Gut microbiota: An overlooked target in dyslipidemia management

Abstract

With the global rise in sedentary lifestyles, obesity, and unhealthy dietary patterns, dyslipidemia has emerged as a leading modifiable risk factor for atherosclerotic cardiovascular disease. Beyond host genetics and diet, the gut microbiota has gained recognition as a critical regulator of lipid homeostasis through mechanisms involving bile acid metabolism, short-chain fatty acid signaling, and microbial modulation of inflammation. Lv et al provide a comprehensive synthesis of the diet microbe-lipid axis and therapeutic strategies, including probiotics, prebiotics, and fecal microbiota transplantation. In this correspondence, we expand on their framework by highlighting underexplored yet clinically relevant dimensions, including circadian rhythm alignment, pharmacotherapy microbe crosstalk, population-specific microbial signatures, and functional microbial phenotyping. Addressing these overlooked aspects could accelerate the translation of microbiome science into precision dyslipidemia management, with the potential to improve cardiovascular outcomes worldwide.

Keywords: Dyslipidemia; Cardiovascular disease; Gut microbiome; Circadian rhythm; Precision medicine

Core Tip: Dyslipidemia has emerged as a leading modifiable risk factor for atherosclerotic, cardiovascular and hepatic diseases. Gut microbiota lipid metabolism interactions offer new opportunities for dyslipidemia management, but translating these insights into clinical practice requires more than compositional profiling. This letter emphasizes overlooked dimensions like circadian rhythm alignment, drug-microbe crosstalk, population-specific microbial patterns, and functional microbial signatures to guide precision, and context-aware strategies for cardiovascular risk reduction.