Search Results (2,408)

Prebiotic-mediated gut microbiota modulation is a promising approach for obesity management. Red onions have been identified as a potential source of inulin and inulin neoseries oligosaccharides. This study evaluated the in vivo effects of short-chain inulin and inulin neoseries oligosaccharides (SCIINOs) on the fecal microbiota of obese rats and assessed their potential role in obesity attenuation. Male Wistar rats were fed a high-fat diet (HFD) for 16 weeks to induce obesity, while control rats received a normal diet (ND). From weeks 16 to 24, HFD-fed obese rats were randomly assigned to four groups: SCIINOs at 0.5 g/day, SCIINOs at 1 g/day, atorvastatin (10 mg/kg/day), or no intervention. Obesity status was confirmed by increased body weight, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and higher food and energy intakes. SCIINOs were enzymatically hydrolyzed and purified by yeast treatment and chromatographic methods. After 8 weeks of SCIINO administration (1 g/day), the fecal microbiota was markedly enriched in Bifidobacterium and Allobaculum, whereas Blautia abundance significantly decreased. SCIINOs also increased taxa negatively associated with obesity-related parameters, including Dubosiella, Rothia, Parabacteroides, Eubacterium, and Coriobacteriaceae UCG-002, which correlated with reductions in body weight, triglycerides, TC, LDL-C, and fasting blood glucose, along with increased high-density lipoprotein cholesterol (HDL-C). In parallel, SCIINOs increased fecal acetate and butyrate levels, which was consistent with the enrichment of Bifidobacterium and butyrate-producing bacteria. Overall, SCIINOs derived from red onions show promise as a prebiotic candidate for obesity attenuation through selective microbiota modulation and enhanced short-chain fatty acid production. Full article

Type 2 diabetes mellitus (T2DM) is increasingly managed through lifestyle measures, yet the value of pairing structured exercise with a well-characterised phytotherapeutic adjunct remains poorly defined. We examined whether adding Nigella sativa (NS) to combined aerobic and resistance exercise (EX) yields greater improvements in metabolic, inflammatory, and oxidative-stress markers than exercise alone in men with T2DM. In this three-arm randomised controlled trial, 90 sedentary, non-smoking men (aged 40–60 years; T2DM duration > 2 years; glycated haemoglobin (HbA1c) 6.5–9.0%; body mass index (BMI) < 30 kg/m²) were allocated 1:1:1 to control, EX, or EX + NS (2 g/day; n = 30 per group) for four weeks. Fasting blood samples obtained before and after the intervention were used to measure glycaemic indices (fasting blood glucose (FBG) and fructosamine), a lipid panel (total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c)), inflammatory markers (tumour necrosis factor-α (TNF-α), interleukin-4 (IL-4), and adiponectin), and oxidative-stress markers (thiobarbituric acid–reactive substances (TBARS) and catalase activity). Outcomes were analysed by two-way repeated-measures analysis of variance (time × group), with partial eta-squared (η_p²) and 95% confidence intervals (CIs) reported for all principal effects. Relative to control, both exercise arms significantly improved body composition and glycaemic, lipid, inflammatory, and oxidative-stress profiles (all p < 0.05). The time × group interaction was significant for every outcome except systolic and diastolic blood pressure and triglycerides. Compared with EX alone, EX + NS produced significantly greater improvements in FBG, HDL-C, TBARS, and catalase activity; changes in fructosamine, total cholesterol, TNF-α, IL-4, and adiponectin favoured EX + NS directionally but did not reach significance after correction for multiple comparisons. Triglycerides, LDL-C, and blood pressure did not differ between the two exercise arms. These hypothesis-generating findings support NS as a candidate adjunct to structured exercise for selected metabolic and redox outcomes, and warrant larger, longer, sex-balanced confirmation. Full article

