Distinct Gut Microbiome Profiles Underlying Cardiometabolic Risk Phenotypes in Individuals with Obesity

<b>Background:</b> Obesity-related cardiometabolic disorders have been linked to alterations in selected gut microbiome components, yet clinically relevant microbial signatures remain incompletely defined. <b>Objectives</b>: This study investigated associations between selected gut bacterial taxa and cardiometabolic risk phenotypes in individuals with obesity. <b>Methods</b>: In this cross-sectional study, 100 adults with obesity were stratified according to metabolic syndrome status. Gut microbiome composition was assessed using targeted multiplex real-time PCR of functionally relevant bacterial taxa. Associations with anthropometric and cardiometabolic parameters were examined using correlation analysis, ROC curves, and multivariable logistic regression models. <b>Results</b>: Reduced relative abundance of <i>Lachnospiraceae</i> was associated with metabolic syndrome, lower <i>Faecalibacterium</i> abundance with arterial hypertension, and increased <i>Prevotella</i> abundance with dyslipidemia. ROC analyses identified cohort-specific discriminative thresholds with moderate accuracy. <b>Conclusions</b>: Selected taxon-specific gut microbiome signatures are associated with cardiometabolic risk phenotypes in obesity. These findings are exploratory and require validation in longitudinal and independent cohorts.