Search Results (455)

Background/Objectives: Conventional lipid parameters incompletely reflect coronary atherosclerotic burden, particularly in the setting of metabolic heterogeneity and residual cardiovascular risk. Composite indices such as the atherogenic index of plasma (AIP) and the triglyceride–glucose (TyG) index have emerged as integrative markers. Fatty acid desaturases regulate key pathways of lipid metabolism, and estimated desaturase activity indices (SCD-16, SCD-18, D5D, and D6D) may provide complementary information on the metabolic pathways underlying AIP and the TyG index. However, the relationships among composite atherogenic indices, plasma fatty acid composition, estimated desaturase activity indices, and coronary artery disease (CAD) severity remain incompletely understood. Methods: In this cross-sectional study, 61 patients undergoing coronary angiography for suspected CAD were evaluated. Coronary atherosclerotic burden was quantified using the Gensini score. AIP and the TyG index were calculated from fasting biochemical parameters. Plasma fatty acid composition was analyzed using gas chromatography–mass spectrometry, and estimated desaturase activity indices were calculated using product-to-precursor ratios. Results: AIP was independently associated with Gensini score (β = 37.020, p < 0.001), whereas the TyG index was not independently associated after adjustment for potential confounders (p = 0.101). In correlation analyses, AIP was positively correlated with HOMA-IR (ρ = 0.352, p < 0.05). Myristic acid was positively correlated with AIP, the TyG index, and VLDL (ρ = 0.297, 0.288, and 0.325, respectively; all p < 0.05), whereas n-6 polyunsaturated fatty acids were positively correlated with LDL (ρ = 0.276, p = 0.031). Among the estimated desaturase activity indices, D6D was positively correlated with AIP, BMI, insulin, and VLDL (ρ = 0.262, 0.376, 0.340, and 0.266, respectively; all p < 0.05), whereas D5D was inversely correlated with BMI and VLDL (ρ = −0.319 and −0.266, respectively; both p < 0.05). No significant associations were observed for SCD-16 or SCD-18. Conclusions: The observed associations between AIP, angiographic CAD severity, selected fatty acid species, and estimated desaturase activity indices suggest that AIP may provide complementary information regarding metabolic alterations associated with coronary atherosclerosis. These findings provide a basis for future studies exploring the relationship between composite atherogenic indices and fatty acid metabolism. Full article

Background/Objectives: Cardiovascular–kidney–metabolic (CKM) syndrome, characterized by disturbances in glucose and lipid metabolism as its core pathophysiological feature, is a major driver of target organ damage. While early risk stratification in CKM stages 0–3 is critical to intercept renal decline, the practical utility of accessible metabolic surrogates remains poorly characterized. This study evaluated and compared the prospective capacity of the atherogenic index of plasma (AIP), triglyceride-glucose (TyG) index, and C-reactive protein–triglyceride glucose index (CTI) for predicting renal deterioration in early-stage CKM. Methods: Data were extracted from the China Health and Retirement Longitudinal Study (2011–2015). In total, 4064 participants aged ≥ 45 with CKM stages 0–3 (with exclusion of participants with baseline CKM stage 4) were prospectively followed. Renal function decline was defined as an estimated glomerular filtration rate (eGFR) decrease of ≥30% over 4 years, calculated using the CKD-EPI 2012 cystatin C equation. Multivariable logistic regression, restricted cubic splines (RCSs), and receiver operating characteristic (ROC) curves were applied. Results: Overall, 122 participants developed the renal outcome. In fully adjusted models, AIP, TyG, and CTI were valid independent risk factors for renal decline, with the lipid-driven AIP exhibiting the strongest association (OR = 5.54, 95% CI: 3.30–9.29; TyG: OR = 1.97, 95% CI: 1.49–2.59; CTI: OR = 1.63, 95% CI: 1.30–2.05; all p < 0.001). RCS analysis demonstrated significant non-linear dose–response trajectories, with renal risk escalating sharply past specific exploratory inflection points (AIP = 0.97, TyG = 7.80, CTI = 8.07). ROC curves confirmed robust predictive performance (AUCs > 0.75), with AIP performing optimally (AUC = 0.773). Conclusions: AIP, TyG, and CTI are independent longitudinal predictors of renal decline in early-stage CKM, with AIP demonstrating superior discriminatory power. Monitoring these composite indices and maintaining them within observed metabolic ranges may aid in early renal risk stratification and monitoring, though the exploratory statistical inflection points identified require validation in independent cohorts before clinical application. Full article

