Regulatory effects of hawthorn on lipid metabolic homeostasis: mechanisms, evidences, and perspectives

Dysregulation of lipid metabolic homeostasis is a central pathological feature of metabolic disorders, including obesity and non-alcoholic fatty liver disease. Owing to the limitations of current pharmacological therapies, safe and effective natural interventions are increasingly sought. Hawthorn, a traditional medicinal and edible plant, contains diverse bioactive constituents such as flavonoids, phenylpropanoids, terpenoids, and polysaccharides, and has shown considerable potential in regulating lipid metabolism. Recent studies demonstrate that hawthorn improves lipid metabolic homeostasis through multiple mechanisms, including suppression of hepatic lipogenesis, enhancement of fatty acid <i>β</i>-oxidation, improvement of insulin signaling, regulation of adipose tissue function, and modulation of cholesterol and bile acid metabolism. In addition, hawthorn participates in the regulation of lipid metabolism by reshaping gut microbiota composition and influencing gut-liver axis signaling. Evidence from <i>in vitro</i> and <i>in vivo</i> studies, together with limited clinical investigations, indicates that hawthorn exhibits favorable safety profiles and metabolic regulatory effects, supporting its potential application in functional foods and nutritional interventions. Nevertheless, current research is limited by suboptimal experimental models, incomplete mechanistic integration, and insufficient high-quality clinical evidence. Future studies should incorporate multi-omics approaches and well-designed clinical trials to further elucidate the core targets and causal mechanisms underlying hawthorn-mediated lipid metabolic regulation.