Flavanones, a subclass of flavonoids predominantly found in citrus fruits, have attracted growing interest for their potential role in cardiometabolic health. While evidence linking overall flavonoid intake to cardiometabolic benefits is relatively consistent, flavanones have received less attention, and available findings remain scattered across heterogeneous outcomes and study designs. This review synthesizes meta-analytic evidence from prospective cohort and intervention studies to provide a comprehensive assessment of the relationship between flavanone intake and cardiometabolic health. A comprehensive literature search was performed to identify published meta-analyses examining flavanone intake in relation to cardiometabolic outcomes and related biomarkers. Twenty-five eligible meta-analyses, including 12 meta-analyses of prospective cohort studies and 13 meta-analyses of randomized controlled trials, were included. Evidence from prospective cohort studies showed that higher flavanone intake was associated with a lower risk of cardiovascular disease (relative risk reductions ranging from 12% to 22%) and stroke (relative risk reductions ranging from 12% to 26%). Intervention studies demonstrated favorable effects on total cholesterol, LDL cholesterol, systolic blood pressure, fasting glucose, and C-reactive protein concentrations, although findings for anthropometric outcomes were inconsistent. Overall, the current evidence supports a potential protective role of flavanone intake in cardiometabolic health. However, these findings should be interpreted with caution given the heterogeneity of studies and outcome measures, as well as methodological limitations within the underlying meta-analyses. Full article

Genetic analysis of patients with lipid metabolism disorders is becoming increasingly prevalent in clinical practice. In particular, researchers are directing considerable attention toward studying familial hypercholesterolemia (FH). Despite its high population frequency (heterozygous FH occurs in approximately 1 in 250–300 individuals, with even higher prevalence reported in some regions of the world), the heterogeneity of this condition presents major obstacles to its diagnosis. Owing to the advancement of molecular methods and laboratory technologies, it has become possible to establish the genetic basis of metabolic disorders. In the present study, using next-generation sequencing (NGS), a cohort of 261 patients with a confirmed clinical diagnosis of familial hypercholesterolemia was investigated. Among the 82 variants identified in FH-associated genes (LDLR, APOB, PCSK9, LDLRAP1), the most prevalent was the LDLR NP_000518.3:p.Leu401His variant, which was detected in 21 patients. The second most frequent variant in our cohort (19 patients) was APOB NP_000433.2:p.Arg3527Gln. Overall, 56.1% of patients with a DLCN score of 3–5 (possible FH) carried pathogenic variants, demonstrating the insufficient sensitivity of clinical criteria alone. The presence of early coronary heart disease in 22.73% of genotype-negative patients, together with the considerable number of individuals displaying a pronounced clinical FH phenotype despite negative genetic testing, underscores the importance of further exploring the genetic architecture of FH across different populations. Full article

Background: Lifestyle intervention is recommended as first-line management for individuals with low-to-moderate cardiovascular (CV) risk and elevated low-density lipoprotein cholesterol (LDL-C), although dietary intervention alone often produces only modest lipid reductions. NUT2 is a proprietary multi-component nutraceutical formulated to target complementary pathways involved in lipid metabolism, oxidative stress and cardiometabolic risk. This study evaluated its efficacy and safety as an adjunct to dietary intervention. Methods: In this randomized, double-blind, placebo-controlled, parallel-group study, 90 adults with low-to-moderate CV risk and elevated LDL-C were randomized to receive NUT2 (n = 45) or placebo (n = 45) for 12 weeks, together with standardized dietary advice. The primary endpoint was a change in LDL-C at Week 12. Secondary outcomes included changes in total cholesterol, triglycerides, fasting glucose, fasting insulin, high-sensitivity C-reactive protein (hsCRP), homocysteine, anthropometric parameters, blood pressure and metabolic syndrome prevalence. Results: Baseline characteristics were generally comparable, although baseline lipid values differed between groups and were accounted for using baseline-corrected change scores. At Week 12, LDL-C decreased by 13.2% with NUT2 and increased by 1.6% with placebo; the baseline-corrected between-group difference was −23 mg/dL (95% CI −29 to −16; p < 0.001). Total cholesterol was also significantly reduced (corrected difference −26 mg/dL, 95% CI −36 to −17; p < 0.001). Significant reductions in homocysteine and lower fasting insulin concentrations were observed with NUT2. Metabolic syndrome prevalence was 13.3% with NUT2 versus 37.8% with placebo at Week 12 (p = 0.008), although this exploratory finding was based on small participant numbers. No significant between-group difference was observed for hsCRP. NUT2 was well tolerated, with no serious treatment-related adverse events. Conclusions: In adults with low-to-moderate cardiovascular risk whose LDL-C remained suboptimal despite dietary intervention, NUT2 produced significant and clinically relevant improvements in LDL-C and total cholesterol over 12 weeks. The significant reduction in homocysteine further supports the broader biological activity of the multi-component formulation. Favourable changes in insulin and metabolic syndrome status suggest potential additional metabolic effects, although these findings warrant further investigation in larger studies specifically designed for populations with metabolic dysfunction. NUT2 was safe and well tolerated. (Clinical trial registry: NCT07492264; trial registration number: NCT07492264, registration date: 23 March 2026.) Full article

