{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T21:50:02Z","timestamp":1793656202946,"version":"4.5.1"},"reference-count":160,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Metabolic syndrome (MetS) is a complex and heterogeneous condition characterized by the coexistence of obesity, type 2 diabetes mellitus (T2DM), hypertension, chronic low-grade inflammation, and metabolic dysfunction. Increasing evidence suggests that the gut microbiota plays a central role in the development and progression of MetS by influencing host metabolism, intestinal barrier integrity, immune activation, endocrine signaling, and vascular homeostasis. This narrative review summarizes current evidence regarding gut microbiota alterations across major obesity-related metabolic phenotypes, including obesity alone, obesity complicated by T2DM, and obesity associated with hypertension. Obesity is generally characterized by reduced microbial diversity, depletion of beneficial taxa such as Faecalibacteriumprausnitzii and Akkermansia muciniphila, impaired short-chain fatty acid (SCFA) signaling, increased intestinal permeability, and metabolic endotoxemia. The coexistence of T2DM is associated with a more pronounced depletion of butyrate-producing bacteria, altered bile acid metabolism, impaired incretin signaling, and enhanced inflammatory activation that may contribute to insulin resistance and hyperglycemia. In hypertensive obesity, gut dysbiosis appears to preferentially involve disturbances within the gut\u2013vascular axis, including reduced SCFA-producing taxa, increased trimethylamine N-oxide production, endothelial dysfunction, oxidative stress, and vascular inflammation. Although microbial signatures partially overlap among metabolic phenotypes, functional alterations in microbial metabolites and host\u2013microbiota interactions may better explain disease heterogeneity than isolated taxonomic changes. Current evidence supports the potential role of microbiota-targeted interventions and integrated multi-omics approaches in future precision medicine strategies for cardiometabolic disease prevention and management.<\/jats:p>","DOI":"10.3390\/medicina62081435","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:05:42Z","timestamp":1784819142000},"page":"1435","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Gut Microbiota in Metabolic Syndrome: Differences in Microbial Signatures and Clinical Profiles"],"prefix":"10.3390","volume":"62","author":[{"given":"Giuseppe Guido Maria","family":"Scarlata","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"},{"name":"Center for Chronic Liver Diseases, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7848-6600","authenticated-orcid":false,"given":"Andrej","family":"Belan\u010di\u0107","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Pharmacology with Toxicology, Faculty of Medicine, University of Rijeka, Bra\u0107e Branchetta 20, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-1118","authenticated-orcid":false,"given":"Emidio","family":"Scarpellini","sequence":"additional","affiliation":[{"name":"Internal and Nutritional Unit, \u201cMadonna del Soccorso\u201d General Hospital, 63074 San Benedetto del Tronto, Italy"},{"name":"Translational Research in Gastrointestinal Disorders (T.A.R.G.I.D.), Gasthuisberg University Hospital, KU Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3722-9701","authenticated-orcid":false,"given":"Almir","family":"Fajki\u0107","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8751-8149","authenticated-orcid":false,"given":"Tomislav","family":"Me\u0161trovi\u0107","sequence":"additional","affiliation":[{"name":"University Centre Vara\u017edin, University North, 42000 Vara\u017edin, Croatia"},{"name":"Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98105, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1878-5411","authenticated-orcid":false,"given":"Roberto","family":"Vicinanza","sequence":"additional","affiliation":[{"name":"Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90007, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0015-4183","authenticated-orcid":false,"given":"Davor","family":"\u0160timac","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5922-1524","authenticated-orcid":false,"given":"Ludovico","family":"Abenavoli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"},{"name":"Center for Chronic Liver Diseases, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1038\/s41467-025-67268-5","article-title":"Worldwide trends in metabolic syndrome from 2000 to 2023: A systematic review and modelling analysis","volume":"17","author":"Noubiap","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"155999","DOI":"10.1016\/j.metabol.2024.155999","article-title":"Global burden of metabolic diseases, 1990\u20132021","volume":"160","author":"Zhang","year":"2024","journal-title":"Metabolism"},{"key":"ref_3","unstructured":"(2025). GBD 2021 Adult BMI Collaborators. Global, regional, and national prevalence of adult overweight and obesity, 1990\u20132021, with forecasts to 2050: A forecasting study for the Global Burden of Disease Study 2021. Lancet, 405, 813\u2013838."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s13679-025-00673-5","article-title":"Beyond Discrete Diagnoses: Conceptualizing Obesity-associated Metabolic Disorders as a Unified, Dynamic Continuum","volume":"14","author":"Xie","year":"2025","journal-title":"Curr. Obes. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.cmet.2024.03.002","article-title":"Cardiometabolic characteristics of people with metabolically healthy and unhealthy obesity","volume":"36","author":"Petersen","year":"2024","journal-title":"Cell Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e220111","DOI":"10.1530\/JOE-22-0111","article-title":"The gut microbiome: A core regulator of metabolism","volume":"256","author":"Fujisaka","year":"2023","journal-title":"J. Endocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/s42255-018-0017-4","article-title":"Microbial regulation of organismal energy homeostasis","volume":"1","author":"Cani","year":"2019","journal-title":"Nat. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5223","DOI":"10.1007\/s12602-025-10855-1","article-title":"Gut Microbiome in Obesity: A Narrative Review of Mechanisms, Interventions, and Future Directions","volume":"18","author":"Vishwakarma","year":"2026","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"104601","DOI":"10.1016\/j.mvr.2023.104601","article-title":"Gut microbiota dysbiosis -associated obesity and its involvement in cardiovascular diseases and type 2 diabetes. A systematic review","volume":"151","author":"Hamjane","year":"2024","journal-title":"Microvasc. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1038\/s41575-023-00867-z","article-title":"Gut microbiota in overweight and obesity: Crosstalk with adipose tissue","volume":"21","author":"Cani","year":"2024","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Borrego-Ruiz, A., and Borrego, J.J. (2025). The Gut Microbiome in Human Obesity: A Comprehensive Review. Biomedicines, 13.","DOI":"10.3390\/biomedicines13092173"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/s41574-019-0156-z","article-title":"Gut microbial metabolites in obesity, NAFLD and T2DM","volume":"15","author":"Canfora","year":"2019","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e70159","DOI":"10.1002\/edm2.70159","article-title":"Gut Dysbiosis as a Shared Mechanism in Obesity and Hypertension: Exploring a Promising Therapeutic Avenue","volume":"9","author":"Sener","year":"2026","journal-title":"Endocrinol. Diabetes Metab."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Shehata, F., Dwyer, K.M., McGee, S.L., and Rivera, L.R. (2026). Gut Microbiome Dysbiosis in Metabolic Syndrome: Current Evidence and Emerging Perspectives. Nutrients, 18.","DOI":"10.3390\/nu18101540"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e37609","DOI":"10.1016\/j.heliyon.2024.e37609","article-title":"The complex link between the gut microbiome and obesity-associated metabolic disorders: Mechanisms and therapeutic opportunities","volume":"10","author":"Zhang","year":"2024","journal-title":"Heliyon"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e70106","DOI":"10.1111\/obr.70106","article-title":"Associations of Adiposity With Gut Microbiota Composition Among Adults-Results From a Federated Analysis of Individual Participant Data From Eight European Observational Studies","volume":"27","author":"Schwedhelm","year":"2026","journal-title":"Obes. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Chen, X., Wang, Y., Lv, Y., Wang, H., Yang, Y., Tang, J., Shen, H., and Dai, Z. (2026). Gut microbiota signatures across BMI categories in adults and combined diagnostic value with clinical indicators for early obesity risk stratification. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1734612"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1017\/thg.2018.26","article-title":"Metataxonomic Analysis of Individuals at BMI Extremes and Monozygotic Twins Discordant for BMI","volume":"21","author":"Finnicum","year":"2018","journal-title":"Twin Res. Hum. Genet."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/nyas.14107","article-title":"Gut microbiome and its role in obesity and insulin resistance","volume":"1461","author":"Lee","year":"2020","journal-title":"Ann. N. Y Acad. Sc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1017\/S0007114520000380","article-title":"Microbial dysbiosis-induced obesity: Role of gut microbiota in homoeostasis of energy metabolism","volume":"123","author":"Amabebe","year":"2020","journal-title":"Br. J. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1056\/NEJMra2402679","article-title":"The Physiology of Hunger","volume":"392","author":"Fasano","year":"2025","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e0047924","DOI":"10.1128\/jb.00479-24","article-title":"Unraveling the gut microbiota\u2019s role in obesity: Key metabolites, microbial species, and therapeutic insights","volume":"207","author":"Iqbal","year":"2025","journal-title":"J. Bacteriol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/s44324-025-00066-1","article-title":"Mechanisms and implications of the gut microbial modulation of intestinal metabolic processes","volume":"3","author":"Jyoti","year":"2025","journal-title":"npj Metab. Health Dis."},{"key":"ref_24","unstructured":"Apovian, C.M., Aronne, L.J., and Barenbaum, S.R. (2024). Clinical Management of Obesity, The Obesity Society. [3rd ed.]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1001\/jamasurg.2013.5","article-title":"The human gut microbiome: A review of the effect of obesity and surgically induced weight loss","volume":"148","author":"Sweeney","year":"2013","journal-title":"JAMA Surg."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Duan, M., Wang, Y., Zhang, Q., Zou, R., Guo, M., and Zheng, H. (2021). Characteristics of gut microbiota in people with obesity. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0255446"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5703","DOI":"10.1038\/s41598-024-54782-7","article-title":"Associations between bacterial and fungal communities in the human gut microbiota and their implications for nutritional status and body weight","volume":"14","author":"Moya","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_28","first-page":"CD015875","article-title":"Gut microbiome-based interventions for the management of obesity in children and adolescents aged up to 19 years","volume":"7","author":"Fahim","year":"2025","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1038\/s41591-019-0495-2","article-title":"Supplementation with Akkermansia muciniphila in overweight and obese human volunteers: A proof-of-concept exploratory study","volume":"25","author":"Depommier","year":"2019","journal-title":"Nat. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"128317","DOI":"10.1016\/j.micres.2025.128317","article-title":"Akkermansia muciniphila: A key player in gut microbiota-based disease modulation","volume":"301","author":"Shaheen","year":"2025","journal-title":"Microbiol. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"C1723","DOI":"10.1152\/ajpcell.00704.2025","article-title":"From gut to blood: Barrier dysfunction as a driver of systemic low-grade inflammation in cardiometabolic disease","volume":"329","author":"Jensen","year":"2025","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"9066","DOI":"10.1073\/pnas.1219451110","article-title":"Cross-talk between Akkermansia muciniphila and intestinal epithelium controls diet-induced obesity","volume":"110","author":"Everard","year":"2013","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.cmet.2024.12.010","article-title":"Akkermansia muciniphila supplementation in patients with overweight\/obese type 2 diabetes: Efficacy depends on its baseline levels in the gut","volume":"37","author":"Zhang","year":"2025","journal-title":"Cell Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1007\/s11739-023-03262-3","article-title":"Are gut dysbiosis, barrier disruption, and endotoxemia related to adipose tissue dysfunction in metabolic disorders? Overview of the mechanisms involved","volume":"18","author":"Viana","year":"2023","journal-title":"Intern. Emerg. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s11894-022-00859-0","article-title":"Gut Microbiome and Its Impact on Obesity and Obesity-Related Disorders","volume":"25","author":"Sankararaman","year":"2023","journal-title":"Curr. Gastroenterol. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"827","DOI":"10.2174\/0929867327666200721160313","article-title":"Relationship between Gut Microbiota, Gut Hyperpermeability and Obesity","volume":"28","author":"Gasmi","year":"2021","journal-title":"Curr. Med. Chem."},{"key":"ref_37","first-page":"377","article-title":"Reframing obesity through the gut microbiota: Functional dysbiosis and metabolic disease","volume":"29","author":"Hamdan","year":"2026","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1038\/nrendo.2015.128","article-title":"Short-chain fatty acids in control of body weight and insulin sensitivity","volume":"11","author":"Canfora","year":"2015","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"18971","DOI":"10.1021\/acs.jafc.4c04193","article-title":"Different Short-Chain Fatty Acids Unequally Modulate Intestinal Homeostasis and Reverse Obesity-Related Symptoms in Lead-Exposed High-Fat Diet Mice","volume":"72","author":"Wang","year":"2024","journal-title":"J. Agric. Food Chem."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1038\/ijo.2014.46","article-title":"Evidence for greater production of colonic short-chain fatty acids in overweight than lean humans","volume":"38","author":"Fernandes","year":"2014","journal-title":"Int. J. Obes."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Jaimes, J.D., Slav\u00ed\u010dkov\u00e1, A., Hurych, J., Cinek, O., Nichols, B., Vodol\u00e1nov\u00e1, L., \u010cern\u00fd, K., and Havl\u00edk, J. (2021). Stool metabolome-microbiota evaluation among children and adolescents with obesity, overweight, and normal-weight using 1H NMR and 16S rRNA gene profiling. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0247378"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5160","DOI":"10.1038\/s41467-023-40874-x","article-title":"Gut microbiota and fecal short chain fatty acids differ with adiposity and country of origin: The METS-microbiome study","volume":"14","author":"Maseng","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"108238","DOI":"10.1016\/j.pharmthera.2022.108238","article-title":"Bile acid metabolism and signaling, the microbiota, and metabolic disease","volume":"237","author":"Cai","year":"2022","journal-title":"Pharmacol. Ther."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"101493","DOI":"10.1016\/j.beem.2021.101493","article-title":"Gut microbiome and bile acids in obesity-related diseases","volume":"35","author":"Li","year":"2021","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Chen, F., and Gong, L. (2025). Bile acid-microbiota interactions in cardiometabolic diseases: Mechanisms and emerging therapeutic approaches. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1689026"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3189","DOI":"10.2174\/0929867329666220105121124","article-title":"The Crosstalk between Gut Microbiota, Intestinal Immunological Niche and Visceral Adipose Tissue as a New Model for the Pathogenesis of Metabolic and Inflammatory Diseases: The Paradigm of Type 2 Diabetes Mellitus","volume":"29","author":"Cianci","year":"2022","journal-title":"Curr. Med. Chem."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1002\/oby.22088","article-title":"Dysbiosis Signatures of Gut Microbiota Along the Sequence from Healthy, Young Patients to Those with Overweight and Obesity","volume":"26","author":"Gao","year":"2018","journal-title":"Obesity"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Del Corn\u00f2, M., Aureli, A., Varano, B., and Conti, L. (2026). Endotoxins and Metabolic Endotoxemia in Obesity and Associated Noncommunicable Diseases: A Focus on Sex Differences. Biomolecules, 16.","DOI":"10.3390\/biom16020226"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e13766","DOI":"10.1111\/obr.13766","article-title":"Deciphering the complex interplay of obesity, epithelial barrier dysfunction, and tight junction remodeling: Unraveling potential therapeutic avenues","volume":"25","author":"AlMarzooqi","year":"2024","journal-title":"Obes. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/path.5134","article-title":"Increased jejunal permeability in human obesity is revealed by a lipid challenge and is linked to inflammation and type 2 diabetes","volume":"246","author":"Genser","year":"2018","journal-title":"J. Pathol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.biochi.2015.06.020","article-title":"Metabolic endotoxemia with obesity: Is it real and is it relevant?","volume":"124","author":"Boutagy","year":"2016","journal-title":"Biochimie"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1210\/er.2014-1100","article-title":"TLR4 at the Crossroads of Nutrients, Gut Microbiota, and Metabolic Inflammation","volume":"36","author":"Velloso","year":"2015","journal-title":"Endocr. Rev."