Reframing glucolipid metabolic disorders through the lens of the oral microbiome: from pathophysiological mechanisms...

With the rising prevalence of metabolic diseases, their comorbidity is increasingly common. Glucolipid metabolic disorders (GLMD) constitute a major health challenge associated with increased cardiovascular risk and mortality. Despite many advances in disease mechanisms and therapeutic strategies, the metabolic disease burden remains substantial. Routine clinical practice still lacks straightforward approaches for identifying individuals at elevated risk, and the challenge of effectively preventing and controlling GLMD has become an urgent clinical problem. Significant gaps remain in our understanding of metabolic disease. Advances in high-throughput sequencing and omics technologies have expanded the research perspective, shifting attention from organ-centered pathology toward microecological and metabolic networks, elucidating the interactions between the oral microbiota and host metabolism. As the second largest microbial community after the gut microbiota, the oral microbiome provides an integrative lens for examining GLMD-related microbial signatures, plausible mechanistic pathways, and translational opportunities, including inflammation, taste signaling, nitric oxide metabolism, and microbial translocation. This review aims to clarify the relationship between the oral microbiome and GLMD, outline characteristic microbial alterations in metabolic diseases, and summarize the plausible mechanisms linking oral microorganisms with metabolic homeostasis. Current evidence indicates partially recurrent microbial patterns across GLMD-related conditions, but no universal oral microbial signature has been established. Building on recent findings, we conclude by outlining the methodological requirements for evaluating the clinical utility of oral microbiome-based markers and interventions, and further discuss the value of oral microbiota in disease prediction, risk assessment, and individualized intervention. We also summarize the key limitations and challenges in the field and outline directions for future prevention and control of GLMD based on oral microecology.