Yeast hydrolysate (YH) has attracted increasing interest as a functional feed additive because of its potential benefits for maternal nutrition and offspring development. However, its effects on milk composition and the physiological responses of donkey foals remain poorly understood. This study evaluated the effects of dietary YH supplementation in lactating Dezhou jennies on milk composition, as well as growth performance, serum biochemical parameters, and fecal microbiota in their foals. Sixteen healthy jennies and their foals were randomly assigned to a control group (OCON) or a YH-supplemented group (OYE; 0.5 g/kg diet) for 60 days. Maternal dietary YH supplementation significantly increased milk fat and milk protein contents. Foals in the OYE group showed a tendency toward greater back skin thickness, although the difference was not statistically significant, while body weight and neck skin thickness were unaffected. Serum biochemical analysis showed increased HDL-C and total cholesterol concentrations together with decreased triglyceride and LDL-C concentrations in the OYE group. In addition, serum ALT activity was significantly decreased, whereas AST levels were significantly increased. Fecal microbiota analysis indicated that YH supplementation did not significantly affect overall microbial diversity but altered the relative abundance of several bacterial taxa, including Prevotella, Alistipes, and Olsenella. Overall, maternal dietary YH supplementation was associated with changes in milk composition, selected serum biochemical parameters, and the relative abundance of specific fecal bacterial taxa in donkey foals. However, no significant improvement in offspring growth performance was observed, and the underlying mechanisms require further investigation. Full article

Background: Metabolic syndrome (MetS) is associated with increased cardiometabolic risk, although substantial metabolic abnormalities may also occur in individuals with normal body weight. This study compared anthropometric characteristics, body composition, lipid profile, LDL subfractions, inflammatory markers, liver biomarkers, and novel cardiometabolic indices in participants with MetS according to obesity status and characterized the metabolic phenotype of normal-weight participants with MetS. Methods: This cross-sectional study included 188 Slovak adults. Anthropometric, biochemical, lipoprotein, inflammatory, liver function, and cardiometabolic parameters were assessed. Group differences were analyzed using the Mann–Whitney U test, and associations were evaluated by Spearman’s correlation analysis. Results: Compared with controls, participants with MetS had significantly greater adiposity, visceral fat accumulation, atherogenic lipid alterations, elevated inflammatory and liver biomarkers, higher blood pressure, and increased cardiometabolic indices (p < 0.05). Within the MetS group, overweight/obese participants exhibited greater visceral adiposity and higher liver enzyme concentrations, whereas most lipid parameters, LDL subfraction distribution, and several cardiometabolic indices were comparable between weight groups. VAI, TyG, TyG-BMI, TyG-WC, TyG-WHtR, LAP, AIP, and CMI showed strong correlations with visceral adiposity, triglycerides, atherogenic LDL subfractions, and smaller LDL particle size. Conclusions: Obesity worsens body composition and hepatic dysfunction in MetS but has limited impact on several metabolic and atherogenic characteristics. LDL-C concentration alone may not sufficiently reflect the true atherogenic risk. These findings support the metabolically unhealthy normal-weight phenotype and highlight the value of novel cardiometabolic indices and LDL subfraction analysis for improved cardiometabolic risk assessment. Full article

