Background: Apolipoprotein B (ApoB), a key component of atherogenic lipoproteins, has been increasingly implicated in cardiometabolic disorders beyond dyslipidemia. However, its role in glycemic dysregulation remains unclear. This study aimed to investigate the association between ApoB levels and glycemic parameters, including fasting glucose, insulin resistance, and glycated hemoglobin (HbA1c), in individuals without diagnosed diabetes. Methods: This study was conducted at the National Research Cardiac Surgery Center (Kazakhstan) over the period between 2023 and 2024 as a cross-sectional analysis. Adults aged ≥ 20 years without diagnosed diabetes and with complete data on their ApoB and glycemic markers were included. Associations between ApoB and fasting plasma glucose (FPG), HbA1c, and HOMA-IR were assessed using multivariable linear and logistic regression models adjusted for demographic, lifestyle, and metabolic covariates. Results: Higher ApoB levels were significantly associated with increased fasting glucose (β = 2.07 mg/dL per 1-SD increase in ApoB, p < 0.001), higher HbA1c (β = 0.06%, p < 0.001), and elevated HOMA-IR (β = 0.54, p < 0.001). Participants in the highest ApoB quartile had 53% higher odds of prediabetes (adjusted OR = 1.53; 95% CI: 1.22–1.91; p < 0.001) compared to the lowest quartile. These associations remained significant after adjusting for BMI, lipid levels, and other confounders. Conclusions: Elevated ApoB is independently associated with adverse glycemic profiles in nondiabetic individuals, suggesting its potential role in early glucose metabolism disturbances.

Background/Objectives: Cardiovascular diseases remain the leading cause of global mortality, with the gut microbiome emerging as a critical factor. This study aimed to characterize gut microbiome composition and metabolic pathways in individuals with low cardiovascular risk (LCR) compared to healthy controls to reveal insights into early disease shifts. Methods: We performed shotgun metagenomic sequencing on fecal samples from 25 LCR individuals and 25 matched healthy controls. Participants underwent a comprehensive cardiovascular evaluation. Taxonomic classification used MetaPhlAn 4, and functional profiling employed HUMAnN 3. Results: Despite similar alpha diversity, significant differences in bacterial community structure were observed between groups (PERMANOVA, p < 0.05). The LCR group showed enrichment of Faecalibacterium prausnitzii (p = 0.035), negatively correlating with atherogenic markers, including ApoB (r = −0.3, p = 0.025). Conversely, Fusicatenibacter saccharivorans positively correlated with ApoB (r = 0.4, p = 0.006). Metabolic pathway analysis revealed upregulation of nucleotide biosynthesis, glycolysis, and sugar degradation pathways in the LCR group, suggesting altered metabolic activity. Conclusions: We identified distinct gut microbiome signatures in LCR individuals that may represent early alterations associated with cardiovascular disease development. The opposing correlations between F. prausnitzii and F. saccharivorans with lipid parameters highlight their potential roles in cardiometabolic health. These findings suggest gut microbiome signatures may serve as indicators of early metabolic dysregulation preceding clinically significant cardiovascular disease.

Background: Lipoprotein(a) (Lp(a)) is a genetically determined lipoprotein that plays an independent role in the development of atherosclerotic cardiovascular disease (ASCVD). Ethnic differences in Lp(a) levels are well-documented, yet regional data from Central Asia, particularly Kazakhstan, remain scarce. Methods: We conducted a retrospective, single-center study involving 3727 patients aged ≥ 18 years who underwent Lp(a) testing between January 2023 and June 2024. Participants were stratified by self-reported ethnicity and atherosclerosis status confirmed via coronary angiography. Lp(a) levels were analyzed using immunoturbidimetric assays. Results: Elevated Lp(a) levels (≥50 mg/dL) were identified in 19.6% of the total population. While Kazakhs exhibited a slightly higher prevalence of elevated Lp(a) compared to Russians, there were no statistically significant differences in Lp(a) levels across ethnic groups. ROC analysis revealed limited discriminatory power of Lp(a) for diagnosing atherosclerosis (AUC = 0.5464), although PRC analysis showed high sensitivity and precision in both Kazakh and Russian subgroups at lower thresholds. Conclusions: Despite modest ethnic variation in Lp(a) distribution, its predictive value for atherosclerosis remains limited as a standalone marker. These findings highlight the need for population-specific thresholds and support incorporating Lp(a) testing in broader cardiovascular risk assessment strategies in Central Asia.