Probiotics and cholesterol metabolism: new frontiers in science from intestinal microecology to cardiovascular health

Cholesterol is essential for cell membrane structure and steroid hormone synthesis, but elevated serum low-density lipoprotein cholesterol can lead to atherosclerosis. Although traditional drugs such as statins are effective, they carry a risk of hepatotoxicity and muscle injury. Gut microbiota regulates cholesterol metabolism through the gut-liver axis, providing a new direction for the intervention of hypercholesterolemia. Probiotics reduce serum cholesterol through bile saline hydrolase activity, secondary bile acid conversion, and cwholesterol adsorption. This article reviews the mechanism and clinical transformation prospects of probiotics in reducing serum cholesterol.