Background/Objectives: Individual responses to weight-loss diets vary widely due to genetic, metabolic, and lifestyle factors, motivating individualized approaches over “one-size-fits-all” advice. We aimed to evaluate long-term (12-month) weight loss, weight maintenance, and cardiometabolic outcomes of a cohort following a nutrigenetically tailored Mediterranean-style dietary program in a real-world, community setting. Methods: The retrospective data cohort included 426 Israeli adults (mean BMI 32.11 ± 4.58 kg/m²; 66.9% women) who participated in a nutrigenetic weight-loss program. Following nutrigenetic direct-to-consumer screening of 425 genetic variants, the participants received a 3-month personalized adjusted diet with remote dietitian-led follow-up by telephone, after which they transitioned to a 9-month self-monitoring and maintenance period. Blood biochemical parameters were reported from routine Health Maintenance Organization (HMO) laboratory testing. Weight/BMI trajectories (0–3, 3–6, 6–9, 9–12 months) were evaluated using linear mixed-effects models; biomarker changes were analyzed with repeated-measures MANOVA and follow-up univariate ANOVAs. Results: Model-estimated cumulative weight loss at 12 months was 10.12 kg (11.4% of baseline) with a mean BMI reduction of 3.68 kg/m² (p < 0.001). The steepest decline occurred during months 3–6 (−1.13 kg/month). Triglycerides (−14.06 mg/dL), total cholesterol (−4.68 mg/dL), LDL cholesterol (−2.49 mg/dL), fasting glucose (−5.14 mg/dL), and HbA1c (−0.14%) improved significantly (p < 0.05), while HDL cholesterol levels remained stable (+0.86 mg/dL; p > 0.05) at 12 months. Among participants with elevated baseline biochemical values, levels transitioned to normal range by 12-month follow-up for triglycerides (46.4%), total cholesterol (29.4%), LDL cholesterol (34.5%), glucose (39.6%), and HbA1c (35.5%). Conclusions: In a real-world cohort, inclusion of genetic information to personalize dietary guidance was implemented through a flexible, individually tailored program supported by an initial 3-month phase of remote dietitian-led counseling. This approach was associated with durable, clinically meaningful reductions in weight and cardiometabolic risk markers over 12 months. Randomized trials are warranted to confirm causality and evaluate cost-effectiveness. Full article

Ficus deltoidea Jack (Moraceae), locally known as Mas Cotek, is a medicinal plant traditionally used throughout Southeast Asia for the management of diabetes mellitus. This review summarises the available evidence on the antidiabetic properties of F. deltoidea based on eleven in vitro, nine in vivo and one clinical study identified through a structured literature search. In vitro investigations show that F. deltoidea inhibits α-glucosidase and α-amylase, stimulates insulin secretion in pancreatic β-cells via both K⁺-ATP channel-dependent and -independent pathways, enhances glucose uptake in hepatocytes and adipocytes, promotes adiponectin secretion and inhibits protein tyrosine phosphatase 1B (PTP1B). Vitexin and isovitexin, the predominant C-glycosyl flavonoids in F. deltoidea leaves, appear to be the main bioactive compounds responsible for these effects. Meanwhile, in vivo studies in streptozotocin-induced diabetic rodents report dose-dependent reductions in fasting blood glucose, improved glucose tolerance, restoration of pancreatic islet architecture, modulation of hepatic gluconeogenic and glucose-metabolic genes, and protection against diabetic nephropathy and bone loss. Inter-varietal differences in chemical composition and biological activity were observed, with var. trengganuensis and var. intermedia reported as the most active. The only available clinical trial in adults with prediabetes (1000 mg/day for 8 weeks) showed a reduction in LDL and total cholesterol but no significant change in fasting blood glucose or insulin. The discrepancy between preclinical and clinical findings highlights the need for standardised extracts, pharmacokinetic studies and adequately powered clinical trials in patients with established type 2 diabetes mellitus. Full article

