterogeneous, indicating substantial between-study variability. CONCLUSIONS: In adults with prediabetes, lifestyle programs incorporating SMS text messaging showed no meaningful effect on BMI or other metabolic outcomes; pooled estimates were near null with considerable uncertainty and heterogeneity for some end points. Variability in intervention design, dose, and tailoring likely contributed to these results. Fut

BACKGROUND: Kudzu root is commonly prescribed in traditional Chinese medicine for non-alcoholic fatty liver disease (NAFLD). Its key active ingredient, puerarin, has shown promising protective effects in experimental NAFLD models. Yet the overall efficacy and the main biological mechanisms have not been systematically assessed. OBJECTIVE: This meta-analysis will synthesize evidence from animal studies to determine how puerarin influences liver-related outcomes in NAFLD. It will also summarize the mechanistic pathways that may account for these effects. METHOD: Literature retrieval was performed up to September 2025, encompassing eight databases. The risk of bias in the included studies was evaluated using the SYRCLE assessment tool. Data analyses were then performed in Stata 15. The primary outcome included triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). Secondary outcome comprised interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione peroxidase (GSH-Px). Subgroup analyses, publication bias assessments, and sensitivity analyses were performed to ensure the robustness. RESULTS: 20 studies were included, involving 331 animals. Puerarin treatment significantly reduced levels of TG, TC, and LDL-C, while improving HDL-C in animal models of NAFLD. Additionally, puerarin significantly upregulated antioxidant indicators SOD and GSH-Px and lowered MDA levels. Furthermore, it inhibited the expression of inflammatory factors IL-6, IL-1β, and TNF-α. CONCLUSION: This meta-analysis concludes that puerarin demonstrates substantial liver-protective effects in NAFLD models by regulating lipid metabolism, anti-inflammatory, and antioxidant. Collectively, these finding lays a solid evidence-based foundation for the subsequent advancement of clinical translation research and the in-depth exploration of its underlying mechanisms. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, Identifier CRD420251170089.

INTRODUCTION: Ischemic stroke (IS) exhibits pronounced geographic variation across China, with a consistently greater burden observed in colder regions. However, whether the strength of associations between major risk factors and IS differs between cold and non-cold regions remains unclear. METHODS: We systematically searched observational studies in PubMed, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM from inception through September 6, 2025. Data were analyzed using Stata 16.0. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Regional differences were evaluated using subgroup analysis. RESULTS: Ninety-six studies involving 800,741 participants were included. In the overall analysis, the largest pooled effect estimates were observed for atrial fibrillation (OR 4.48, 95% CI 2.41-8.36, I2 = 62.1%), coronary heart disease (OR 3.20, 95% CI 2.29-4.46, I2 = 86.2%), and hypertension (OR 3.05, 95% CI 2.55-3.64, I2 = 92.9%), all of which were accompanied by moderate to substantial between-study heterogeneity. Subgroup analysis demonstrated significantly larger pooled associations in cold regions for hypertension (OR 4.31 vs. 2.69, I2 = 94.8% vs. 92.0%), diabetes mellitus (OR 2.60 vs. 1.77, I2 = 71.6% vs. 90.7%), triglycerides (OR 3.41 vs. 1.48, I2 = 96.7% vs. 92.4%), and low-density lipoprotein cholesterol (OR 1.91 vs. 1.43, I2 = 0.0% vs. 67.2%) (all p < 0.05). In contrast, age was more strongly associated with IS in non-cold regions (OR 1.31 vs. 1.05, I2 = 91.4% vs. 91.8%). CONCLUSION: Our analysis identified substantial geographic heterogeneity in the reported associations between selected cardiometabolic risk factors and IS in China. These exploratory, study-level findings generate hypotheses regarding contextual modification of risk factor associations, warranting confirmation in prospective, individual-level studies before informing region-specific prevention strategies. © 2026 S. Karger AG, Basel.

OBJECTIVE: Currently, effective drugs for metabolic dysfunction-associated steatotic liver disease (MASLD) are limited, with treatment primarily focusing on diet and exercise. Recent studies suggest that gut microbiota-regulating drugs may offer therapeutic benefits. Therefore, our aim is to evaluate the efficacy of these medications in MASLD patients. METHODS: This systematic review and network meta-analysis involved a search of PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) published from January 1, 2012, to January 28, 2026. The intervention measures encompassed probiotics, prebiotics, synbiotics, antibiotics, postbiotics, and a combination of antibiotics and gut microbiota-regulating drugs. The control group received a placebo or usual care. The risk of bias in the included research was evaluated utilizing the revised Cochrane risk of bias tool for randomised trials. The confidence of evidence will be evaluated through the CINeMA (Confidence in Network Meta-Analysis) web application. Liver enzymes and hepatic steatosis were taken as the primary outcome and were analyzed by random-effects, Bayesian network meta-analyses. A two stage network meta-analysis harnessing the surface under the cumulative ranking curve (SUCRA) was performed for assessing the comparative efficacy of medications classes and particular gut microbiota-regulating drugs. The study was registered on PROSPERO: CRD42024606333. RESULTS: A total of 27 studies comprising 1,511 participants were included in this meta-analysis. Relative to placebo, reductions in alanine aminotransferase (ALT) levels were observed with probiotics (Mean Difference (MD): -7.51, 95% credible intervals (CI) [-12.36 to -2.66]), prebiotics (MD: -13.64, 95% CI [-27.07 to -0.22]) and antibiotics (MD: -24.30, 95% CI [-47.02 to -1.58]). Probiotics (MD: -6.42, 95% CI [-11.91 to -0.92]) and synbiotics (MD: -13.13, 95% CI [-20.82 to -5.45]) were both associated with a reduction in aspartate aminotransferase (AST) levels compared to placebo. Declines in gamma-glutamyl transferase (GGT) levels (MD: -12.40, 95% CI [-23.13 to -1.68]) were observed with synbiotics com

BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is a highly prevalent monogenic disorder characterized by elevated low-density lipoprotein-cholesterol (LDL-C) levels and premature atherosclerotic cardiovascular disease (ASCVD). The risk factors associated with cardiovascular events in this population vary considerably among studies. This systematic review aims to identify the key risk factors predicting cardiovascular events in patients with a confirmed genetic diagnosis of heterozygous FH (PROSPERO, CRD42022304273). METHODS AND ANALYSIS: Cochrane Library, Embase, MEDLINE, Scopus, UpToDate and other literature databases were searched from inception to June 2023. Records were eligible if they included studies reporting risk factors for ASCVD endpoints in adult patients with a genetic diagnosis of FH. A meta-analysis was performed using MetaEasy. RESULTS: A total of 21 studies were identified, involving 23,613 individual participants and 3489 prevalent cardiovascular events. The sex distribution was 47.2% male and 52.8% female. Most of the studies were conducted in European populations, representing 90.5% of the total. The meta-analysis found associations between ASCVD and hypertension (effect size 0.414; 95% CI: 0.346-0.482), male sex (0.334; 0.213-0.456), smoking (0.324; 0.203-0.445), lipoprotein(a) (0.219; 0.127-0.312), age (0.212; 0.161-0.264), body mass index (0.108; 0.028-0.188), triglycerides (0.084; 0.057-0.111) and LDL-C (0.015; 0.002-0.028). CONCLUSIONS: This is the first systematic review and meta-analysis demonstrating that hypertension, male sex, smoking, lipoprotein(a), age, body mass index, triglycerides and LDL-C are significantly and independently associated with ASCVD in genetically confirmed patients with heterozygous FH. These data can inform risk stratification models and optimise therapy in such patients.

BACKGROUND: Dihydromyricetin (DHM) is a food-derived flavonoid widely investigated as a nutraceutical candidate for metabolic dysfunction-associated steatotic liver disease (MASLD) in preclinical models; however, its overall efficacy in diet-induced MASLD/NAFLD models has not been systematically quantified. METHODS: This PRISMA 2020 systematic review and meta-analysis was registered in PROSPERO (CRD420251119087). PubMed, Embase, Web of Science Core Collection, the Cochrane Library, and four major Chinese databases were searched from inception to December 15, 2025. Controlled murine studies comparing DHM monotherapy with high-fat diet controls were included. Random-effects meta-analyses pooled standardized mean differences (SMDs) with 95% confidence intervals; risk of bias was assessed using SYRCLE's tool. RESULTS: Fourteen controlled studies were included. Compared with controls, DHM reduced hepatic triglycerides and total cholesterol, improved liver enzymes (ALT, AST, ALP), and decreased body weight and liver index. DHM improved serum lipid profiles (lower total cholesterol and LDL; higher HDL) and glucose homeostasis (lower fasting glucose and insulin). Antioxidant defenses increased (SOD, CAT, GSH, GSH-Px) with reduced malondialdehyde, while inflammatory markers (TNF-α and IL-6) decreased. At the signaling level, DHM increased the pAMPK/AMPK ratio. Heterogeneity was moderate to high for several outcomes, partly explained by dose and treatment duration. CONCLUSION: In murine diet-induced MASLD/NAFLD models, DHM shows promising multidomain benefits across various physiological outcomes, though some variability remains due to differences in study design. More standardized preclinical designs and well-controlled nutraceutical/clinical studies are needed to define clinically relevant, bioavailable dosing and efficacy. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251119087, PROSPERO, Identifier CRD420251119087.

BACKGROUND: Vitamin D, a fat-soluble vitamin critical for bone metabolism, has recently been implicated in metabolic homeostasis. Growing evidence suggests its potential role in modulating lipid profiles in metabolic syndrome. OBJECTIVES: This meta-analysis evaluated the effects of vitamin D supplementation on blood lipids in patients with metabolic syndrome. METHODS: We searched the randomized controlled trials from 1948 to February 1, 2026 involving vitamin D supplementation treatment for patients with metabolic syndrome from PubMed, EMBASE, Cochrane library, SinoMed, and conducted a meta-analysis. The meta-analysis was registered on the PROSPERO, the registration number is CRD42024591657. RESULTS: Finally, seven trials were included in the meta-analysis. The results demonstrated that vitamin D supplementation significantly reduced triglyceride levels (MD = -12.64, 95% CI [-21.23∼-4.04], P = 0.004). However, no significant differences were observed in total cholesterol or low-density lipoprotein cholesterol levels between the vitamin D treated groups and control groups. Notably, vitamin D supplementation showed potential benefits in increasing high-density lipoprotein cholesterol levels particularly with daily regimens (MD = 1.77, 95% CI [0.90∼2.64] P < 0.0001, I2 = 35%). CONCLUSIONS: Our meta-analysis confirmed the effects of vitamin D in the management of triglyceride level in metabolic syndrome patients. Vitamin D supplementation showed potential benefits on increasing the high-density lipoprotein cholesterol levels especially with daily regimens. More randomized controlled trials are needed to confirm the result. ©2026 Wang et al.

