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, Год журнала: 2023, Номер 148(20), С. 1636 - 1664

Опубликована: Окт. 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,

Язык: 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, Год журнала: 2025, Номер 25(1)

Опубликована: Янв. 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.

Язык: 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, Год журнала: 2025, Номер 24(1)

Опубликована: Фев. 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.

Язык: Английский

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Metabolic and inflammatory status in prepuberty and early adulthood for individuals with a history of extrauterine growth restriction: a cohort study

Journal of Translational Medicine, Год журнала: 2025, Номер 23(1)

Опубликована: Янв. 14, 2025

Perinatal growth and nutrition have been shown to be determinants in the programming of different tissues, such as adipose tissue, predisposing individuals metabolic alterations later life. Previous studies documented an increased risk disturbances low-grade inflammation prepubertal children with a history extrauterine restriction (EUGR). The aim this study was evaluate possible resulting from impaired during early childhood their impact on young adult health. This is longitudinal, descriptive analytical cohort EUGR recruited at age followed up for 10 years until end puberty. Anthropometric measurements, blood pressure, biochemical parameters related lipid carbohydrate metabolism plasma adipokines cytokines were analyzed. Compared children, adults presented abdominal circumference percentiles. Moreover, insulin levels homeostatic model assessment resistance (HOMA-IR) index higher adults, considerable proportion participants (22%) becoming insulin-resistant after pubertal development. In contrast, arterial hypertension observed 36% compared 18% postpubertal adults. Lipid values within normal ranges without differences. Adiponectin leptin remained similar adulthood, decrease resistin. Individuals which emphasizes importance clinical follow-up prevent development further future associated diseases.

Язык: Английский

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

Nutrients, Год журнала: 2022, Номер 14(10), С. 2152 - 2152

Опубликована: Май 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

Язык: Английский

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Obesity and dysregulated innate immune responses: impact of micronutrient deficiencies

Trends in Immunology, Год журнала: 2023, Номер 44(3), С. 217 - 230

Опубликована: Янв. 26, 2023

Язык: 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, Год журнала: 2024, Номер 9(9), С. 2608 - 2618

Опубликована: Июнь 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.

Язык: Английский

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Inflammatory markers mediate the association between weight-adjusted waist circumference and mortality in patients with cardiometabolic syndrome

Scientific Reports, Год журнала: 2025, Номер 15(1)

Опубликована: Март 12, 2025

Cardiometabolic Syndrome (CMS) is associated with increased risks of cardiovascular disease, type 2 diabetes mellitus, and all-cause mortality. The Weight-Adjusted Waist Circumference Index (WWI) has emerged as a novel metric for assessing obesity its health implications. To investigate the relationship between WWI mortality in CMS patients, considering mediating role inflammatory markers. study analyzed National Health Nutrition Examination Survey (NHANES) data from 2003 to 2018 identified 6506 patients CMS. was calculated square root waist circumference (cm) divided by weight (kg). Mortality were correlated Death (NDI). Cox regression models, adjusted demographic clinical covariates, assessed effect on cause-specific Finally, markers explored using mediation analysis. observed positive linear association all-cause, cardiovascular, diabetes-related mortalities among patients. After adjusting confounders, remained significant predictor Mediation analysis revealed that markers, particularly neutrophil systemic immune-inflammation index (SII), significantly mediated an independent inflammation potentially linking risk. These findings may inform risk assessment management strategies

Язык: Английский

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Elevated high-sensitivity C-reactive protein and dyslipidaemia in type 2 diabetes mellitus: implications for cardiovascular risk prediction in Nigerian patients

BMC Endocrine Disorders, Год журнала: 2025, Номер 25(1)

Опубликована: Апрель 17, 2025

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus (T2DM). Inflammation, marked by elevated high-sensitivity C-reactive protein (hs-CRP) levels, dyslipidaemia, are critical contributors to atherosclerosis cardiovascular risk. In Nigeria, where T2DM prevalence rising, there need for more comprehensive risk prediction tools, incorporating both traditional newer biomarkers such as hs-CRP. This study aimed investigate the association between hs-CRP levels dyslipidaemia in Nigerian patients explore potential implications prediction. A hospital-based cross-sectional was conducted 150 age-matched controls. Data on socio-demographics, medical history, clinical characteristics, laboratory parameters, including lipid profiles were collected. The relationship parameters assessed using Pearson's correlation coefficient independent t-tests. exhibited significantly higher (2.2 ± 1.8 mg/L vs. 1.2 1.0 mg/L, p < 0.001), (p blood pressure (SPB- 127.6 12.4 mmHg, DBP- 77.6 6.6 mmHg SBP- 119.6 10.8 72.1 8.0 mmHg; = 0.001) compared However, no significant found parameters. Although direct remains an important marker possibly through non-lipid pathways, inflammation-driven endothelial dysfunction. Further research needed evaluate its role refining assessment population. Not applicable.

Язык: 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, Год журнала: 2023, Номер 21(1)

Опубликована: Июль 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

Язык: Английский

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