A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association

Circulation, Journal Year: 2023, Volume and Issue: 148(20), P. 1636 - 1664

Published: Oct. 9, 2023

A growing appreciation of the pathophysiological interrelatedness metabolic risk factors such as obesity and diabetes, chronic kidney disease, cardiovascular disease has led to conceptualization cardiovascular-kidney-metabolic syndrome. The confluence within syndrome is strongly linked for adverse outcomes. In addition, there are unique management considerations individuals with established coexisting factors, or both. An extensive body literature supports our scientific understanding of, approach to, prevention However, critical gaps in knowledge related terms mechanisms development, heterogeneity clinical phenotypes, interplay between social determinants health biological accurate assessments incidence context competing risks. There also key limitations data supporting care syndrome, particularly early-life prevention, screening interdisciplinary models, optimal strategies lifestyle modification weight loss, targeting emerging cardioprotective kidney-protective therapies, patients both impact systematically assessing addressing health. This statement uses a crosswalk major guidelines, addition review literature, summarize evidence fundamental science, screening,

Language: Английский

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Joint association of the inflammatory marker and cardiovascular-kidney-metabolic syndrome stages with all-cause and cardiovascular disease mortality: a national prospective study

BMC Public Health, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 2, 2025

Cardiovascular-kidney-metabolic (CKM) syndrome and systemic inflammation significantly contribute to mortality. However, the joint associations of CKM stages with all-cause cardiovascular disease (CVD) mortality remain unclear. This study aimed evaluate independent CVD in a representative cohort United States adults. We analyzed data from 29,459 adults aged ≥ 20 years National Health Nutrition Examination Survey (1999–2018). were classified based on metabolic risk factors, CVD, chronic kidney disease. Systemic was assessed using multiple indicators, time-dependent ROC analysis identified inflammatory response index (SIRI) as most effective marker. The SIRI evaluated. Over median follow-up 109 months, 5,583 deaths 1,843 CVD-specific occurred. Both advanced elevated associated higher risks Individuals (Stages 3–4) (> 0.81) had highest (HR: 1.84, 95% CI: 1.65–2.05) 2.50, 2.00–3.12). These particularly pronounced < 60 (P for interaction 0.001). Advanced are increased mortality, younger findings highlight significance targeted interventions address progression, potentially improving long-term outcomes high-risk populations.

Language: Английский

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Comparison of triglyceride glucose index and modified triglyceride glucose indices in predicting cardiovascular diseases incidence among populations with cardiovascular-kidney-metabolic syndrome stages 0–3: a nationwide prospective cohort study

Cardiovascular Diabetology, Journal Year: 2025, Volume and Issue: 24(1)

Published: Feb. 28, 2025

Cardiovascular-kidney-metabolic (CKM) syndrome has been recently proposed by American Heart Association recently. The triglyceride glucose (TyG) index and TyG-related indices combined with obesity indicators have proven to be associated the incidence of cardiovascular diseases (CVD). However, there are few studies explore whether these associations exist among people CKM stages 0–3. A total 7,364 participants from China Health Retirement Longitudinal Study were included. Cox hazard regression restricted cubic spline used analyze CVD incidence. To compare predictive performance, time-dependent Harrell's C-indices, net reclassification integrated discrimination improvement conducted. was 20.55% over nine years. TyG single all modified capable predicting RCS analyses showed that had linear relationships waist circumference (TyG-WC) or waist-to-height ratio (TyG-WHtR) still existed in stage 1, 2 3. TyG-WC (C-index: 0.621, p < 0.001) TyG-WHtR almost highest C-indices incidence, compared 0.611, body mass 0.616, 0.001). independent predictors It found better especially ratio.

Language: Английский

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Cannabidiol and Cannabidiol Metabolites: Pharmacokinetics, Interaction with Food, and Influence on Liver Function

Nutrients, Journal Year: 2022, Volume and Issue: 14(10), P. 2152 - 2152

Published: May 21, 2022

Cannabidiol (CBD) is widely available and marketed as having therapeutic properties. Over-the-counter CBD unregulated, many of the claims lack scientific support, controversy exists to safety CBD-liver interaction. The study aims were compare pharmacokinetics commercial metabolites following ingestion five different formulations, determine influence on food induced thermogenesis, pharmacokinetics, markers liver function. Fourteen males (body mass index ≥ 25 kg/m2) studied in a placebo-controlled, randomized, crossover design. On occasions, formulations ingested (one per visit). two additional or placebo was meal. servings standardized 30 mg. Considerable pharmacokinetic variability existed between formulations; this transferred several metabolites. did not thermogenesis but favorably modify early insulin triglyceride responses. Food appreciably altered CBD. Finally, evoke physiologically relevant changes Collectively, these data suggest that consumers should be aware appreciable differences unlikely caloric cost eating may prove some benefit initial metabolic responses, consuming with alters dynamics metabolism increases systemic availability, low-dose probably does represent risk normal