BACKGROUND: Age-related declines in metabolic, cardiovascular, and physical function contribute to reduced quality of life in older adults. Although structured exercise is central to healthy aging, the optimal modality remains unclear. Community-based exercise programs in China are heterogeneous, and their comparative effects on health outcomes and cardiovascular safety have not been systematically evaluated. OBJECTIVE: We aimed to compare the effects of 4 common community-based exercise modalities on cardiometabolic health, physical function, and quality of life in middle-aged and older adults, and to assess their relative efficacy and safety across intervention exposure. METHODS: This single-blind randomized controlled trial included 113 middle-aged and older adults (mean age 62.3, SD 4.25 years). Participants were assigned to one of the 5 groups: 12-form Chen-style Tai Chi (CTC12), 24-form Tai Chi, square dance, walking, or a control group. The 12-week intervention comprised 2 supervised sessions per week, each lasting 90 minutes. Pre- and postintervention assessments included blood pressure, lipid profiles, fasting glucose, interleukin-6 levels, Short Physical Performance Battery (SPPB) scores, activities of daily living, and the World Health Organization Quality of Life (WHOQOL) index. RESULTS: The CTC12 and square dance groups showed significant improvements in several outcomes. In the CTC12 group, triglyceride and low-density lipoprotein cholesterol levels significantly decreased (P=.008 and P=.002, respectively), whereas SPPB and WHOQOL scores significantly improved (P=.02 and P=.002, respectively). In the square dance group, total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels significantly decreased (P=.01, P=.002, and P=.002, respectively), whereas SPPB, activities of daily living, and WHOQOL scores significantly improved (P=.04, P=.04, and P=.002, respectively). The walking group showed a significant improvement only in WHOQOL scores (P=.02). No significant changes were observed in the control group for any outcome. CONCLUSIONS: CTC12 and square dance were associated with significant improvements in cardiometabolic, physica

BACKGROUND: Limited time for counseling and infrequent follow-ups in pharmacies may affect clinical outcomes. While additional home visits by community pharmacists may improve outcomes in patients with hypertension and/or dyslipidemia, their impact in Thailand remains unstudied. The objective of this study was to compare clinical outcomes, medication adherence, and disease knowledge between patients with hypertension and/or dyslipidemia who received additional pharmaceutical care with home visits and those who received care only at a community pharmacy. METHODS: This randomized controlled study was conducted in a community pharmacy. Patients aged 20 years and older with uncontrolled hypertension and/or dyslipidemia were included. All patients received standard care in a community pharmacy dispensing service. A home visit by a pharmacist was conducted in the intervention group after 1 month and a telephone call after 3 months. Blood pressure (BP) and medication adherence were assessed at each visit, while low-density lipoprotein (LDL) cholesterol levels and disease knowledge were assessed at baseline and after 5 months. The primary outcome was the control of diseases by the end of the study. RESULTS: Seventy-five patients were included (38 and 37 patients in the home visit group and the control group, respectively). At the end of the study, systolic BP, diastolic BP, and LDL cholesterol levels were significantly lower in the home visit group compared with the control group (p < 0.05). Patients in the home visit group significantly achieved BP or LDL cholesterol targets compared with the control group (52.6% vs. 29.7% and 84.2% vs. 51.4%, respectively). In addition, more patients in the home visit group significantly achieved controlled hypertension from the second month (p < 0.05). Medication adherence and knowledge of hypertension and dyslipidemia were significantly higher in the home visit group compared with the control group (p < 0.05). CONCLUSION: The addition of home visits by a community pharmacist improved clinical outcomes, medication adherence, and disease knowledge. © 2026 ACCP Foundation, Ltd.

Background/Objectives: Liver fat represents an early metabolic lesion in the development of diabetes and its cardiometabolic complications. Diets high in free sugars, particularly from sugar-sweetened beverages (SSBs), are associated with abdominal obesity and increased cardiometabolic risk, prompting global guidelines to limit SSBs as a major public health strategy. Low-fat cow's milk is promoted as the preferred caloric replacement strategy for SSBs due to its high nutritional value and cardiometabolic advantages. Fortified soymilk is a plant-based alternative with approved health claims for cholesterol and coronary heart disease risk reduction that offers an equivalent nutritional value to cow's milk. However, given concerns about its classification as an ultra-processed food (UPF), it is unclear whether soymilk offers comparable metabolic health benefits to milk as part of clinical and public health strategies to reduce SSB intake. The Soy Treatment Evaluation for Metabolic (STEM) health trial seeks to evaluate the impact of replacing SSBs with either 2% soymilk or 2% cow's milk on liver fat and other cardiometabolic risk factors in habitual adult consumers of SSBs with obesity. Methods: The STEM trial is a 24-week, pragmatic, 3-arm, parallel, randomized trial. We recruited adults with obesity (high BMI plus high waist circumference based on ethnic specific cut-offs) consuming ≥1 SSB/day. Participants were randomized to one of three groups based on their usual SSB intake at baseline (servings/day): continued SSB (355 mL can) intake; replacement with fortified, sweetened 2% soymilk (250 mL); or replacement with 2% cow's milk (250 mL). The primary outcome is the change in intrahepatocellular lipid (IHCL) measured by 1H-MRS at 24 weeks. Hierarchical testing will be done to reduce the familywise error rate. The superiority of cow's milk to SSBs will be assessed first to establish assay sensitivity. If superiority is established, then the non-inferiority of soymilk to cow's milk will be assessed using a pre-specified non-inferiority margin of 1.5% IHCL units (assessed by difference of means using a 90% confidence interval [CI]). Analyses will be conducted accordi

