代谢和炎症途径之间的关系在各种心脏代谢紊乱性疾病中起到致病作用，并且可能也参与了其他疾病的发病机制，比如癌症、自身免疫性疾病和传染性疾病。共同可变免疫缺陷（CVID）是成年人中最常见的原发性免疫缺陷症，其特征是咽部感染的频率增加，同时伴有蒂芦鳗菌感染相关的自身免疫和炎症并发症。我们总结了支持在CVID中存在炎症和代谢紊乱之间双向致病相互作用的证据。这包括高密度脂蛋白（HDL）的低水平和功能、甘油三酯（TG）及其主要载脂蛋白极低密度脂蛋白（VLDL）的高水平，以及不利的脂肪酸（FA）谱。TG、VLDL和FA的失调与肠道微生物群的紊乱有关，而TG和VLDL水平与大肠杆菌脂多糖（LPS）在血液中的渗漏标志密切相关。值得注意的是，CVID中的脂质谱未包括总胆固醇水平或高低密度脂蛋白水平。此外，血液中VLDL和TG水平的升高与饮食、高身体质量指数和肝脂肪变性无关，这表明与代谢综合征等传统心血管风险患者的表型不同。我们假设这些代谢紊乱与炎症以双向方式相关，而紊乱的肠道微生物群可能是一个潜在的共同因素。 版权所有 © 2023 Jorgensen，Macpherson，Skarpengland，Berge，Fevang，Halvorsen和Aukrust。

The relationship between metabolic and inflammatory pathways play a pathogenic role in various cardiometabolic disorders and is potentially also involved in the pathogenesis of other disorders such as cancer, autoimmunity and infectious diseases. Common variable immunodeficiency (CVID) is the most common primary immunodeficiency in adults, characterized by increased frequency of airway infections with capsulated bacteria. In addition, a large proportion of CVID patients have autoimmune and inflammatory complications associated with systemic inflammation. We summarize the evidence that support a role of a bidirectional pathogenic interaction between inflammation and metabolic disturbances in CVID. This include low levels and function of high-density lipoprotein (HDL), high levels of triglycerides (TG) and its major lipoprotein very low-density lipoprotein (VLDL), and an unfavorable fatty acid (FA) profile. The dysregulation of TG, VLDL and FA were linked to disturbed gut microbiota profile, and TG and VLDL levels were strongly associated with lipopolysaccharides (LPS), a marker of gut leakage in blood. Of note, the disturbed lipid profile in CVID did not include total cholesterol levels or high low-density lipoprotein levels. Furthermore, increased VLDL and TG levels in blood were not associated with diet, high body mass index and liver steatosis, suggesting a different phenotype than in patients with traditional cardiovascular risk such as metabolic syndrome. We hypothesize that these metabolic disturbances are linked to inflammation in a bidirectional manner with disturbed gut microbiota as a potential contributing factor.Copyright © 2023 Jorgensen, Macpherson, Skarpengland, Berge, Fevang, Halvorsen and Aukrust.