Background/Objectives: Dental implant and guided bone regeneration (GBR) procedures rely on successful bone healing and remodeling. Systemic metabolic factors, including vitamin D deficiency and elevated low-density lipoprotein cholesterol (LDL-C), may adversely affect osseointegration and bone regeneration. This study aimed to investigate the association between implant/GBR failure and serum vitamin D and LDL-C levels. Methods: A retrospective clinical study was conducted on 40 patients treated with dental implants and/or GBR procedures between 2023 and 2025 in the Eastern Province of Saudi Arabia. Twenty patients with failed outcomes and twenty patients with successful outcomes were included. Smokers, immunocompromised patients, individuals with a history of radiotherapy or chemotherapy, and patients with uncontrolled diabetes mellitus (HbA1c > 6.5%) were excluded. Failure was defined as progressive bone loss, loss of osseointegration, implant mobility, graft resorption, or persistent infection and was categorized as early or late failure. Serum vitamin D and LDL-C levels were obtained after treatment and analyzed using bivariate and exploratory multinomial logistic regression analyses. Results: Significant differences in serum vitamin D and LDL-C levels were observed among failure groups. Mean vitamin D levels were highest in the non-failure group (91.3 ± 47.9 nmol/L), followed by early failure (53.3 ± 33.7 nmol/L) and late failure (28.3 ± 11.3 nmol/L) (p = 0.001). Mean LDL-C levels increased progressively from the non-failure group (107.0 ± 26.8 mg/dL) to early failure (137.6 ± 47.3 mg/dL) and late failure groups (161.3 ± 57.0 mg/dL) (p = 0.003). Vitamin D status and LDL-C category were significantly associated with failure type (p = 0.001 and p = 0.012, respectively). Conclusions: Lower serum vitamin D levels and higher LDL-C levels were associated with implant and GBR failure, particularly in late failure cases. However, because serum vitamin D and LDL-C levels were measured after treatment outcomes and the study was limited by its retrospective design and relatively small sample size, these findings should be interpreted with caution and do not establish a causal relationship. Larger prospective studies are needed to determine whether preoperative assessment and optimization of vitamin D and lipid status may improve implant and regenerative treatment outcomes. Full article

Background: Non-proliferative diabetic retinopathy (NPDR) is a common microvascular complication of type 2 diabetes mellitus (T2DM) associated with chronic inflammation, metabolic dysregulation, and multiple interacting systemic factors. This study evaluated the associations of inflammatory biomarkers, serum 25-hydroxyvitamin D [25(OH)D], electrolyte homeostasis, and lipid-derived indices with NPDR. Methods: In this cross-sectional study with prospective recruitment, 98 patients with T2DM were classified into NPDR (n = 55) and non-DR (n = 43) groups. Clinical characteristics, hematological inflammatory indices, serum interleukin-6 (IL-6), C-reactive protein (CRP), 25(OH)D, electrolyte concentrations, lipid profile, and derived biomarkers—including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune–inflammation index (SII), LDL-C/HDL-C ratio, and calculated serum osmolarity—were compared. Receiver operating characteristic (ROC) analysis and multivariable logistic regression were performed to assess discriminatory performance and independent associations with NPDR. Results: Patients with NPDR had significantly lower serum 25(OH)D concentrations than the non-DR group (16.6 ± 7.5 vs. 21.0 ± 5.2 ng/mL, p < 0.001). Serum IL-6 levels (4.2 ± 3.1 vs. 2.8 ± 1.4 pg/mL, p = 0.047), NLR (p = 0.043), LDL-C/HDL-C ratio (p = 0.031), and calculated serum osmolarity (p = 0.033) were significantly higher, whereas lymphocyte count and the lymphocyte-to-monocyte ratio were significantly lower. Among individual biomarkers, serum 25(OH)D showed the best discriminatory performance (AUC = 0.712). A multivariable model including insulin therapy, IL-6, serum 25(OH)D, and the LDL-C/HDL-C ratio demonstrated good discrimination (AUC = 0.813), with 81.8% sensitivity and 81.4% specificity. Bootstrap validation supported the stability of the model. Conclusions: NPDR was associated with lower serum 25(OH)D concentrations, systemic inflammation, and a less favorable LDL-C/HDL-C ratio. A multivariable model integrating inflammatory, metabolic, and nutritional biomarkers showed better discriminatory performance than individual biomarkers. The association between insulin therapy and NPDR likely reflects greater diabetes severity rather than a direct effect of insulin. These findings are exploratory, and prospective studies in larger independent cohorts are needed to determine whether these biomarkers improve risk stratification beyond established clinical factors. Full article