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1210\/jc.2013-3092","article-title":"Toll-like receptor status in obesity and metabolic syndrome: A translational perspective","volume":"99","author":"Jialal","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e70107","DOI":"10.1111\/obr.70107","article-title":"Toll Like Receptor 4: A Potential Link Between Obesity and Metabolic Diseases","volume":"27","author":"Alhamar","year":"2026","journal-title":"Obes. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00018-024-05124-3","article-title":"Decreased expression of the NLRP6 inflammasome is associated with increased intestinal permeability and inflammation in obesity with type 2 diabetes","volume":"81","author":"Becerril","year":"2024","journal-title":"Cell Mol. Life Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1089\/ars.2019.7737","article-title":"Abrogation of Toll-Like Receptor 4 Mitigates Obesity-Induced Oxidative Stress, Proinflammation, and Insulin Resistance Through Metabolic Reprogramming of Mitochondria in Adipose Tissue","volume":"33","author":"Lin","year":"2020","journal-title":"Antioxid. Redox Signal"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"101020","DOI":"10.1016\/j.plipres.2019.101020","article-title":"A global perspective on the crosstalk between saturated fatty acids and Toll-like receptor 4 in the etiology of inflammation and insulin resistance","volume":"77","author":"Li","year":"2020","journal-title":"Prog. Lipid Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.14309\/ajg.0000000000002730","article-title":"Role of the Intestine and Its Gut Microbiota in Metabolic Syndrome and Obesity","volume":"119","author":"Busch","year":"2024","journal-title":"Am. J. Gastroenterol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"75","DOI":"10.23736\/S2724-5985.25.04054-9","article-title":"Effect of supplementation with synbiotics in metabolic syndrome: Mechanisms and clinical implications","volume":"72","author":"Abenavoli","year":"2026","journal-title":"Minerva Gastroenterol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Ahmad, A., Yang, W., Chen, G., Shafiq, M., Javed, S., Ali Zaidi, S.S., Shahid, R., Liu, C., and Bokhari, H. (2019). Analysis of gut microbiota of obese individuals with type 2 diabetes and healthy individuals. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0226372"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"3965","DOI":"10.2147\/DMSO.S477494","article-title":"Alterations in the Gut Microbiota Composition in Obesity with and without Type 2 Diabetes: A Pilot Study","volume":"17","author":"Wang","year":"2024","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1111\/jdi.70074","article-title":"Research on the characteristics of gut microbiota in overweight patients with early-onset type 2 diabetes mellitus","volume":"16","author":"Huang","year":"2025","journal-title":"J. Diabetes Investig."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Yu, Y., Ding, Y., Wang, S., and Jiang, L. (2025). Gut Microbiota Dysbiosis and Its Impact on Type 2 Diabetes: From Pathogenesis to Therapeutic Strategies. Metabolites, 15.","DOI":"10.3390\/metabo15060397"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"116735","DOI":"10.1016\/j.biopha.2024.116735","article-title":"GPR41 and GPR43: From development to metabolic regulation","volume":"175","author":"Lee","year":"2024","journal-title":"Biomed. Pharmacother."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Scarpellini, E., Scarcella, M., Tack, J.F., Scarlata, G.G.M., Zanetti, M., and Abenavoli, L. (2024). Gut Microbiota and Metabolic Dysfunction-Associated Steatotic Liver Disease. Antioxidants, 13.","DOI":"10.3390\/antiox13111386"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Guo, H., Pan, L., Wu, Q., Wang, L., Huang, Z., Wang, J., Wang, L., Fang, X., Dong, S., and Zhu, Y. (2025). Type 2 Diabetes and the Multifaceted Gut-X Axes. Nutrients, 17.","DOI":"10.3390\/nu17162708"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Liu, J., Li, F., Yang, L., Luo, S., and Deng, Y. (2025). Gut microbiota and its metabolites regulate insulin resistance: Traditional Chinese medicine insights for T2DM. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1554189"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"108299","DOI":"10.1016\/j.micpath.2026.108299","article-title":"Gut microbiota: Origin or panacea for all ills? Gut microbiota and systemic diseases","volume":"212","author":"Colica","year":"2026","journal-title":"Microb. Pathog."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"102573","DOI":"10.1016\/j.xcrm.2025.102573","article-title":"Gut microbiome and obesity care: Bridging dietary, surgical, and pharmacological interventions","volume":"7","author":"Masi","year":"2026","journal-title":"Cell Rep. Med."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Guo, Y., Li, X., Wang, Z., and Yu, B. (2021). Gut Microbiota Dysbiosis in Human Hypertension: A Systematic Review of Observational Studies. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.650227"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1002\/ame2.12233","article-title":"Regulatory effect of gut microbes on blood pressure","volume":"5","author":"Yan","year":"2022","journal-title":"Anim. Models Exp. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1111\/jch.14722","article-title":"Gut microbiota changes in patients with hypertension: A systematic review and meta-analysis","volume":"25","author":"Cai","year":"2023","journal-title":"J. Clin. Hypertens."