Gut Microbiome in Dyslipidemia and Atherosclerosis

Classical risk factors for cardiovascular disease, such as dyslipidemia, arterial hypertension, obesity, diabetes mellitus, smoking, and genetic predisposition, are well-studied, and their impacts on the pathogenesis of atherosclerotic disease remain beyond question. Recently, intestinal microbiota became of more interest in cardiovascular research. Their crucial role in the pathogenesis of obesity has been elucidated previously. Over the last two decades new scientific findings indicate a further influence of the gut microbiome on lipid metabolism and atherosclerosis. Alterations in the microbiota composition can be observed in patients with dyslipidemia as well as with atherosclerosis. The intestinal microbiota influence lipid metabolism and also directly contribute to atherosclerosis. Here, microbiota-derived metabolites, such as TMAO or short chain fatty acids (SCFA), are of particular interest as mediators in the crosstalk between microbiome and host. An impact on adaptive and innate immune response and inflammatory pathways linked to atherosclerosis has also been described. This chapter will enlighten interactions of the intestinal microbiome with lipid metabolism, atherosclerosis, and subsequently cardiovascular disease.