Objectives: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, yet population-specific evidence regarding the contribution of MIA3 genetic variation in Middle Eastern populations remains limited. This study investigated the association of the MIA3 rs17465637 polymorphism with CAD susceptibility and its relationship with lipid-related phenotypes in a Saudi population. Methods: A case–control study was conducted between June 2020 and August 2022, including 200 patients with angiographically confirmed CAD and 200 age- and sex-matched healthy Saudi controls. Genotyping of rs17465637 was performed using a TaqMan real-time polymerase chain reaction assay. Genotype distributions were evaluated using chi-square analysis under multiple inheritance models. Multivariable logistic regression was subsequently performed to estimate adjusted odds ratios after controlling age, BMI, smoking, physical inactivity, systolic BP, diastolic BP, blood glucose, triglycerides, total cholesterol, LDL-C, and HDL-C. Associations between rs17465637 genotypes and serum lipid parameters were also examined. Results: Genotype frequencies of rs17465637 differed modestly between cases and controls; however, unadjusted comparisons under codominant, dominant, recessive, and allelic inheritance models did not reach statistical significance, and none remained significant after Bonferroni correction. In contrast, multivariable logistic regression demonstrated an independent association between the rs17465637 C allele and CAD after adjustment for conventional cardiovascular risk factors. In genotype–phenotype analyses, carriers of the C allele exhibited higher association with low-density lipoprotein cholesterol concentrations and less favorable lipid profiles than AA homozygotes, supporting a relationship between the variant and lipid metabolism. These findings are consistent with a potential contribution of rs17465637 to CAD susceptibility through lipid-related pathways. Conclusions: Although unadjusted genotype comparisons were not statistically significant after correction for multiple testing, multivariable analysis provides evidence supporting an independent association between the MIA3 rs17465637 variant and CAD susceptibility in this Saudi cohort. The observed associations with adverse lipid profiles further provide evidence linking this specific locus to the molecular mechanisms underlying cardiovascular disease. Replication in larger, multi-center studies incorporating genome-wide ancestry-informative markers and functional investigations is warranted to further minimize the possibility of residual population stratification, confirming these findings and clarifying the biological mechanisms underlying this association. Full article

Background: Risk profiles of premature coronary heart disease (PCHD, ≤45 years) among high-altitude acute coronary syndrome (ACS) populations remain poorly characterized. This study explored clinical features and independent predictors of early-onset ACS in Lhasa. Methods: We retrospectively enrolled 467 first-ACS patients (1 July 2022–30 June 2024). Patients were further dichotomized into PCHD and non-PCHD groups for comparison. Univariable and multivariable logistic regression identified PCHD risk factors. Results: Compared with non-PCHD patients, PCHD patients featured higher proportions of male non-Tibetans, higher smoking and alcohol consumption rates, lower prevalence of hypertension and diabetes, and elevated SpO₂ (all p < 0.05). They had significantly higher CHOL, TG, LDL-C, UA and Hb (all p < 0.05), accompanied by lower WBC, PLT and D-dimer (all p < 0.001). Multivariate regression confirmed diabetes mellitus (OR = 1.158, p = 0.014), TG (OR = 1.625, p < 0.001), WBC (OR = 1.995, p = 0.007), D-dimer (OR = 2.841, p = 0.043) and SpO₂ (OR = 0.937, p = 0.019) as independent predictors of PCHD. Conclusions: Integrated monitoring of glucose, lipids, hypoxia and thromboinflammatory biomarkers may supply preliminary auxiliary reference for early prevention of PCHD in local highland youth, while large multi-center verification is still needed to confirm its clinical value. Full article