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Tsiavos, A., Antza, C., Trakatelli, C., and Kotsis, V. (2024). The Microbial Perspective: A Systematic Literature Review on Hypertension and Gut Microbiota. Nutrients, 16.","DOI":"10.3390\/nu16213698"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12986-025-00963-8","article-title":"Association between the gut microbiotic composition and dietary patterns in hypertensive elderly patients: A cross-sectional study","volume":"22","author":"Hung","year":"2025","journal-title":"Nutr. Metab."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"107334","DOI":"10.1016\/j.phrs.2024.107334","article-title":"Microbiota alterations associated with vascular diseases: Postbiotics as a next-generation magic bullet for gut-vascular axis","volume":"207","author":"Flori","year":"2024","journal-title":"Pharmacol. Res."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Zhu, Y., and Li, Y. (2026). Gut microbiota in perimenopausal atherosclerosis: The estrogen-gut-vascular axis and personalized cardiovascular prevention. Front. Endocrinol., 17.","DOI":"10.3389\/fendo.2026.1815352"},{"key":"ref_77","first-page":"2007","article-title":"Gut microbiota and arterial hypertension: A narrative review","volume":"21","author":"Adamczak","year":"2025","journal-title":"Arch. Med. Sci."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3400\/avd.ra.24-00121","article-title":"Role of Gut Microbes in Hypertension: A Systematic Review of Literature","volume":"18","author":"Garde","year":"2025","journal-title":"Ann. Vasc. Dis."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Casas-Deza, D., Garc\u00eda-L\u00f3pez, S., Bernal-Monterde, V., Polo-Cuadro, C., Yag\u00fce-Caballero, C., and Arbones-Mainar, J.M. (2025). Obesity-Mediated Inflammation and Its Influence on Inflammatory Bowel Disease: Pathophysiology, Clinical Impact, and Therapeutic Implications. Biomolecules, 15.","DOI":"10.3390\/biom15081185"},{"key":"ref_80","first-page":"e29927","article-title":"Association of Gut Microbial Dysbiosis and Hypertension: A Systematic Review","volume":"14","author":"Naik","year":"2022","journal-title":"Cureus"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1007\/s00467-025-06883-2","article-title":"Therapeutic strategies for hypertension: Exploring the role of microbiota-derived short-chain fatty acids in kidney physiology and development","volume":"41","author":"Tortelote","year":"2026","journal-title":"Pediatr. Nephrol."},{"key":"ref_82","first-page":"1","article-title":"Immunomodulatory potential of gut microbiome-derived short-chain fatty acids (SCFAs)","volume":"66","author":"Ratajczak","year":"2019","journal-title":"Acta Biochim. Pol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1002\/ame2.12464","article-title":"Role of short-chain fatty acids in host physiology","volume":"7","author":"Liu","year":"2024","journal-title":"Anim. Models Exp. Med."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"4410","DOI":"10.1073\/pnas.1215927110","article-title":"Olfactory receptor responding to gut microbiota-derived signals plays a role in renin secretion and blood pressure regulation","volume":"110","author":"Pluznick","year":"2013","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Fu, J., Zheng, Y., Gao, Y., and Xu, W. (2022). Dietary Fiber Intake and Gut Microbiota in Human Health. Microorganisms, 10.","DOI":"10.3390\/microorganisms10122507"},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Breton, J., Galmiche, M., and D\u00e9chelotte, P. (2022). Dysbiotic Gut Bacteria in Obesity: An Overview of the Metabolic Mechanisms and Therapeutic Perspectives of Next-Generation Probiotics. Microorganisms, 10.","DOI":"10.3390\/microorganisms10020452"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"15718","DOI":"10.1073\/pnas.0407076101","article-title":"The gut microbiota as an environmental factor that regulates fat storage","volume":"101","author":"Ding","year":"2004","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1038\/s41579-020-0433-9","article-title":"Gut microbiota in human metabolic health and disease","volume":"19","author":"Fan","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Avram, A.-C., Craciun, M.-L., Pah, A.-M., Buleu, F., Cotet, I.-G., Mateescu, D.-M., Iurciuc, S., Crisan, S., Belei, O., and Militaru, A.G. (2025). Association Between Gut Microbiome Alterations and Hypertension-Related Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Microbiol. Res., 16.","DOI":"10.3390\/microbiolres16110244"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"111766","DOI":"10.1016\/j.isci.2025.111766","article-title":"CKD patients comorbid with hypertension are associated with imbalanced gut microbiome","volume":"28","author":"Wang","year":"2025","journal-title":"iScience"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1042\/CS20180087","article-title":"Imbalance of gut microbiome and intestinal epithelial barrier dysfunction in patients with high blood pressure","volume":"132","author":"Kim","year":"2018","journal-title":"Clin. Sci."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"111334","DOI":"10.1016\/j.biopha.2021.111334","article-title":"Link between microbiota and hypertension: Focus on LPS\/TLR4 pathway in endothelial dysfunction and vascular inflammation, and therapeutic implication of probiotics","volume":"137","author":"Grylls","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1152\/physiolgenomics.00081.2016","article-title":"Alterations in the gut microbiota can elicit hypertension in rats","volume":"49","author":"Adnan","year":"2017","journal-title":"Physiol. Genom."