IMPORTANCE: Familial hypercholesterolemia is a common genetic disorder associated with premature cardiovascular disease. Genetic cascade screening is recommended but remains underused due to privacy laws that prevent clinicians from directly contacting at-risk relatives. OBJECTIVE: To examine whether implementing a web-based communication platform in a patient-mediated genetic cascade screening program for familial hypercholesterolemia increases uptake compared with usual care. DESIGN, SETTING, AND PARTICIPANTS: This open-label, multicenter, implementation randomized clinical trial (CATCH) was conducted between November 1, 2020, and October 31, 2023, at 7 cardiovascular prevention or lipid clinics across Switzerland, representing French-, German-, and Italian-speaking regions. Adults aged 16 years or older with genetically confirmed familial hypercholesterolemia and at least 1 eligible first-degree relative living in Switzerland participated. A total of 87 index patients with 359 eligible first-degree relatives were randomized by family cluster (1:1) to the intervention or usual care arm. INTERVENTION: A secure web-based platform allowing participants to send preprepared electronic messages (email or text) to their relatives, linking them directly to participating centers for genetic testing. MAIN OUTCOMES AND MEASURES: The primary outcome was cascade screening uptake, defined as the proportion of eligible first-degree relatives undergoing genetic testing within 6 months. The secondary outcome was new cases identified. RESULTS: Among 221 adults screened across multiple families, 87 (39.4%) had genetically confirmed familia hypercholesterolemia (median [IQR] age, 49.2 [16.4-83.7] years; 46 [52.9%] female; median [IQR] highest low-density lipoprotein cholesterol, 289.58 [139.00-498.07] mg/dL); 43 were randomized to the usual care arm, and 44 were randomized to the intervention arm. Among the 359 eligible relatives (median family size, 4), 99 (27.6%) underwent genetic testing. Uptake was higher in the intervention arm (30.4%; 95% CI, 22.0%-40.4%) than in usual care arm (16.7%; 95% CI, 10.1%-26.3%), yielding an odds ratio of 2.18 (95% CI, 1.06-4.51; P = .03). New ca

Two large randomized, placebo-controlled phase 3 trials, CORALreef Lipids1 and CORALreef heFH,2 demonstrated that once-daily oral enlicitide lowered LDL cholesterol by approximately 56%-60% on top of background lipid-lowering therapy. Reductions were sustained through 24-52 weeks and accompanied by improvements in other lipid parameters. Safety outcomes were comparable to placebo, with efficacy similar to monoclonal antibody PCSK9 inhibitors.

INTRODUCTION: Poor adherence to risk factor control and life-saving medications is a key factor affecting long-term patient prognosis. Evidence indicates that sex plays a significant role in the uptake of both pharmacological and non-pharmacological interventions, ultimately influencing long-term outcomes. This study aimed to quantify sex differences in risk factor management and medication adherence following acute coronary syndrome (ACS). METHODS: This is a secondary analysis of the TEXTMEDS randomised clinical trial - a single-blind, multicentre randomised controlled trial of patients post-ACS. We compared sex differences in achieving clinical and lifestyle targets for secondary prevention, namely blood pressure control (<140/90 mm Hg), low-density lipoprotein cholesterol (LDL-C) (<1.8 mmol/L), healthy body mass index (BMI) (<25 kg/m²), regular physical activity (Global Physical Activity Questionnaire score ≥600), smoking status and adherence to cardioprotective medications (aspirin, beta blockers, ACE/angiotensin receptor blockers, statins, antiplatelets), using adjusted logistic regression models. Medication adherence was defined as taking ≥80% of prescribed doses in the month prior to follow-up, across all five drug classes, unless contraindicated. RESULTS: Of 1379 patients (mean age 58.5±10.7 years; 1095 (79.4%) male), females were less likely than men to achieve LDL-C targets (adjusted OR (aOR): 0.61, 95% CI 0.45 to 0.82) and engage in regular physical activity (aOR: 0.61, CI 0.47 to 0.80), but more likely to achieve a healthy BMI (aOR: 1.47, CI 1.04 to 2.06). Female patients are less likely to adhere to their medication compared with male counterparts (aOR: 0.68, CI 0.50 to 0.92). However, this association weakened and lost statistical significance after further adjustment for socio-economic factors (aOR: 0.71, CI 0.50 to 1.03). There were no significant interactions between sociodemographic or clinical factors and sex in relation to overall medication adherence (P-interactions >0.05). CONCLUSION: This study reveals that female patients are less likely to achieve LDL-C targets and engage in physical activity but more likely to maintain a healthy BMI. Al

17. Open Heart. 2026 Apr 9;13(1):e003856. doi: 10.1136/openhrt-2025-003856. Sex differences in risk factor control and medication adherence post-ACS: insights from the TEXTMEDS randomised clinical trial. Mishra SR(1), Marschner S(2), Min H(3), Mahendran S(4)(5), Thiagalingam A(6), Poulter R(7),

