Högskolan i Skövde

Despite medical advances, cardiovascular disease (CVD) remains one of the leading causes of death worldwide and results from complex interactions among multiple risk factors. Metabolic syndrome (MetS) represents a cluster of these risk factors that collectively increase CVD risk. Although CVD is influenced by lifestyle, it may be partly prevented through healthy diets such as the Mediterranean diet (MD). Beyond traditional risk factors, circulating cardiometabolic biomarkers may help identify early cardiometabolic dysfunction before clinical disease develops. The aim of this study was to investigate associations between dietary patterns, cardiometabolic biomarkers, MetS, CVD risk, and sex differences in an adult Portuguese cohort. A total of 354 adults (180 men and 174 women), aged 40–69 years, were included. Biomarkers related to inflammation, lipid metabolism, and glucose regulation, including C-reactive protein (CRP), highdensity lipoprotein (HDL), and leptin, were explored. Leptin was measured using enzyme-linked immunosorbent assay (ELISA). Participants were classified according to a healthy diet score. CVD risk was estimated using SCORE2, and MetS was defined using NCEP criteria. Logistic regression analyses were performed to evaluate associations with CVD risk and MetS. Healthier diets were associated with more favorable lipid and glucose profiles, particularly in women, but associations with CVD risk were weak, possibly due to the relatively healthy cohort and self-reported diet. Predictive models highlighted apolipoprotein B (ApoB) as a strong biomarker, while leptin and uric acid showed potential relevance. Leptin appeared more influenced by sex than by CVD risk, suggesting the importance of sex-specific analyses in future research.