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Verhaar, B.J.H., Prodan, A., Nieuwdorp, M., and Muller, M. (2020). Gut Microbiota in Hypertension and Atherosclerosis: A Review. Nutrients, 12.","DOI":"10.3390\/nu12102982"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s40168-016-0222-x","article-title":"Gut microbiota dysbiosis contributes to the development of hypertension","volume":"5","author":"Li","year":"2017","journal-title":"Microbiome"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Yan, Q., Gu, Y., Li, X., Yang, W., Jia, L., Chen, C., Han, X., Huang, Y., Zhao, L., and Li, P. (2017). Alterations of the Gut Microbiome in Hypertension. Front. Cell Infect. Microbiol., 7.","DOI":"10.3389\/fcimb.2017.00381"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1161\/CIRCULATIONAHA.118.036652","article-title":"Short-Chain Fatty Acid Propionate Protects From Hypertensive Cardiovascular Damage","volume":"139","author":"Bartolomaeus","year":"2019","journal-title":"Circulation"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e1900616","DOI":"10.1002\/mnfr.201900616","article-title":"Probiotics Prevent Dysbiosis and the Rise in Blood Pressure in Genetic Hypertension: Role of Short-Chain Fatty Acids","volume":"64","author":"Toral","year":"2020","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e73","DOI":"10.1038\/cti.2016.17","article-title":"Regulation of immune cell function by short-chain fatty acids","volume":"5","author":"Fachi","year":"2016","journal-title":"Clin. Transl. Immunol."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Toral, M., Robles-Vera, I., de la Visitaci\u00f3n, N., Romero, M., Yang, T., S\u00e1nchez, M., G\u00f3mez-Guzm\u00e1n, M., Jim\u00e9nez, R., Raizada, M.K., and Duarte, J. (2019). Critical Role of the Interaction Gut Microbiota\u2014Sympathetic Nervous System in the Regulation of Blood Pressure. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.00231"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1161\/CIRCRESAHA.121.318065","article-title":"The Gut Microbiome in Hypertension: Recent Advances and Future Perspectives","volume":"128","author":"Avery","year":"2021","journal-title":"Circ. Res."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1097\/MNH.0000000000000149","article-title":"Gut microbiota in hypertension","volume":"24","author":"Jose","year":"2015","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1038\/nature09922","article-title":"Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease","volume":"472","author":"Wang","year":"2011","journal-title":"Nature"},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Mutengo, K.H., Masenga, S.K., Mweemba, A., Mutale, W., and Kirabo, A. (2023). Gut microbiota dependant trimethylamine N-oxide and hypertension. Front. Physiol., 14.","DOI":"10.3389\/fphys.2023.1075641"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Su, I.M., Wang, J.H., Liu, C.H., and Hsu, B.G. (2025). Elevated Serum Trimethylamine N-Oxide Predicts Impaired Vascular Reactivity in Patients with Hypertension. Diagnostics, 15.","DOI":"10.3390\/diagnostics15182400"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1093\/advances\/nmz064","article-title":"The Gut Microbial Metabolite Trimethylamine N-Oxide and Hypertension Risk: A Systematic Review and Dose-Response Meta-analysis","volume":"11","author":"Ge","year":"2020","journal-title":"Adv. Nutr."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Chen, K., Zheng, X., Feng, M., Li, D., and Zhang, H. (2017). Gut Microbiota-Dependent Metabolite Trimethylamine N-Oxide Contributes to Cardiac Dysfunction in Western Diet-Induced Obese Mice. Front. Physiol., 8.","DOI":"10.3389\/fphys.2017.00139"},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Yang, S., Li, X., Yang, F., Zhao, R., Pan, X., Liang, J., Tian, L., Li, X., Liu, L., and Xing, Y. (2019). Gut Microbiota-Dependent Marker TMAO in Promoting Cardiovascular Disease: Inflammation Mechanism, Clinical Prognostic, and Potential as a Therapeutic Target. Front. Pharmacol., 10.","DOI":"10.3389\/fphar.2019.01360"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1113\/JP277336","article-title":"Suppression of the gut microbiome ameliorates age-related arterial dysfunction and oxidative stress in mice","volume":"597","author":"Brunt","year":"2019","journal-title":"J. Physiol."},{"key":"ref_110","first-page":"1700","article-title":"Trimethylamine-N-oxide: A carnitine-derived metabolite that prolongs the hypertensive effect of angiotensin II in rats","volume":"30","author":"Ufnal","year":"2014","journal-title":"Can. J. Cardiol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1002\/ame2.70125","article-title":"Establishment of a mouse model of TMAO-induced cardiac injury and application of MICT intervention","volume":"9","author":"Xie","year":"2026","journal-title":"Anim. Models Exp. Med."},{"key":"ref_112","doi-asserted-by":"crossref","unstructured":"Janeiro, M.H., Ram\u00edrez, M.J., Milagro, F.I., Mart\u00ednez, J.A., and Solas, M. (2018). Implication of Trimethylamine N-Oxide (TMAO) in Disease: Potential Biomarker or New Therapeutic Target. Nutrients, 10.","DOI":"10.3390\/nu10101398"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"720","DOI":"10.12688\/f1000research.14421.1","article-title":"Recent advances in understanding and managing non-alcoholic fatty liver disease","volume":"7","author":"Albhaisi","year":"2018","journal-title":"F1000Research"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1002\/j.2040-4603.2013.tb00517.x","article-title":"Bile acid metabolism and signaling","volume":"3","author":"Chiang","year":"2013","journal-title":"Compr. Physiol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3727\/105221618X15156018385515","article-title":"Bile Acid Metabolism in Liver Pathobiology","volume":"18","author":"Chiang","year":"2018","journal-title":"Gene Expr."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1152\/physrev.00049.2019","article-title":"Molecular Physiology of Bile Acid Signaling in Health, Disease, and Aging","volume":"101","author":"Perino","year":"2021","journal-title":"Physiol. Rev."