Background/Objectives: Metabolic dysregulation has emerged as a potential modifier of disease activity and disability in multiple sclerosis (MS). However, the relationship between glycemic status and clinical outcomes in patients with MS remains incompletely understood. This study aimed to investigate the associations of glycemic regulation with disease severity, relapse activity, inflammatory markers, and metabolic characteristics in patients with MS. Methods: In this retrospective single-center observational study, 455 patients with MS aged 18–65 years were included. Patients were categorized into normoglycemia (n = 241), prediabetes (n = 98), and diabetes (n = 116) according to American Diabetes Association criteria and documented diabetes diagnosis. Demographic characteristics, Expanded Disability Status Scale (EDSS) scores, annualized relapse rate (ARR), disease-modifying therapy (DMT), hematological indices, inflammatory markers, and metabolic parameters were retrieved from electronic medical records. Associations between glycemic status and clinical outcomes were evaluated using group comparisons, Spearman correlation analyses, and multivariable linear regression models. Results: Significant differences were observed among glycemic groups for age, disease duration, EDSS score, ARR, MS phenotype, platelet count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), lipid parameters, estimated glomerular filtration rate, alanine aminotransferase, gamma-glutamyl transferase, triglyceride–glucose (TyG) index, and atherogenic index of plasma (all p < 0.05). HbA1c, FPG, TyG index, lipid parameters, CRP, and ESR were positively correlated with EDSS scores (all p < 0.05). In contrast, these markers showed inverse correlations with ARR. However, after adjustment for demographic and clinical variables, including age, sex, disease duration, MS phenotype, and disease-modifying therapy (DMT), neither prediabetes nor diabetes remained independently associated with disability, as measured by the EDSS score, or with ARR. Progressive MS phenotype, older age, and longer disease duration were independently associated with higher disability, whereas age, disease duration, and progressive phenotype were independently associated with lower ARR. Conclusions: Impaired glycemic status is associated with greater disability, unfavorable metabolic profiles, and increased systemic inflammation in patients with MS. Nevertheless, glycemic status was not independently associated with disability or relapse activity after adjustment for major clinical confounders. These findings suggest that metabolic dysregulation accompanies more severe clinical characteristics but may not independently drive disease progression in MS. Full article

Background and Objectives: Chronotype and sleep quality are related but non-identical dimensions of sleep health. We examined whether later chronotype is associated with subclinical visceral adiposity and atherogenic dyslipidaemia independently of perceived sleep quality, and whether this association differs by sex, in adults without previously diagnosed chronic disease. Materials and Methods: This single-centre cross-sectional study included 282 adults without previously diagnosed chronic disease or regular medication use. Chronotype was assessed with the Morningness–Eveningness Questionnaire (MEQ) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Composite cardiometabolic indices were calculated from routine anthropometric and biochemical data. Primary dependent variables were log-transformed Visceral Adiposity Index (log[VAI]) and Atherogenic Index of Plasma (AIP). Multivariable linear models used heteroscedasticity-consistent type 3 (HC3) robust standard errors and adjusted for age, sex, education, physical activity, and PSQI; body mass index (BMI) was additionally included in the AIP model. Sex × MEQ interactions, false-discovery-rate (FDR) correction, and glycaemic sensitivity analyses were performed. Results: Median age was 28.0 years; 50.4% were women, 25.9% were evening type, and 51.8% had poor sleep quality. Higher MEQ score (greater morningness) was independently associated with lower log(VAI) (B = −0.0096; 95% confidence interval (CI), −0.0159 to −0.0033; β = −0.190; p = 0.003) and AIP (B = −0.0035; 95% CI, −0.0063 to −0.0008; β = −0.160; p = 0.011), whereas PSQI was not independently associated with either outcome. Sex × MEQ interactions were nominally significant and estimates were stronger in women, but interaction terms did not survive FDR correction. Associations persisted after excluding diabetes-range glycaemia but attenuated in strictly normoglycaemic participants. Conclusions: Later chronotype was associated with a less favourable subclinical adiposity–atherogenic profile independently of perceived sleep quality. Findings are cross-sectional, and the sex-specific pattern is hypothesis-generating. Prospective studies with objective circadian, sleep, dietary-timing, behavioural, and hormonal measures are required. Full article