Background/Objectives: Achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) targets in patients with chronic coronary syndrome (CCS) remains challenging despite intensive lipid-lowering therapy. Bempedoic acid (BA) offers an oral therapeutic option, although data on its clinical performance and patient-level determinants of response in real-world Spanish settings are limited. Methods: We conducted a prospective multicentre study across the four healthcare areas of Cáceres province, Spain, including consecutive CCS patients with LDL-C ≥ 55 mg/dL despite stable intensive lipid-lowering therapy. BA 180 mg/day was added to background treatment. Lipid parameters, metabolic profile, and safety outcomes were assessed after a median follow-up of 28 weeks (IQR 23–47). Multivariable analyses were performed to identify factors associated with of LDL-C reduction and target attainment. A total of 118 patients were analyzed for outcomes. Results: A total of 118 patients (mean age 62.4 ± 10.0 years; 79.2% male) were included. BA reduced LDL-C by 22.8% (−16.36 mg/dL; p < 0.001), enabling 48.3% of patients to achieve LDL-C < 55 mg/dL. Higher baseline LDL-C (β = −0.515; p = 0.001) and the presence of diabetes mellitus (B = 13.8 mg/dL; p = 0.024) were independently associated with greater LDL-C reduction. Notably, 56.3% of patients presented with elevated baseline lipoprotein(a) levels (>50 mg/dL), describing a high underlying burden of residual risk. BA was well tolerated, with a modest increase in uric acid levels but no gout events and a high treatment persistence rate (94.4%). Conclusions: In a real-world CCS population receiving intensive lipid-lowering therapy, BA provides clinically meaningful LDL-C reduction with a favorable safety profile in this multicentre cohort from Cáceres province. Patients with higher baseline LDL-C and diabetes derive greater benefit, supporting a more personalized approach to therapy. These findings reinforce the role of BA in Spanish patients as an intermediate step in lipid-lowering strategies before escalation to more costly therapies, addressing the scarcity of local real-world data. Full article

This study evaluated the effects of olive leaf extract (OLE) on growth, intestinal health, and resistance against Vibrio parahaemolyticus challenge in juvenile Litopenaeus vannamei. To a basal diet containing 12% fishmeal, OLE was added at 0%, 0.10%, 0.20%, 0.40%, and 0.80%, forming diets with equal nitrogen and lipid contents. The diets were divided into five groups and named OLE0 (control group), OLE1, OLE2, OLE4, and OLE8. The findings revealed that relative to OLE0, the weight gain rate (WGR) and specific growth rate (SGR) increased in the OLE1 group, whereas the feed conversion ratio (FCR) declined (p < 0.05). The crude protein (CP) content for whole shrimp in the OLE8 group was significantly higher (p < 0.05), and the crude lipid (CL) content in the OLE1, OLE2 and OLE8 groups significantly decreased compared with OLE0 (p < 0.05). In serum indices, the OLE8 group had notably higher total protein (TP) content than the control (p < 0.05). Compared with the OLE0 group, high-density lipoprotein cholesterol (HDL-C) levels in the OLE1 and OLE2 groups were increased, whereas low-density lipoprotein cholesterol (LDL-C) levels in the OLE4 and OLE8 groups were significantly decreased compared with the control (p < 0.05). Hepatopancreatic malondialdehyde (MDA) in all experimental groups was significantly decreased compared with the control (p < 0.05). The superoxide dismutase (SOD) activity in all experimental groups increased (p < 0.05) and was the largest in the OLE1 group. The OLE1, OLE2 and OLE4 groups had significantly increased glutathione peroxidase (GPX) activity (p < 0.05). Catalase (CAT) activity in the OLE1 group was significantly higher than the control (p < 0.05). The toll, lzm, imd, cru a and propo mRNA expression levels in the hepatopancreas were significantly upregulated in each experimental group (p < 0.05). Intestinal microbial analysis indicated that the relative abundance of Bacteroidetes was elevated in the OLE4 and OLE8 groups, accompanied by a reduction in Vibrio proportion (p < 0.05). Post-challenge assays demonstrated that the OLE4 and OLE8 groups achieved remarkably higher cumulative survival rates than OLE0 (p < 0.05). In summary, OLE in a low-fishmeal diet can promote growth performance, intestinal health and disease resistance for shrimp. According to the broken-line regression model of WGR against OLE dosage, 0.08% was the optimal dietary OLE inclusion level of the OLE additive in juvenile L. vannamei. Full article