},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Cheng, S., Li, H., Sun, Z., Xiong, Y., Li, J., Tian, J., Shen, Y., Shen, L., Yang, J., and Yang, Y. (2025). Smilax china L. Extract Alleviates Metabolic-Associated Fatty Liver Disease by Regulating Gut Microbiota and Bile Acid Metabolism. Metabolites, 16.","DOI":"10.3390\/metabo16010031"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1038\/nrgastro.2017.119","article-title":"Bile acid-microbiota crosstalk in gastrointestinal inflammation and carcinogenesis","volume":"15","author":"Jia","year":"2018","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"2658","DOI":"10.1681\/ASN.2018030271","article-title":"Bile Acid G Protein-Coupled Membrane Receptor TGR5 Modulates Aquaporin 2-Mediated Water Homeostasis","volume":"29","author":"Li","year":"2018","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"156133","DOI":"10.1016\/j.metabol.2025.156133","article-title":"TGR5 attenuates DOCA-salt hypertension through regulating histone H3K4 methylation of ENaC in the kidney","volume":"165","author":"Xu","year":"2025","journal-title":"Metabolism"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.cmet.2013.03.013","article-title":"Pleiotropic roles of bile acids in metabolism","volume":"17","author":"Tarling","year":"2013","journal-title":"Cell Metab."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1161\/CIRCRESAHA.116.309006","article-title":"Hypertension-Linked Pathophysiological Alterations in the Gut","volume":"120","author":"Santisteban","year":"2017","journal-title":"Circ. Res."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1161\/HYPERTENSIONAHA.117.07802","article-title":"Oxidative Stress, Inflammation, and Vascular Aging in Hypertension","volume":"70","author":"Guzik","year":"2017","journal-title":"Hypertension"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/obr.12370","article-title":"Gut microbiota-derived lipopolysaccharide uptake and trafficking to adipose tissue: Implications for inflammation and obesity","volume":"17","author":"Hersoug","year":"2016","journal-title":"Obes. Rev."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Campos-Bayardo, T.I., Rom\u00e1n-Rojas, D., Garc\u00eda-S\u00e1nchez, A., Cardona-Mu\u00f1oz, E.G., S\u00e1nchez-Lozano, D.I., Totsuka-Sutto, S., G\u00f3mez-Hermosillo, L.F., Casillas-Moreno, J., Andrade-Sierra, J., and Pazar\u00edn-Villase\u00f1or, L. (2025). The Role of TLRs in Obesity and Its Related Metabolic Disorders. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26052229"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.immuni.2021.12.013","article-title":"Inflammation in obesity, diabetes, and related disorders","volume":"55","author":"Rohm","year":"2022","journal-title":"Immunity"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.tcb.2017.01.006","article-title":"Inflammation and the Metabolic Syndrome: The Tissue-Specific Functions of NF-\u03baB","volume":"27","author":"Catrysse","year":"2017","journal-title":"Trends Cell Biol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1161\/CIRCRESAHA.116.303697","article-title":"Inflammation, immunity, and hypertensive end-organ damage","volume":"116","author":"McMaster","year":"2015","journal-title":"Circ. Re"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/978-3-319-48382-5_9","article-title":"The Pathogenesis of Obesity-Associated Adipose Tissue Inflammation","volume":"960","author":"Engin","year":"2017","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.amjms.2025.03.014","article-title":"A cross-sectional study on gut microbiota and inflammation in patients with chronic kidney disease","volume":"370","author":"Paiva","year":"2025","journal-title":"Am. J. Med. Sci."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1038\/nature24628","article-title":"Salt-responsive gut commensal modulates TH17 axis and disease","volume":"551","author":"Wilck","year":"2017","journal-title":"Nature"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1161\/HYPERTENSIONAHA.109.145094","article-title":"Interleukin 17 promotes angiotensin II-induced hypertension and vascular dysfunction","volume":"55","author":"Madhur","year":"2010","journal-title":"Hypertension"},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1038\/nature11868","article-title":"Sodium chloride drives autoimmune disease by the induction of pathogenic TH17 cells","volume":"496","author":"Kleinewietfeld","year":"2013","journal-title":"Nature"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1093\/cvr\/cvae062","article-title":"Influence of angiotensin II on the gut microbiome: Modest effects in comparison to experimental factors","volume":"120","author":"Nakai","year":"2024","journal-title":"Cardiovasc. Res."},{"key":"ref_135","doi-asserted-by":"crossref","unstructured":"Wang, X., Lang, F., and Liu, D. (2024). High-Salt Diet and Intestinal Microbiota: Influence on Cardiovascular Disease and Inflammatory Bowel Disease. Biology, 13.","DOI":"10.3390\/biology13090674"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"e70846","DOI":"10.1002\/jbt.70846","article-title":"Resveratrol as a Multi-Domain Modulator of Oxidative Stress, Gut Dysbiosis, and Epigenetic Remodeling in Obesity: A Systems Biology Interpretation","volume":"40","author":"Ganamurali","year":"2026","journal-title":"J. Biochem. Mol. Toxicol."},{"key":"ref_137","first-page":"E85","article-title":"Vascular superoxide production by NAD(P)H oxidase: Association with endothelial dysfunction and clinical risk factors","volume":"86","author":"Guzik","year":"2000","journal-title":"Circ. Res."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1161\/CIRCRESAHA.116.309326","article-title":"Roles of Vascular Oxidative Stress and Nitric Oxide in the Pathogenesis of Atherosclerosis","volume":"120","author":"Xia","year":"2017","journal-title":"Circ. Res."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1002\/hep.30361","article-title":"Intestinal Microbiota Mediates the Susceptibility to Polymicrobial Sepsis-Induced Liver Injury by Granisetron Generation in Mice","volume":"69","author":"Gong","year":"2019","journal-title":"Hepatology"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1038\/s41574-022-00794-0","article-title":"The gut microbiota in obesity and weight management: Microbes as friends or foe?","volume":"19","author":"Cani","year":"2023","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"5593","DOI":"10.1038\/s41598-023-32411-z","article-title":"Exploring body weight-influencing gut microbiota by elucidating the association with diet and host gene expression","volume":"13","author":"Nemoto","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/s41577-019-0198-4","article-title":"The intestinal microbiota fuelling metabolic inflammation","volume":"20","author":"Tilg","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1007\/s13679-015-0152-0","article-title":"Gut microbiome and obesity: A plausible explanation for obesity","volume":"4","author":"Sanmiguel","year":"2015","journal-title":"Curr. Obes. Rep."