Despite the success of modern antiretroviral therapy in achieving virological suppression, people living with HIV face an elevated risk of cardiovascular diseases, particularly heart failure with preserved ejection fraction. This study evaluates the cardiometabolic phenotype and functional capacity in a Romanian HIV cohort to delineate the metabolic footprint of chronic infection. In this cross-sectional study based on prospectively collected, protocol-driven phenotyping, we evaluated 50 consecutive outpatients from a university-affiliated infectious diseases clinic in Timisoara. Eligibility strictly required clinical stability and sustained virological suppression (plasma HIV-RNA < 50 copies/mL for ≥12 months). The analysis revealed widespread metabolic dysregulation, with 52% exhibiting excess weight and 64% showing atherogenic dyslipidemia. Integrase strand transfer inhibitor-based regimens were significantly correlated with an increased body mass index (p = 0.034) and elevated LDL cholesterol (aOR = 2.4, 95% CI [1.18–4.95], p = 0.022). Furthermore, we observed a pronounced metabolic age gap (+4.5 ± 2.8 years), defined as the deviation of bioimpedance-estimated metabolic age from the patients’ chronological age. This gap (p = 0.028), alongside historical immunodeficiency indicated by a low nadir CD4+ count (aOR = 0.998, 95% CI [0.991–0.999], p = 0.021), strongly predicted exercise intolerance, independent of current immune reconstruction. Sarcopenic obesity (present in 18% of the cohort) and an elevated triglycerides-to-HDL ratio (aOR = 2.14, 95% CI [1.15–3.98], p = 0.016) emerged as robust independent negative predictors of functional capacity. Additionally, subclinical myocardial remodeling, evidenced by impaired Global Longitudinal Strain, significantly predicted reduced aerobic capacity (aOR = 0.72, 95% CI [0.58–0.89], p = 0.003). Consequently, contemporary HIV management must transition beyond virological control to integrated cardiometabolic screening. Utilizing cardiopulmonary exercise testing, echocardiography, and metabolic biomarkers is critical for the early identification of subclinical “functional HIV-associated frailty” and mitigating the trajectory toward overt cardiovascular diseases. Full article

Background: Coronary in-stent restenosis (ISR) remains a major limitation of percutaneous coronary intervention (PCI) with drug-eluting stents (DES), adversely affecting long-term outcomes. Most available prediction models rely on invasive procedural variables and have been developed predominantly in high-income populations, limiting their generalizability. This study aimed to identify independent predictors of coronary ISR and to develop and internally validate a clinically applicable risk stratification model based on routinely available clinical, laboratory, and procedural factors in a cohort of patients from Kazakhstan. Methods: In this retrospective case–control study, 910 patients with coronary artery disease (CAD) who underwent follow-up coronary angiography after PCI between January 2018 and July 2025 were included. The study comprised 455 patients with angiographically confirmed coronary in-stent restenosis and 455 patients without restenosis selected using a consecutive sampling approach. Clinical characteristics, laboratory parameters, echocardiographic findings, and angiographic data were analyzed. Independent predictors were identified using multivariable binary logistic regression. Model discrimination was assessed using receiver operating characteristic (ROC) curve analysis, and internal validation was performed using bootstrap resampling. Results: The mean age was 62.9 ± 8.9 years, and 75.2% of patients were male. Restenosis was independently associated with prior myocardial infarction (MI) (OR 2.20; 95% CI 1.65–2.80), type 2 diabetes mellitus (T2DM) (OR 2.60; 95% CI 1.93–3.47), and smoking (OR 1.40; 95% CI 1.01–1.89). Patients with restenosis demonstrated a less favorable inflammatory and metabolic profile, including higher NLR, MHR, atherogenic index, and TyG index (all p < 0.05). LVEF was significantly lower, while multivessel disease and the number of implanted stents was higher (p < 0.001). A risk stratification model incorporating T2DM, the number of implanted stents, MPV, neutrophil count, HDL-C, LVEF demonstrated good discrimination (AUC 0.828) and 74.4% accuracy. Conclusions: The proposed model demonstrated good discrimination and satisfactory internal validity with limited optimism after internal bootstrap validation. It may serve as a useful tool for patient risk stratification after PCI. External validation in independent cohorts is required before widespread clinical implementation. Full article

