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Metabolic Diseases / Cardiovascular Diseases / Cardiometabolic Disease · Journal article
Gut Microbes · August 26, 2026
A consensus or society position rather than new primary data.
This is a narrative review synthesizing current evidence on sexually dimorphic gut microbiota and microbiota-related metabolites as contributors to sex disparities in cardiometabolic disease across the life course. The authors identify associations between specific microbial taxa (Akkermansia muciniphila, Eubacterium, Ruminococcus, Firmicutes) and metabolites (short-chain fatty acids, secondary bile acids, trimethylamine N-oxide) with cardiometabolic pathways, but note heterogeneous findings and incomplete mechanistic understanding. The review emphasizes the need for large prospective longitudinal studies integrating repeated microbiome, metabolomics, and sex steroid measurements.
Narrative review. Humans of both sexes across pre-puberty, adolescence, and adulthood (with emphasis on pre- and postmenopausal periods); relevant animal models included for mechanistic insight..
Women generally exhibit a more favorable cardiometabolic profile than men during reproductive years, but risk significantly increases after menopause due to declining estrogen levels Men have higher incidence of cardiovascular disease at younger age, while women have higher morbidity and mortality rates after menopause Men have higher risk of developing severe type 2 diabetes and metabolic dysfunction-associated steatotic liver disease despite women having higher obesity prevalence
Men have higher incidence of cardiovascular disease at younger age, while women have higher morbidity and mortality rates after menopause
Clinicians should recognize that sex-specific mechanisms contribute to disparities in cardiometabolic disease presentation and progression, particularly around menopause. Microbiota-modifying interventions (diet, probiotics) may offer personalized prevention strategies, though the authors emphasize that current evidence is heterogeneous and sex-specific clinical guidelines remain inadequately developed.
A narrative review synthesizing evidence on sex differences in gut microbiome and cardiometabolic disease, providing an integrative summary rather than new empirical data or a definitive trial.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that sex-specific mechanisms contribute to disparities in cardiometabolic disease presentation and progression, particularly around menopause. Microbiota-modifying interventions (diet, probiotics) may offer personalized prevention strategies, though the authors emphasize that current evidence is heterogeneous and sex-specific clinical guidelines remain inadequately developed.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Sex differences in major cardiometabolic diseases (CMD), such as type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, and cardiovascular disease, have been increasingly recognized across the life course. During the reproductive stage, women generally have a more favorable cardiometabolic risk profile than men, but their risk of experiencing CMD significantly increases after menopause. Emerging evidence suggests that sexually dimorphic gut microbiota and gut microbiota-related metabolites (GMRMs) may contribute to such sex disparities. However, existing findings are heterogeneous and underlying mechanisms remain incompletely understood. In this review, we synthesize the evidence examining sex differences in gut microbial diversity, overall composition, taxa abundances, and levels of GMRMs across key life stages, including pre-puberty, adolescence, and different phases of adulthood (with emphasis on pre- and post-menopausal periods). We summarize potential biological mechanisms underlying sexual dimorphism in the gut microbiome and GMRMs, emphasizing the central role of sex steroids, along with contributions from immune function and other host and environmental factors. We further integrate evidence linking sexually dimorphic microbial taxa (e.g., Akkermansia muciniphila, Eubacterium, Ruminococcus, and other Firmicutes taxa) and GMRMs (e.g., microbiota-derived short-chain fatty acids, secondary bile acids, and trimethylamine N-oxide) to key cardiometabolic pathways involving inflammation, glucose and lipid metabolism, and vascular function. Finally, we identify critical knowledge gaps and emphasize the need for future large longitudinal studies that would integrate repeated measurements of the gut microbiome, untargeted metabolomics, and sex steroid hormones across the life course. Such approaches are essential to clarify biological pathways and inform sex-specific microbiome-based interventions for CMD prevention and management.
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