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1038\/s41366-024-01590-8","article-title":"Enhancing gut microbiota and microbial function with inulin supplementation in children with obesity","volume":"48","author":"Visuthranukul","year":"2024","journal-title":"Int. J. Obes."},{"key":"ref_145","first-page":"e49740","article-title":"Type-2 diabetes mellitus and the gut microbiota: Systematic review","volume":"15","author":"Slouha","year":"2023","journal-title":"Cureus"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"e0203223","DOI":"10.1128\/mbio.02032-23","article-title":"Crosstalk between glucagon-like peptide 1 and gut microbiota in metabolic diseases","volume":"15","author":"Zeng","year":"2024","journal-title":"mBio"},{"key":"ref_147","doi-asserted-by":"crossref","unstructured":"Wu, J., Yang, K., Fan, H., Wei, M., and Xiong, Q. (2023). Targeting the gut microbiota and its metabolites for type 2 diabetes mellitus. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1114424"},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.4239\/wjd.v15.i9.1833","article-title":"New therapy for metabolic syndrome: Gut microbiome supplementation","volume":"15","author":"Qureshi","year":"2024","journal-title":"World J. Diabetes"},{"key":"ref_149","doi-asserted-by":"crossref","unstructured":"Dumitru, I.G., Todor, S.B., Ichim, C., Helgiu, C., and Helgiu, A. (2025). A Literature Review on the Impact of the Gut Microbiome on Cancer Treatment Efficacy, Disease Evolution and Toxicity: The Implications for Hematological Malignancies. J. Clin. Med., 14.","DOI":"10.3390\/jcm14092982"},{"key":"ref_150","doi-asserted-by":"crossref","unstructured":"Ichim, C., Boicean, A., Todor, S.B., Boeras, I., Anderco, P., and Birlutiu, V. (2026). Clinical and MicroRNA Responses to Fecal Microbiota Transplantation in Patients with Alcohol-Related Cirrhosis: A Pilot Study. Diagnostics, 16.","DOI":"10.3390\/diagnostics16060846"},{"key":"ref_151","doi-asserted-by":"crossref","unstructured":"M\u0142ynarska, E., Wasiak, J., Gajewska, A., Bili\u0144ska, A., Ste\u0107, G., Jasi\u0144ska, J., Rysz, J., and Franczyk, B. (2024). Gut Microbiota and Gut\u2013Brain Axis in Hypertension: Implications for Kidney and Cardiovascular Health\u2014A Narrative Review. Nutrients, 16.","DOI":"10.3390\/nu16234079"},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1161\/HYPERTENSIONAHA.121.17288","article-title":"Essential Hypertension Is Associated With Changes in Gut Microbial Metabolic Pathways: A Multisite Analysis of Ambulatory Blood Pressure","volume":"78","author":"Nakai","year":"2021","journal-title":"Hypertension"},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"116116","DOI":"10.1016\/j.bcp.2024.116116","article-title":"The pathophysiology of visceral adipose tissues in cardiometabolic diseases","volume":"222","author":"Lee","year":"2024","journal-title":"Biochem. Pharmacol."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/S2213-8587(19)30084-1","article-title":"Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: A position statement","volume":"7","author":"Neeland","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_155","doi-asserted-by":"crossref","unstructured":"Emamat, H., Jamshidi, A., Farhadi, A., Ghalandari, H., Ghasemi, M., and Tangestani, H. (2024). The association between the visceral to subcutaneous abdominal fat ratio and the risk of cardiovascular diseases: A systematic review. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-19358-0"},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"e1917","DOI":"10.1093\/nutrit\/nuae192","article-title":"Diet-Gut Microbiota Relations: Critical Appraisal of Evidence From Studies Using Metagenomics","volume":"83","author":"Lotankar","year":"2025","journal-title":"Nutr. Rev."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"23723","DOI":"10.1038\/s41598-024-71571-4","article-title":"New connections of medication use and polypharmacy with the gut microbiota composition and functional potential in a large population","volume":"14","author":"Larsson","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"e0054125","DOI":"10.1128\/msystems.00541-25","article-title":"A hidden confounder for microbiome studies: Medications used years before sample collection","volume":"10","author":"Aasmets","year":"2025","journal-title":"mSystems"},{"key":"ref_159","doi-asserted-by":"crossref","unstructured":"Dumitru, C.N., Dumitru, A.O., Goroftei, L., Niculet, E., Ignat, M.D., Baroiu, L., Nechita, A., and Balan, G. (2026). Pharmacomicrobiomics of Non-Antibiotic Drugs: Mechanisms and Clinical Consequences of Gut Microbiota Alterations. Pharmaceutics, 18.","DOI":"10.3390\/pharmaceutics18060651"},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"2644682","DOI":"10.1080\/19490976.2026.2644682","article-title":"Gut microbiome in type 2 diabetes: Insights from metagenomics, multi-omics, and diet-microbe interactions","volume":"18","author":"Zhang","year":"2026","journal-title":"Gut Microbes"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/8\/1435\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:35:15Z","timestamp":1784820915000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/8\/1435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":160,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["medicina62081435"],"URL":"https:\/\/doi.org\/10.3390\/medicina62081435","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]}}}