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Fecal metabolomic profiles by LDL-C target achievement status in statin-treated patients: a cross-sectional study

Yi-Hsueh Liu, Wei-Chun Hung, Ping-Hsun Wu, Po Peng, Pei-Yu Wu, Jiun-Chi Huang, Yi-Hsiung Lin, Szu-Chia Chen

Journal of Lipid Research, 2026

86 participants

Abstract

Whether the fecal metabolome differs according to intensive low-density lipoprotein cholesterol (LDL-C) target achievement among statin-treated patients is unclear. In this cross-sectional study, 124 statin-treated adults with chronic disease were stratified by fasting LDL-C into a target-achieved group (<70 mg/dl, n = 52) and a target-not-achieved group (≥70 mg/dl, n = 72). Stool samples were profiled by untargeted ultra-high-performance liquid chromatography–tandem mass spectrometry, and multivariable models adjusted for age, sex, chronic kidney disease, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use were used to identify metabolites independently associated with target achievement. Statin dose, treatment duration, and glucose-lowering therapy were also compared between the groups. Paired 16S rRNA gene sequencing data available for a subset (n = 86) were used for integrative correlation and network analyses. Partial least-squares discriminant analysis showed separation between the two groups. Eight annotated metabolites—glutamine, glutamate, phenylalanine, N-acetyl-L-phenylalanine, L-methionine, N-acetyl-L-methionine, lysine, and N-methyl-D-aspartic acid, predominantly amino acids and their derivatives—were present at lower fecal levels in participants who achieved the LDL-C target. Metabolite set enrichment analysis implicated amino acid and nitrogen metabolism, and multiomics network analysis identified an Anaerotruncus-centered amino acid…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 86 participants or records.

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