The quality of edible oils is determined not only by the raw material, but also by the applied processing technology. Rapeseed oil is widely valued for its favorable fatty acid profile, however, the effects of combined pressing conditions and low-temperature bleaching on its lipid profile and calculated nutritional quality indices remain insufficiently characterized. This study aimed to evaluate the effects of oil production method and bleaching earth addition on the fatty acid profile, nutritional quality indices, and oxidizability-related indices of rapeseed oil from an applied food processing perspective. Rapeseed oil samples were obtained from a commercial producer using cold pressing, hot pressing, and mixed two-stage pressing. The oils were subjected to low-temperature bleaching with 1–5% bleaching earth. The fatty acid profile was determined by gas chromatography, and selected fatty acid-based indices were calculated and grouped into three categories: fatty acid class ratios, nutritional quality indices, and oxidizability-related indices. These included ratios describing the balance between omega-6 s omega-3 polyunsaturated fatty acids (Σ PUFA n-6/n-3), unsaturated and saturated fatty acids (Σ UFA/Σ SFA), and polyunsaturated and saturated fatty acids (Σ PUFA/Σ SFA). Health-oriented indices such as the Desirable Fatty Acids/Undesirable Fatty Acids ratio (Σ DFA/Σ OFA), hypocholesterolemic/hypercholesterolemic ratio (h/H), Nutritive Value Index (NVI), Atherogenic Index (AI), and Thrombogenic Index (TI), and oxidizability-related indices including the Unsaturation Index (UI), Peroxidizability Index (PI), Oxidizability Index (OI), calculated Oxidizability Value (Cox), and Oxidative Stability Index (OS). The results showed that the production method significantly influenced saturated fatty acid content and selected fatty acid-based nutritional quality indices. Cold-pressed oil was characterized by the lowest saturated fatty acid content and the most beneficial values of selected nutritional quality indices. Hot-pressed oil showed higher saturated fatty acid content and less favorable values for selected indices, whereas mixed oil generally showed values between those of cold-pressed and hot-pressed oils. However, differences in the main unsaturated fatty acid fractions were limited and, for most monounsaturated and polyunsaturated fatty acid parameters, were not statistically significant. Across all processing variants, the nutritional quality indices remained advantageous, with omega-6/omega-3 polyunsaturated fatty acid ratio values of 2.1–2.4, atherogenic index values of approximately 0.04–0.05, and thrombogenic index values of approximately 0.08–0.09. Although significant interactions between production method and bleaching earth addition were observed for selected oxidizability-related indices, the magnitude of bleaching-induced changes was limited. Overall, the findings indicate that low-temperature bleaching may be applied as a mild processing step without substantially compromising the fatty acid-based quality characteristics of rapeseed oil. The study provides practical insight into the relationship between pressing technology, bleaching conditions, and lipid quality assessment in industrial rapeseed oil production. Full article

In this study, the effect of sonication on the bioactive components, antioxidant capacity, phenolic components, and fatty acid composition of tea seeds sonicated for different periods of time was investigated. The total phenol content (TPC) and total flavonoid content (TFC) of non-sonicated (raw) and sonicated tea seeds were established to be between 58.31 (15 min) and 75.55 mg GAE/100 g (control) to 85.00 (15 min) and 127.95 mg/100 g (5 min), respectively. With the increase in sonication time, TPC and TFC of the tea seeds decreased, while the antioxidant capacities of the seeds increased partially. In general, an increase in the antioxidant value of tea seeds was observed with increasing sonication time. Catechin and p-coumaric acid contents of the tea seeds were assessed to be between 123.69 (25 min) and 360.87 (5 min) to 7.29 (15 min) and 13.26mg/100 g (5 min), respectively. The amount of palmitic acid, the highest saturated fatty acid in tea seed oils, was identified to be between 13.51 (15 min) and 13.77% (5 min). While the amount of oleic acid of the tea seed oils was assessed to be between 61.72 (15 min) and 62.98% (25 min), linoleic acid results of the tea seed oils were characterized to be between 19.32 (5 min) and 19.69% (control). Nutritive Value Index (NVI) and Atherogenic Index (AI) results of sonicated tea seed oils were calculated to be between 4.74 (5 min) and 4.81 (25 min) to 0.161 (15 min) and 0.178 (control), respectively. Considering its overall fatty acid profile and other chemical properties, tea seed oil appears to be a promising alternative edible oil with characteristics similar to commonly consumed cooking oils such as olive and sunflower oil. Full article