Loss-of-function variants in the gene encoding angiopoietin-like protein 3 (ANGPTL3) are associated with decreased triglyceride and low-density lipoprotein cholesterol levels, as well as with lower cardiovascular risk. Here we describe a 16-week phase 1 trial of zodasiran, an ANGPTL3‑targeting small interfering RNA, in patients on lipid-lowering therapy with either hyperlipidemia (with a placebo control arm) (n = 9; 7 male and 2 female), familial hypercholesterolemia (n = 17; 9 male and 8 female) or moderate-to-severe hypertriglyceridemia (n = 6; 4 male and 2 female). Patients received zodasiran subcutaneously on days 1 and 29, followed by a 48-week open-label extension in the familial hypercholesterolemia cohort (n = 13; 7 male and 6 female) in which zodasiran was dosed every 12 weeks. No serious treatment-related adverse events, the primary endpoint of the trial, were observed. Moreover, no elevations in hepatic aminotransferases, bilirubin or glycated hemoglobin were observed, and there were no drug discontinuations. All cohorts showed reductions at week 16 (12 weeks postdosing) in serum ANGPTL3 (≤-85.4%) and triglycerides (≤-67.1%), which were secondary endpoints. Reduction in ANGPTL3 was sustained to end-of-open-label extension in the familial hypercholesterolemia cohort. These results indicate a favorable safety profile for zodasiran, with promise for correcting isolated hypercholesterolemia and moderate-to-severe hypertriglyceridemia, and support further studies of zodasiran in treating a wide spectrum of dyslipidemias. ClinicalTrials.gov registration: NCT03747224 . © 2026. The Author(s), under exclusive licence to Springer Nature America, Inc.

BACKGROUND: Hypertension is a key modifiable driver of cardiovascular risk and often clusters with dyslipidemia and insulin resistance within the metabolic syndrome. Olive leaf extract (OLE) and potassium have traditionally been used to support blood pressure (BP) management and cardiometabolic health. PURPOSE: To investigate the effect of this OLE - potassium combination on BP and key cardiometabolic markers. STUDY DESIGN: In this randomized, double-blind, placebo-controlled study, 70 adults with untreated mildly to moderately elevated BP received an OLE - potassium supplement (1000 mg OLE, ≥160 mg oleuropein, 300 mg potassium/day) or placebo for 12 weeks. RESULTS: While office BP fell significantly over time in both groups, 7-day home-based BP monitoring showed a significant greater response, with morning systolic BP decreasing by 5.4 mmHg, in the verum group. Supplementation also reduced total cholesterol by 11.1 mg/dL, LDL-cholesterol by 6.9 mg/dL, and triglycerides by approximately 22 mg/dL at Week 6, while HDL-cholesterol remained stable. Fasting glucose and HbA1c were unchanged, but fasting insulin and HOMA-Index declined in the verum group, indicating a modest improvement in insulin sensitivity. Additionally, oxidized LDL decreased by ∼23 %, without changes in hs-CRP. Quality-of-life scores remained stable, although global self-ratings favoured the combination. The intervention was well tolerated, with no product-related serious adverse events. CONCLUSION: The combination of OLE and potassium is a safe adjunctive strategy for individuals with mildly to moderately elevated BP, with favourable effects on lipid profile, oxidative status, and insulin sensitivity that may help reduce cardiometabolic risk in the context of metabolic syndrome.

BACKGROUND: Postprandial metabolic impairments play a key role in the pathophysiology of cardiometabolic diseases. While liver fat content has been linked to distinct fasting metabolite profiles, its relationship with postprandial metabolite profiles remains unexplored. In this study, we aimed to (1) examine to what extent liver fat content is associated with the postprandial metabolomic profile beyond fasting metabolites; and (2) investigate whether diet-induced changes in liver fat content are associated with changes in plasma metabolites identified in objective 1. METHODS: In a subpopulation (n = 1986) of an existing cohort study and a 12-week dietary intervention study (n = 80), liver fat content was measured by proton magnetic resonance spectroscopy and categorized as low (< 2.5%), middle (2.5-5.5%), or high (> 5.5%). In the cohort study, plasma metabolomic profiles were quantified by NMR spectroscopy at fasting (T0) and 150 min after a mixed meal (T150). We examined associations between liver fat content and plasma metabolites at T0, T150 and postprandial response (ΔT150-T0) using multivariate linear regression. In the intervention study, plasma metabolomic profiles were quantified at fasting (T0) and at multiple postprandial time points (120, 240, and 360 min) following a mixed meal, both before and after the intervention. We further examined associations between liver fat content and plasma metabolites at T0, and postprandial response (incremental area under the curves [iAUCs]) and explored associations between diet-induced changes in liver fat content and changes in identified metabolites at fasting and postprandial responses (iAUCs). RESULTS: High liver fat group was characterized by higher fasting and postprandial levels of triglycerides, all VLDL and the small LDL/HDL subclasses, ApoB, fatty acids, glycoprotein acetyls, and BCAAs, and lower medium/larger HDL subclasses, and acetate compared to the low liver fat group. In the high vs. low liver fat group, postprandial responses of cholesterol content of S-LDL, IDL, and S-HDL, glutamine and histidine, omega-3% and DHA % were lower. Diet-induced reductions in liver fat were associated with reductions in

