{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T15:55:23Z","timestamp":1774454123228,"version":"3.50.1"},"reference-count":59,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Carvascare Research Group from the Universidad de Castilla-La Mancha","award":["2025-GRIN-38419"],"award-info":[{"award-number":["2025-GRIN-38419"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Carotid intima-media thickness (IMT) is a well-established surrogate marker of subclinical atherosclerosis and a predictor of cardiovascular risk. Carotenoids, particularly lycopene and \u03b2-carotene, have been proposed as protective antioxidants against vascular damage, but evidence from population-based studies is inconsistent. Objective: We aim to perform a systematic review and meta-analysis of the associations between circulating levels of lycopene and \u03b2-carotene and carotid IMT in the general adult population, including potential sex-specific effects. Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science up to March 2025, following PRISMA guidelines (PROSPERO registration: CRD420251003810). Observational and experimental studies reporting cross-sectional associations between plasma carotenoids and IMT were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated via random effects models. Subgroup and meta-regression analyses explored potential modifiers, including sex and cardiovascular risk factors. Results: Thirteen studies (n = 9131; mean age 46.4\u201371.6 years) met the inclusion criteria, eight of which were eligible for meta-analysis. High circulating lycopene levels were significantly associated with low IMT (pooled OR = 0.70; 95% CI: 0.59\u20130.84; I2 = 65.7%). The association was stronger in men (OR = 0.62; 95% CI: 0.45\u20130.84) than in women (OR = 0.74; 95% CI: 0.58\u20130.95). In contrast, \u03b2-carotene was only marginally associated with IMT (pooled OR = 0.96; 95% CI: 0.92\u20130.99; I2 = 72.6%). Meta-regression suggested that systolic blood pressure modified the lycopene-IMT relationship, whereas body mass index and low-density lipoprotein cholesterol influenced the \u03b2-carotene-IMT association. No evidence of publication bias was found. Conclusions: Increased serum lycopene concentrations, and to a lesser extent \u03b2-carotene concentrations, are inversely associated with carotid IMT, suggesting a protective role of lycopene in vascular health. The effect appears more pronounced in men, highlighting potential sex-specific differences in carotenoid metabolism and cardiovascular risk modulation.<\/jats:p>","DOI":"10.3390\/nu18071043","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T15:05:33Z","timestamp":1774451133000},"page":"1043","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Circulating Lycopene and \u03b2-Carotene Levels Are Inversely Associated with Carotid Intima\u2013Media Thickness: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2617-0430","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Cavero-Redondo","sequence":"first","affiliation":[{"name":"CarVasCare Research Group, Instituto de Biomedicina\/Facultad de Enfermer\u00eda de Cuenca, Universidad de Castilla-La Mancha, 16001 Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0669-8625","authenticated-orcid":false,"given":"Alicia","family":"Saz-Lara","sequence":"additional","affiliation":[{"name":"CarVasCare Research Group, Instituto de Biomedicina\/Facultad de Enfermer\u00eda de Cuenca, Universidad de Castilla-La Mancha, 16001 Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea Del","family":"Saz-Lara","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Tecnol\u00f3gica Atl\u00e1ntico Mediterr\u00e1neo (UTAMED), C. de Marie Curie, 1, Campanillas, 29590 M\u00e1laga, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8743-8249","authenticated-orcid":false,"given":"\u00d3scar","family":"Mart\u00ednez-Cifuentes","sequence":"additional","affiliation":[{"name":"CarVasCare Research Group, Instituto de Biomedicina\/Facultad de Enfermer\u00eda de Cuenca, Universidad de Castilla-La Mancha, 16001 Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3784-9926","authenticated-orcid":false,"given":"Iris","family":"Otero-Luis","sequence":"additional","affiliation":[{"name":"CarVasCare Research Group, Instituto de Biomedicina\/Facultad de Enfermer\u00eda de Cuenca, Universidad de Castilla-La Mancha, 16001 Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4455-9075","authenticated-orcid":false,"given":"Ana","family":"Gonz\u00e1lez-Collado","sequence":"additional","affiliation":[{"name":"CarVasCare Research Group, Instituto de Biomedicina\/Facultad de Enfermer\u00eda de Cuenca, Universidad de Castilla-La Mancha, 16001 Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Rey-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad Internacional de Valencia (VIU), 46002 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3735","DOI":"10.1093\/eurheartj\/ehae471","article-title":"Atherosclerosis quantification and cardiovascular risk: The ISCHEMIA trial","volume":"45","author":"Nurmohamed","year":"2024","journal-title":"Eur. 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