Background: Metabolic dysfunction is a complex process arising from coordinated interactions among insulin resistance, dyslipidemia, hepatic dysfunction, obesity, low-grade inflammation, and endocrine alterations. The triglyceride–glucose (TyG) index is a simple, reproducible surrogate of insulin resistance, but most studies have evaluated it through isolated association-based analyses. We characterized the endocrine–metabolic architecture associated with TyG in patients with thyroid dysfunction using a systems-phenotyping approach. Methods: In this retrospective, single-center, cross-sectional study of 387 adults evaluated for thyroid dysfunction, unsupervised phenotypes were derived by principal component analysis (PCA), K-means, Gaussian mixture models (GMM), and hierarchical (Ward) clustering using fully measured primary metabolic variables (fasting glucose, triglycerides, HDL- and LDL-cholesterol, body mass index, alanine, and aspartate aminotransferase). TyG was then examined as a descriptor of the identified architecture. Model-based latent profile analysis (BIC, entropy) and a censoring-aware, rank-based Gaussian graphical model (GGM) of partial correlations were additionally estimated. Results: Three overlapping, clinically interpretable phenotypic partitions of an underlying metabolic continuum were identified: a metabolically preserved phenotype (MP), an intermediate hepatic-dominant phenotype (IHD), and a severe insulin-resistance-dominant phenotype (SIRD), characterized by obesity, atherogenic dyslipidemia, and hyperuricemia. TyG values increased monotonically across the three partitions (medians 8.24, 8.74, and 8.87 in MP, IHD, and SIRD, respectively; p < 0.001), providing an accessible single-number summary of the metabolic gradient. Cluster separation was modest (silhouette = 0.17), consistent with a continuum, but the three-profile solution was supported by latent profile analysis (ΔBIC = −96.7; relative entropy = 0.75) and was reproduced across frameworks (adjusted Rand index of 0.75 with GMM and 0.46 with Ward). In the censoring-aware GGM, metabolic and thyroid variables formed two near-orthogonal blocks (maximum absolute metabolic–thyroid partial correlation: 0.16; median: 0.05). Conclusions: The systems phenotyping approach identified three clinically interpretable phenotypic partitions (MP, IHD, SIRD) along a metabolic continuum in patients evaluated for thyroid dysfunction. TyG values increased monotonically across partitions (medians 8.24, 8.74, 8.87) and provided a pragmatic single-number summary of the principal metabolic axis. The IHD phenotype indicates that hepatic dysregulation can emerge as a distinct early stage rather than solely a late consequence of insulin resistance. Metabolic and thyroid axes were near-orthogonal, positioning thyroid autoimmunity as a parallel modulatory layer. These findings support TyG as an accessible descriptor for multidimensional endocrine–metabolic risk stratification. Full article

Metabolic risk increases with age and may be accompanied by changes in adipocytokine secretion and insulin sensitivity. The primary exploratory aim of this prospective, uncon-trolled study was to determine whether repeated whole-body cryotherapy (WBC) changes circulating meteorin-like hormone (METRNL) concentrations in women of different ages. Secondary exploratory outcomes included irisin, asprosin, leptin, adiponectin, insulin, fasting blood glucose (FBG), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride–glucose index (TyG), atherogenic index of plasma (AIP), and the leptin/adiponectin ratio. A total of 48 women were divided into three groups: GR-60 (60–70 years, n = 14), GR-40 (40–50 years, n = 18), and GR-20 (20–30 years, n = 16). Participants underwent 30 WBC sessions, each lasting 3 min at minus 120 °C. Blood samples were collected before the first WBC session, after the 10th, 20th, and 30th sessions, and two weeks after the final session. Repeated WBC did not significantly change circulating METRNL or other adipocytokines in any age group. A preliminary decrease in insulin concentration and HOMA-IR was observed after 20 WBC sessions only in GR-60. These findings suggest that repeated WBC may be associated with favorable changes in selected insulin-resistance markers in older postmenopausal women; however, the absence of a non-WBC control group, small subgroup sizes, and the multiplicity burden preclude causal or therapeutic conclusions. Randomized controlled studies are needed to verify these exploratory observations. Full article