The present work was designed to investigate the impacts of tartary buckwheat flavonoids (TBF) on the growth performance and physiological metabolism of Liangshan Yanying chickens. A total of 144 healthy 4-week-old Liangshan Yanying chickens of uniform body weight were randomly divided into four groups. Each group consisted of six replicates with six chickens per replicate. The control group was fed a basal diet, whereas the treatment groups received the same basal formulation supplemented with TBF at concentrations of 20, 40, and 60 mg/kg, respectively. The entire feeding trial lasted for 10 consecutive weeks. Growth performance, serum parameters, bone quality, slaughter traits, and hepatic lipid metabolism were determined and statistically analyzed. Results showed that dietary TBF supplementation had no significant impact on the overall growth performance (p > 0.05); however, final body weight and average daily weight gain displayed a positive linear trend in response to increasing TBF levels (0.05 < p < 0.1). For serum parameters, TBF supplementation significantly increased total antioxidant capacity (p < 0.05) and decreased malondialdehyde content (p < 0.05) in a linear manner. Specifically, compared with the control group, the 60 mg/kg TBF group increased T-AOC by approximately 64.6% and reduced MDA by approximately 67.9%, demonstrating a robust antioxidant effect. A linear increase in high-density lipoprotein cholesterol levels approaching significance (p = 0.055) was also observed. A significant quadratic regulatory effect of TBF was observed on serum glucose concentrations (p < 0.05), whereby the 60 mg/kg TBF dose reduced serum glucose by 15.6% relative to the control (p < 0.05), reflecting a robust hypoglycemic effect. Regarding bone quality, supplementation with 20 and 60 mg/kg TBF significantly elevated tibial phosphorus content relative to the 0 mg/kg TBF group (p < 0.05). Regression analysis showed that increasing dietary TBF levels linearly elevated tibial calcium content (p < 0.05) and resulted in linear increasing trends in tibial ash content, tibial phosphorus content, femur ash content, and femur calcium content (0.05 < p < 0.1). Concerning sla

Introduction: Oxidative stress and inflammation are major factors linked to obesity and metabolic dysfunction, leading to a significantly higher risk of related diseases. Atorvastatin and liraglutide possess lipid-lowering, antioxidant, and anti-inflammatory effects that could synergistically improve obesity-related perturbations through modulation of the Nrf2/HO-1 signaling pathway. Methodology: We assessed liraglutide's pharmacological potential in extending atorvastatin's benefit on obesity, hyperlipidemia, and fatty liver in rats fed a high-fat diet (HFD) for 12 weeks. We specifically evaluated the effects of liraglutide treatment on atorvastatin-induced anti-inflammatory and antioxidant mechanisms, with a particular focus on Nrf2/HO 1 modulation in adipose and hepatic tissue. In silico analyses, including molecular docking and AlphaFold- Multimer modeling, evaluated the binding affinities of atorvastatin and liraglutide to Nrf2 and HO 1. Results: Compared to ND, the HFD-fed rats had a significantly higher final body weight (362.4 ± 12.7 g vs. 245.6 ± 9.8 g in ND, p < 0.05). There was a marked increase in serum total cholesterol (178.6 ± 9.2 mg/dL vs. 98.3 ± 6.4), fasting glucose (340.1 ± 8.2 mg/dL vs. 82.3 ± 3.1), HbA1c (7.8 ± 0.3 vs. 4.5 ± 0.2), and hepatic COX-2 expression (99.9 ± 6.3 vs 19.6 ± 2.4). The oxidative stress markers were also disturbed, as indicated by SOD (42.5 ± 3.1 vs. 95.2 ± 4.6 U/mg protein), GSH (18.3 ± 1.5 vs. 42.7 ± 2.8 nmol/mg), and p62 (0.005 ± 0.001 vs. 0.125 ± 0.01). Atorvastatin lowered cholesterol (121.2 ± 7.5 mg/dL), COX-2 (61.3 ± 3.3), and body weight (301.7 ± 11.5 g) compared to HFD. Meanwhile, liraglutide caused a greater reduction in body weight (268.5 ± 10.3 g), glucose (112.5 ± 6.7 mg/dL), and COX-2 (42.2 ± 2.9) than atorvastatin. The combination therapy produced the most significant effects, returning body weight (253.6 ± 9.1 g) to baseline, normalizing glucose and lipids, reducing COX-2 to 22.9 ± 2.0, and reactivating the Nrf2/HO-1 pathway, as shown by increased HO-1 expression and the restoration of p62 levels (0.078 ± 0.004). In silico analyses suggest that atorvastatin favorably binds to Nrf2 and HO-1, while liraglut

Nanomedicine has advanced rapidly as engineered nanoparticles have become increasingly capable of improving drug stability, targeting, controlled release, and biocompatibility. However, nanoparticle clinical utility relies on both delivery efficiency and how they are metabolized, retained, and cleared. This review examines the major biological pathways governing nanoparticle clearance and discusses how engineering parameters can be tuned to influence bioaccumulation, metabolism, excretion, and therapeutic performance with a wide range of available materials. This article is a narrative review of the recent and foundational literature on medically relevant nanoparticles, including lipid-based, polymeric, biopolymer, inorganic, polylactide, and bile-derived systems. All relevant translational, biochemical, chemical, and clinical literature from PubMed was searched from January 1971 to January 2026 to obtain a representative sample of work before information extraction. Nanoparticle clearance is governed by interconnected molecular and organ-level processes that vary according to composition, size, surface chemistry, and route of administration. Surface modifications with PEGylation, zwitterionic coatings, cholesterol, proteins, or responsive linkers can prolong circulation, alter immune recognition, and direct organ-specific handling. While rapid clearance remains desirable for many systemically acting drugs, prolonged intracellular or intratumoral retention may improve outcomes, particularly in boron neutron capture therapy and other activation-dependent treatments. Nanoparticle clearance should be regarded as a context-dependent design parameter rather than a universal limitation. Rational control of clearance kinetics may improve both safety and therapeutic effectiveness in next-generation engineered drug delivery systems.

