Aim: To investigate the potential association among Craniopharyngioma (CP), chronotypes and metabolic risk profile. Subjects and Methods: The study population included 28 patients (46.4% males; 42.6 ± 15.8 years) and 28 controls, age, gender and BMI matched (46.4% males; 46.5 ± 12.9 years). In this study sample, we evaluated: anthropometric measurements (waist circumference, WC; BMI), plasma glucose, lipid profile, and systolic (SBP) and diastolic (DBP) blood pressure. Morningness-Eveningness was measured with the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ), which included 19 questions about preferred sleep time and daily performance. Results: in both patients and controls grade I obesity was detected in 15 subjects (53.6%), grade II obesity in 13 subjects (46.4%). In the patient group, the mean score of chronotype was 47.8 ± 12.6. In particular, 9 patients (32.1%) exhibited the morning chronotype, 6 (21.4%) the intermediate chronotype and 13 (46.4.%) the evening chronotype. No significant difference was found in gender and age among the chronotype categories. Patients with the evening chronotype had higher blood pressure values and worse metabolic parameters than those with the morning chronotype. In the control group, the mean score of the chronotype was 57.6 ± 9.5. In particular, 16 (57.1%) subjects exhibited the morning chronotype, 10 (35.7%) the intermediate chronotype and only 2 (7.1.%) the evening chronotype. The prevalence of intermediate and evening chronotypes was higher in females than males (p = 0.021), while males have a higher prevalence of the morning chronotype. Subjects with intermediate and evening chronotypes had worse metabolic parameters than those with the morning chronotype. In patients, the chronotype score was inversely correlated to WC, BMI, SBP, DBP, plasma glucose, total cholesterol, triglycerides, LDL cholesterol and positively correlated with HDL cholesterol. No correlation was found between age and chronotype. In controls, the chronotype score was inversely correlated to WC, BMI, plasma glucose, total cholesterol, LDL cholesterol. No correlation was found among chronotype and age, blood pressure, triglycerides, HDL cholesterol. Considering the whole population of the study (patients and controls), at logistic regression the chronotype score was significantly associated with the presence of CP. Conclusions: for the first time thus far, our study puts the light on the association of the CP with chronotypes and metabolic alterations in this disease, which are the main determinants of the reduced quality of life, higher morbidity and mortality in this setting of patients. This finding suggests that alterations of chronotype might represent an adjunctive risk for CP patients and a possible target for their integrate management.

Omega-3 polyunsaturated fatty acids (ω-3 PUFAs), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are critical modulators of cardiovascular physiology, acting through anti-inflammatory signaling, membrane remodeling, and transcriptional regulation. Despite strong biological plausibility, clinical evidence remains heterogeneous. This narrative review evaluates the complexities of ω-3 supplementation, moving beyond standardized dosing to discuss the emerging role of biomarker-based assessments. While traditional low-dose mixed formulations often failed to show significant benefits, high-dose purified EPA (icosapent ethyl, 4 g/day) has demonstrated a substantial reduction in residual cardiovascular risk in specific populations. However, this clinical success is accompanied by a modest but consistent increase in atrial fibrillation risk at pharmacological doses, suggesting a need for better risk stratification. We highlight that therapeutic efficacy is closely tied to bioavailability—driven by chemical form and dietary context. In this setting, objective metrics such as the ω-3 Index or EPA/arachidonic acid (AA) ratio are discussed as validated biomarkers of ω-3 status that, although not yet incorporated into clinical guidelines as routine treatment targets, may help account for inter-individual variability. Furthermore, we address the environmental burden of marine-derived oils, considering microalgae-based alternatives as sustainable solutions. Ultimately, this review advocates for a more nuanced approach that integrates clinical evidence, the potential of biomarker monitoring, and global environmental responsibility.