Regulation of sterol metabolism by gut microbiota and its relevance to disease

Sterols play an indispensable role in maintaining cell membrane stability, regulating hormone synthesis, and preserving physiological homeostasis. Recently, the function of the gut microbiota in modulating host sterol metabolism has become the focus of extensive research. Nonetheless, the specific functions carried out by the gut microbiota in sterol metabolism and their health implications remain unclear due to a lack of comprehensive synthesis and analysis. This review aims to consolidate current perspectives regarding the sources and metabolic mechanisms of sterols, with an emphasis on the involvement of gut microbiota in the biotransformation of zoosterols, phytosterols, and mycosterols. Additionally, it explores the pathological implications of sterol metabolism disorders in diseases such as Alzheimer's disease and cancer. Finally, the review highlights the potential of dietary interventions to reshape gut microbiota composition and restore sterol metabolic homeostasis, presenting novel strategies for disease prevention and therapy through targeted modulation of sterol metabolism.