Background/Objectives: Benefiting from their outstanding tumor-penetrating ability and cytotoxic proteins and cytokines, natural-killer-cell-derived exosomes (NEX) show great potential for cell-free tumor immunotherapy. To meet the clinical tumor therapeutic need, engineered NEX are highly required to further enhance their tumor-tropism and antitumor abilities. Methods: We proposed a NEX engineering strategy, using a structure of AS1411-bivalent-cholesterol (B-Chol) anchor equipped with photosensitizer zinc phthalocyanine (ZnPc) attached on the membrane of NEX to form A-P-NEX. It not only preferably maintains the spatial structure of the AS1411 aptamer via a B-Chol anchor contributing to the tumor-tropism and stability of NEX but also significantly improves the photodynamic therapy (PDT) effect by firmly binding ZnPc in the unique G-quadruplex structure in the AS1411 aptamer. Results: The results showed that A-P-NEX could promote the precise uptake of NEX and ZnPc by tumor cells and produce obvious synergistic NEX-based immunotherapy and PDT upon laser irradiation, demonstrating excellent targeted antitumor effects both in vitro and in vivo. Conclusions: This study demonstrates a reliable NEX engineering strategy and paves the way for developing a useful tumor-tropism PDT method.

Fermented foods and probiotics represent complementary yet distinct components of human nutrition. Fermented foods are shaped by biochemical transformations driven by microbial metabolism, whereas probiotics are live microorganisms that may confer health benefits to the host. In both cases, bacteria, yeasts, and filamentous fungi mediate key metabolic activities that generate bioactive compounds and modulate host-microbiota interactions. During fermentation, microbial communities synthesize organic acids, peptides, exopolysaccharides, vitamins, and other metabolites that enhance food safety, sensory attributes, and potential health-promoting properties. Several microbial products, such as bacteriocins, reuterin, hydroxylated fatty acids, and exopolysaccharides, exhibit antimicrobial, immunomodulatory, antioxidant, and cholesterol-lowering activities. Advancing our understanding of microbial metabolism in fermented foods is essential for developing next-generation functional foods and nutraceuticals that leverage microbial biotransformations to support human health. Nonetheless, multiple challenges limit the translation of these advances into commercial products. Inadequately controlled fermentation may introduce microbiological or chemical hazards, regulatory frameworks governing microbial use in foods remain insufficiently defined, and standardized procedures for microbial strain handling and characterization are still lacking. This narrative review integrates current evidence on the nutraceutical properties of fermented foods and probiotics, while also examining the associated safety considerations and the technological factors that influence fermentation processes.

The integration of rooted plant flour into traditional noodle matrices, such as rice noodles and qingke noodles, represents a novel approach to enhancing the nutritional and sensory profiles of staple foods. This study investigates the volatile flavor components and functional compounds derived from rooted plant flours, including Gongmi "tribute rice", qingke "highland barley" flour, kudzu vine flour, Gastrodia elata blume flour, dried ginger flour, and fishwort root flour, when incorporated into rice and qingke noodles. The novelty of this research lies in its comprehensive analysis of how these flours influence not only the nutritional and textural properties but also the volatile organic compounds (VOCs) that define sensory acceptance and health benefits. Using advanced gas chromatography mass spectrometry (GC-MS), we identified key VOCs, such as esters, aldehydes, and terpenes, which contribute to unique flavor profiles like umami, sweetness, and earthy notes in fortified noodles. Additionally, the study highlights the best functional compounds for health, including polyphenols, resistant starch, and polysaccharides, which demonstrate significant antioxidants, anti-inflammatory, and cholesterol-lowering properties. For instance, highland barley enriched flour exhibited high levels of phenolic compounds and carotenoids, which correlated with improved antioxidant activity and a reduced glycemic index. Similarly, Gongmi flour contributed elevated levels of γ-aminobutyric acid (GABA) and rutin, enhancing the rice noodles' potential to manage metabolic diseases and support cardiovascular health. Molecular docking analyses predicted strong interactions between key volatile compounds (e.g., 3-dihydro-1, 3-trimethyl-33-phenyl-1H-indene) and metabolic targets like ACE and SGLT1, suggesting mechanisms for their cardioprotective and anti-diabetic effects. This research provides a groundbreaking framework for developing next generation functional foods by leveraging rooted plant flours to bridge the gap between sensory appeal and health efficacy, offering strategic insights for personalized nutrition and sustainable food production.