Agronomic practices and interannual climate variability significantly modulate the bioactive composition of agricultural by-products. This study evaluated the effects of farming systems (organic vs. conventional) and geographic locality across two harvest seasons (2022–2023) on the fatty acid (FA) profiles of peel and seeds from the “Mollar de Elche” pomegranate (Punica granatum L.) Protected Designation of Origin (PDO). Gas chromatography (GC-FID) analyses demonstrated that the harvest year, characterized by significantly reduced extreme temperature days in 2023, exerted a dominant, overriding effect on lipid biosynthesis compared to agronomic management. In the seeds, punicic acid was the unequivocal predominant FA, increasing dramatically from an average of ~75,700 mg/kg dry matter (DM) under severe heat stress (2022) to ~150,000 mg/kg DM under milder conditions (2023) (p < 0.001). In the peel, polyunsaturated fatty acid (PUFA) accumulation was strictly dependent on the interaction between localized geographic micro-conditions and climate, rendering the farming system a secondary factor. Crucially, the milder 2023 season significantly enhanced the unsaturated-to-saturated (U/S) ratio in both tissues and markedly improved cardiovascular lipid quality, lowering both the Atherogenic (AI) and Thrombogenic (TI) indices. These findings demonstrate that while organic farming can optimize lipid unsaturation under favorable climatic conditions, severe environmental stress nullifies these agronomic benefits, highlighting the need for climate-resilient strategies to valorize pomegranate by-products. Full article

In the present study, cardiovascular risk indices (Atherogenic Index of Plasma [AIP], Atherogenic Coefficient [AC], Castelli Risk Index-1 [CRI-1], and Castelli Risk Index-2 [CRI-2]) and bone mineral density (BMD SDS) were evaluated in patients with Familial Mediterranean Fever (FMF), and the association of these parameters with disease severity and MEFV gene mutations was investigated. A total of 126 participants (96 FMF patients and 30 healthy controls) were included in the study. FMF patients were classified as mild, moderate, or severe according to the PRAS severity score. Cardiovascular risk indices, biochemical parameters of bone metabolism, and BMD SDS values were compared among the groups. The relationship between BMD SDS and atherogenic indices was assessed by Spearman correlation analysis. The results were also analyzed according to MEFV gene mutations. No significant difference was detected among the groups in terms of sex or age (p > 0.05). FMF patients were found to have substantially higher cardiovascular risk indices than the control group, and these indices increased in parallel with disease severity (p < 0.05). The BMD SDS value of the severe FMF group was significantly lower than that of the other groups (p = 0.025). No difference was detected among the groups with respect to bone metabolism parameters (p > 0.05). No significant correlation was observed between BMD SDS and cardiovascular risk indices (p > 0.05). M694V was the most frequently detected mutation, and the BMD SDS value was lower in patients carrying mutations other than M694V (p = 0.011). The increased cardiovascular risk in FMF patients is associated with disease severity. Severe disease is accompanied by a reduction in bone mineral density. The lack of an association between cardiovascular risk and bone mineral density suggests that these systems may be affected through different mechanisms. It is important that FMF patients are monitored with respect to cardiovascular and bone health. Full article

Background: This study aimed to investigate the relationships of AHA/ACC blood pressure stages and circadian blood pressure patterns with clinical, metabolic, inflammatory, and structural echocardiographic parameters in newly diagnosed hypertensive (HT) patients, and to identify independent predictors of high-risk circadian disruptions. Methods: A total of 539 patients undergoing 24 h Ambulatory Blood Pressure Monitoring (ABPM) between 2022 and 2024 were retrospectively analyzed. Patients were grouped by nocturnal blood pressure dipping percentages and HT stages; laboratory markers (TyG index (Triglyceride–Glucose İndex), AIP (Atherogenic İndex of Plasma), SII (Systemic Immune-Inflammation Index), AISI (Aggregate Index of Systemic Inflammation), NLR (Neutrophil-to-Lymphocyte Ratio)) and echocardiographic data were evaluated via multivariable logistic regression. Results: The mean cohort age was 46.49 ± 13.98 years. Progressing HT stages were associated with significant increases in metabolic risk indicators: TyG index (p = 0.002) and AIP (p = 0.004). The prevalence of left ventricular hypertrophy (LVH) increased significantly from 7.3% in the normal group to 34.5% in Stage 2 HT (p < 0.001). The highest-risk “reverse-dipper” group had a significantly higher mean age (50.32 ± 14.55 years) than other groups (p < 0.001). In multivariable logistic regression, left atrial diameter (LAd) was the only common independent structural predictor of circadian disruption across all models (Extreme-Dipper OR: 1.19, p = 0.003; Non-Dipper OR: 1.11, p = 0.001). In the Reverse-Dipper model score analysis, both LAd (p < 0.001) and LVH (p = 0.001) demonstrated strong independent predictive potential. Inflammatory indices (SII, AISI, NLR) showed no independent predictive value (p > 0.05). Conclusions: Advanced HT stages and disrupted circadian rhythms are strongly associated with metabolic impairment, left atrial dilatation, and LVH. In older hypertensive patients presenting with left atrial enlargement and LVH, echocardiographic screening and close ABPM are crucial for early “reverse-dipper” pattern detection. Full article