Language: Английский

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Obesity and dysregulated innate immune responses: impact of micronutrient deficiencies

Trends in Immunology, Journal Year: 2023, Volume and Issue: 44(3), P. 217 - 230

Published: Jan. 26, 2023

Language: Английский

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Combination of Cardiovascular, Kidney, and Metabolic Diseases in a Syndrome Named Cardiovascular-Kidney-Metabolic, With New Risk Prediction Equations

Kidney International Reports, Journal Year: 2024, Volume and Issue: 9(9), P. 2608 - 2618

Published: June 7, 2024

Associations of chronic kidney disease (CKD) with metabolic syndrome and cardiovascular (CVD) have long been recognized. Until recently, such associations were mainly limited to interrelationships between either heart kidney, syndrome, or kidney. It is the merit American Heart Association (AHA) set up a work group cardiologists, endocrinologists, nephrologists for purpose combining all 3 disorders in single entity, as an appreciation their pathophysiological interrelatedness. To this end, they proposed term cardiovascular-kidney-metabolic (CKM) which reflects multidirectional relationships among risk factors, CKD, system. Following consensus approach defining CKM 5 stages, subsequently developed new prediction equations, named predicting CVD events (PREVENT) included estimated glomerular filtration rate (eGFR) albuminuria variables addition traditional factors. Despite several limitations, development major step forward prediction. Its clinical application should translate into earlier, more appropriate treatment prevention syndrome.

Language: Английский

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Can the ketogenic diet improve our dreams? Effect of very low-calorie ketogenic diet (VLCKD) on sleep quality

Journal of Translational Medicine, Journal Year: 2023, Volume and Issue: 21(1)

Published: July 18, 2023

Abstract Background Obesity is a condition that often associated with sleep disorders, including reduced quality (SQ). Very low calorie ketogenic diet (VLCKD) has proven to be effective in the management of obesity and metabolic disorders. However, little still known about effects this promising nutritional protocol on SQ. Thus, purpose study was investigate short-term effect VLCKD SQ women overweight/obesity if any changes, identify predictive factor through modified Methods Were consecutively enrolled total 324 subjects, who met inclusion criteria accepted adhere VLCKD. Assessment status, anthropometric measurements (height, weight, waist circumference), bioelectrical impedance analysis (phase-sensitive system, 50 kHz BIA 101 RJL, Akern Bioresearch, Florence, Italy Akern), high sensitivity C reactive protein levels (hs-CRP), were carried out at baseline after 31 days active stage evaluated using validated questionnaire Pittsburgh Sleep Quality Index (PSQI). Results In addition expected general improvement parameters body composition, improved significantly SQ, as demonstrated by all included PSQI (p < 0.001). Both VLCKD, score BMI, circumference, fat mass, free mass 0.001 for all) hs-CRP = 0.023). PhA negatively only ∆% positively correlated 0.001), 0.031). multiple regression represented predictor changes Finally, ROC analysis, threshold value > − 8.4% predicted Conclusion conclusion, determines an overweight obesity, mostly mediated reduction related protocol. Graphical

Language: Английский

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Exploring the Link between Inflammatory Biomarkers and Adipometrics in Healthy Young Adults Aged 20–35 Years

Nutrients, Journal Year: 2024, Volume and Issue: 16(2), P. 257 - 257

Published: Jan. 15, 2024

Obesity and aging are associated with an inflammatory state, which represents the common background for a wide range of diseases. This study aims to explore correlation between hsCRP, IL-1β, IL-6, TNF-α, IFN-γ, white blood cell count (WBC) adipometrics (arm, waist, hip circumferences: AC, WC, HC; total body fat mass: TBFM, visceral level: VFL, mass index: BMI; waist/hip ratio: WHR; waist/height WHtR) in young healthy adults aged 20-35 years old. The subjects were divided by BMI into overweight/obesity (OW/OB) group normal weight (NW) group, hsCRP level Group 1 (<1 mg/L), 2 (≥1-2.99 3 (≥3 mg/L). concentration all biomarkers was significantly higher OW/OB compared NW exception IL-1β. Significant positive correlations found WBC, adipometrics; IL-6 WHR, WHtR, BMI, VFL; IFN-γ HC, TBFM. IL-1β correlates positively WHR VFL. In Groups 1-3, differences showed significant differences. Subclinical inflammation persists association being overweight obese

Language: Английский

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Body roundness index as a predictor of all-cause and cardiovascular mortality in patients with diabetes and prediabetes

Diabetes Research and Clinical Practice, Journal Year: 2024, Volume and Issue: 219, P. 111958 - 111958

Published: Dec. 13, 2024

Language: Английский

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Sex-specific association of visceral and subcutaneous adipose tissue volumes with systemic inflammation and innate immune cells in people living with obesity

International Journal of Obesity, Journal Year: 2023, Volume and Issue: 48(4), P. 523 - 532

Published: Dec. 22, 2023

Language: Английский

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