Oxidative stress generates oxidized phospholipids (OxPLs) that alter membrane structure and inflammatory lipid signaling, yet the underlying biophysical mechanisms remain poorly understood. Here, we examine how two structurally distinct truncated oxidized phosphatidylcholines (OxPCs), 1-palmitoyl-2-(5'-oxo-valeroyl)-sn-glycero-3-phosphocholine (POVPC) and 1-palmitoyl-2-glutaryl-sn-glycero-3-phosphocholine (PGPC), remodel membrane lateral organization and regulate secretory phospholipase A2 (sPLA2) activity. Large unilamellar vesicles composed of sphingomyelin, cholesterol, and either monounsaturated 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) or polyunsaturated 1-palmitoyl-2-docosahexaenoyl-sn-glycero-3-phosphocholine (PDPC) were used to reconstitute the liquid-ordered/liquid-disordered (Lo/Ld) phase coexistence characteristic of eukaryotic plasma membranes. Fluorescence spectroscopy revealed that OxPLs modulate lipid packing and nanodomain organization in a structure- and composition-dependent manner. POVPC promoted pronounced membrane ordering and Lo domain stabilization compared with PGPC, particularly in monounsaturated membranes with low cholesterol content. In contrast, PDPC-containing membranes, especially at elevated cholesterol, exhibited enhanced structural resilience to OxPL-induced perturbations. These biophysical changes were associated with distinct functional outcomes. Notably, the relationship between membrane structural parameters and sPLA2 activity was not linear, indicating a decoupling between bulk membrane properties and enzymatic response. sPLA2 activity was linked to membrane lateral organization: the size of Lo domains modulate hydrolysis by influencing the physicochemical properties of Lo/Ld interfaces, which may represent preferential sites for enzyme activation. Consistent with this, POVPC reduced sPLA2 activity through stabilization of ordered domains at both low and high cholesterol, while PGPC enhanced hydrolysis at high cholesterol. Importantly, PDPC-containing membranes attenuated sPLA2 activity and exhibited a protective effect against OxPC-induced enzymatic activation. Together, these findings identify membrane later

Background/Objectives: Metabolic syndrome (MS) is associated with an increased cardiovascular risk. The aim of this study was to reveal the effects of Chaenomeles japonica fruit juice (CJFJ) on energy balance and biochemical and histological parameters in rats with diet-induced MS. Methods: Fifty Wistar rats were allocated into five groups. For ten weeks, the Control group received a standard laboratory diet and tap water, while the other groups were given a high-fat high-fructose (HFHF) diet. The Control and MS groups were treated with distilled water, while the other three groups were treated with CJFJ at increasing doses. Results: Rats on an HFHF diet consumed less food and more liquids and had a higher caloric intake than the Control group. Among the CJFJ-treated animals, an increased food consumption, as well as an increased total caloric intake, and no difference in body weight gain were observed in comparison with the MS group. CJFJ did not affect glucose tolerance or the triglyceride and total cholesterol levels. CJFJ prevented an HFHF-induced decrease in superoxide dismutase and caused a decrease in thiobarbituric acid-reactive substances in serum. The medium CJFJ dose prevented an HFHF-induced increase in adipose tissue indices. Liver and adipose tissue histology revealed a protective effect of CJFJ. Conclusions: CJFJ may exert beneficial effects on visceral adiposity, oxidative status, and histopathological changes in the liver and adipose tissue in rats with diet-induced MS.

Background and Objectives: During the past 25 years, a significant body of research has been conducted reporting on the salutary effects of the Mediterranean diet and extra-virgin olive oil, one of its main components. The initial studies were epidemiological observations on populations with very low mortality rates due to significant reductions in myocardial infarction fatalities. Population-based studies demonstrated that the Mediterranean diet with olive oil consumption is associated with a lower prevalence of cardiovascular and cerebrovascular disease, obesity, arthritis, and cancer. Materials and Methods: In this narrative review, we present recent studies on the effects of extra-virgin olive oil and the Mediterranean diet-compared with various other diets-on several vascular risk factors, including hypertension, hyperlipidemia, type 2 diabetes mellitus, and obesity, as well as their impact on cognitive decline and dementia. Results: This diet has been shown to improve cognitive function in patients with mild cognitive impairment, Alzheimer's disease, vascular cognitive impairment, and vascular dementia. The main mechanisms responsible for cognitive improvement include control of arterial hypertension by reducing systolic and diastolic blood pressure, lowering triglycerides and low-density lipoprotein cholesterol and increasing high-density lipoprotein cholesterol, along with improvement in fasting glucose, insulin levels, and hemoglobin A1c in subjects with type 2 diabetes mellitus, as well as lowering body mass index and obesity. Conclusions: The Mediterranean diet and olive oil induce-along with prevention of cardiovascular disease and stroke-a significant improvement of vascular risk factors, slowing the progression of both vascular dementia and Alzheimer's disease. There is a need for additional placebo-controlled clinical trials to confirm the supportive nutritional role of extra-virgin olive oil in age-associated cognitive decline in the elderly.

Background: Vitamin D deficiency has been implicated in disturbances of glucose and lipid metabolism, particularly in occupational groups with limited sunlight exposure. This study aimed to examine the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and markers of carbohydrate and lipid metabolism in salt mine workers. Methods: This cross-sectional study involved 62 male salt miners (aged 25-63 years), stratified by work depth (surface, ≤750 m, and >750 m). Anthropometric characteristics, body composition, cardiorespiratory fitness (VO2max), and biochemical parameters were assessed. Blood analyses included fasting glucose, insulin, lipid profile, TSH, and 25(OH)D. Insulin resistance was evaluated via the HOMA-IR index. Results: The cohort exhibited a high prevalence of overweight and obesity (mean BMI > 28 kg/m2). Significant differences in VO2max were observed between groups (p < 0.05). Elevated fasting glucose (>100 mg/dL) was observed in 47% of participants, and 22% presented HOMA-IR values > 2.5. In the regression model, vitamin D supplementation was the strongest predictor of 25(OH)D levels, explaining 25.5% of its variance. The addition of HDL cholesterol increased the explained variance to 35.6%, whereas HOMA-IR contributed an additional 3.9% (p = 0.094). Conclusions: In salt miners, insufficient vitamin D status coexists with excess adiposity and impaired glucose homeostasis. Serum 25(OH)D was more strongly associated with supplementation and HDL-C than with HOMA-IR. These findings suggest that monitoring vitamin D status is relevant in the occupational health evaluation of this group.