Background/Objectives: Vitamin D has been implicated in lipid metabolism, but data regarding its association with atherogenic lipoproteins in elite athletes remain limited. Elite athletes represent a unique research model to investigate these associations with reduced confounding from obesity, chronic disease, smoking, and physical inactivity. Methods: This cross-sectional study included 773 male professional athletes from mixed sports disciplines (mean age 25.5 ± 5.0 years). Serum 25-hydroxyvitamin D [25(OH)D] concentrations and lipid parameters, including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and lipoprotein(a) [Lp(a)], were assessed. Associations were analyzed using correlation analyses, subgroup comparisons according to predefined 25(OH)D categories (<30, 30–50, and >50 ng/mL), and multivariable linear regression models adjusted for age, body mass index, season, and training-related variables. Results: Higher serum 25(OH)D concentrations were independently associated with lower LDL-C (p = 0.028), triglyceride (p = 0.002), and Lp(a) concentrations (p = 0.036), whereas no independent association was observed with HDL-C (p = 0.559). Athletes with 25(OH)D concentrations ≥30 ng/mL demonstrated lower LDL-C, triglyceride, and Lp(a) levels compared with athletes below this threshold (all p < 0.05). Higher vitamin D status was additionally associated with greater peak exercise performance (4.29 ± 1.15 vs. 3.36 ± 0.68 W/kg; p < 0.001). Conclusions: Higher 25(OH)D concentrations were independently associated with a more favorable lipid profile in elite athletes, including lower LDL-C, triglyceride, and Lp(a) concentrations. Prospective studies are warranted to further investigate the relationship between vitamin D status and lipid metabolism in athletic populations. Full article

Background/Objectives: Obesity-related insulin resistance is accompanied by chronic low-grade inflammation, but the extent to which weight loss modifies circulating cytokines in a sex-specific manner remains insufficiently understood. The aim of this study was to assess sex-specific cytokine responses and metabolic adaptation in adults with obesity and insulin resistance following a six-month weight-reduction program (WRP). Methods: Thirty-six participants (24 women and 12 men) with a value of Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) ≥ 2 underwent an individualized low-calorie diet combined with moderate physical activity and health education. Anthropometric, body composition, biochemical, oxidative stress, and cytokine parameters were evaluated before and after the intervention. Results: Both women and men showed significant reductions in body mass, Body Mass Index (BMI), waist circumference, visceral fat area (VFA), body fat mass (BFM), fasting glucose, HOMA-IR, modified Atherogenic Index of Plasma (new-AIP), malondialdehyde (MDA), and Oxidative Stress Index (OSI). Women additionally showed significant decreases in fat-free mass (FFM), skeletal-muscle mass (SMM), total body water (TBW), glycated hemoglobin A_1c (HbA1c), and triacylglycerols, whereas cholesterol in high-density lipoproteins (HDL-C) increased significantly in men. Cytokine changes were selective rather than uniform. Interleukin-1 receptor antagonist (IL-1ra), Interleukin 6 (IL-6), and Tumor Necrosis Factor alpha (TNF-α) decreased in both women and men. In sex-stratified analyses, IL-1β decreased significantly only in women, whereas IL-7 decreased significantly only in men. ClinicalTrials.gov Registration: [NCT07645105] (retrospectively registered on [11 June 2026]). Conclusions: A 6-month lifestyle-based weight-reduction program in adults with overweight or obesity and insulin resistance was associated with metabolic improvement, reduced oxidative stress, and partial attenuation of obesity-related low-grade inflammation. The observed cytokine and metabolic changes suggest sex-related patterns of immunometabolic adaptation to weight reduction. However, these findings should be interpreted cautiously because of the relatively small sex-stratified subgroups and the number of cytokine endpoints analyzed, and they require confirmation in larger, sex-balanced studies. Full article