Integrated Management of Cardiovascular–Renal–Hepatic–Metabolic Syndrome: Expanding Roles of SGLT2is, GLP-1RAs, and GIP/GLP-1-RAs
Biomedicines,
Год журнала:
2025,
Номер
13(1), С. 135 - 135
Опубликована: Янв. 8, 2025
Cardiovascular-Kidney-Metabolic
syndrome,
introduced
by
the
American
Heart
Association
in
2023,
represents
a
complex
and
interconnected
spectrum
of
diseases
driven
shared
pathophysiological
mechanisms.
However,
this
framework
notably
excludes
liver-an
organ
fundamental
to
metabolic
regulation.
Building
on
concept,
Cardiovascular-Renal-Hepatic-Metabolic
(CRHM)
syndrome
incorporates
liver's
pivotal
role
disease
spectrum,
particularly
through
its
involvement
via
dysfunction-associated
steatotic
liver
(MASLD).
Despite
increasing
prevalence
CRHM
unified
management
strategies
remain
insufficiently
explored.
This
review
addresses
following
critical
question:
How
can
novel
anti-diabetic
agents,
including
sodium-glucose
cotransporter-2
inhibitors
(SGLT2is),
glucagon-like
peptide-1
receptor
agonists
(GLP-1RAs),
dual
gastric
inhibitory
polypeptide
(GIP)/GLP-1RA,
offer
an
integrated
approach
managing
beyond
boundaries
traditional
specialties?
By
synthesizing
evidence
from
landmark
clinical
trials,
we
highlight
paradigm-shifting
potential
these
therapies.
SGLT2is,
such
as
dapagliflozin
empagliflozin,
have
emerged
cornerstone
guideline-directed
treatments
for
heart
failure
(HF)
chronic
kidney
(CKD),
providing
benefits
that
extend
glycemic
control
are
independent
diabetes
status.
GLP-1RAs,
e.g.,
semaglutide,
transformed
obesity
enabling
weight
reductions
exceeding
15%
improving
outcomes
atherosclerotic
cardiovascular
(ASCVD),
diabetic
CKD,
HF,
MASLD.
Additionally,
tirzepatide,
GIP/GLP-1RA,
enables
unprecedented
loss
(>20%),
reduces
risk
over
90%,
improves
HF
with
preserved
ejection
fraction
(HFpEF),
MASLD,
obstructive
sleep
apnea.
moving
organ-specific
approach,
propose
integrates
agents
into
holistic
syndrome.
paradigm
shift
moves
away
fragmented,
organ-centric
toward
more
fostering
collaboration
across
specialties
marking
progress
precision
cardiometabolic
medicine.
Язык: Английский
From Cardiovascular-Kidney-Metabolic Syndrome to Cardiovascular-Renal-Hepatic-Metabolic Syndrome: Proposing an Expanded Framework
Biomolecules,
Год журнала:
2025,
Номер
15(2), С. 213 - 213
Опубликована: Фев. 2, 2025
Cardiometabolic
diseases
represent
an
escalating
global
health
crisis,
slowing
or
even
reversing
earlier
declines
in
cardiovascular
disease
(CVD)
mortality.
Traditionally,
conditions
such
as
obesity,
type
2
diabetes
mellitus
(T2DM),
atherosclerotic
CVD,
heart
failure
(HF),
chronic
kidney
(CKD),
and
metabolic
dysfunction-associated
steatotic
liver
(MASLD)
were
managed
isolation.
However,
emerging
evidence
reveals
that
these
disorders
share
overlapping
pathophysiological
mechanisms
treatment
strategies.
In
2023,
the
American
Heart
Association
proposed
Cardiovascular-Kidney-Metabolic
(CKM)
syndrome,
recognizing
interconnected
roles
of
heart,
kidneys,
system.
Yet,
this
model
omits
liver—a
critical
organ
impacted
by
dysfunction.
MASLD,
which
can
progress
to
steatohepatitis
(MASH),
is
closely
tied
insulin
resistance
contributing
directly
renal
impairment.
Notably,
MASLD
bidirectionally
associated
with
development
progression
CKM
syndrome.
As
a
result,
we
introduce
expanded
framework—the
Cardiovascular-Renal-Hepatic-Metabolic
(CRHM)
syndrome—to
more
comprehensively
capture
broader
inter-organ
dynamics.
We
provide
guidance
for
integrated
diagnostic
approach
aimed
at
halting
advanced
stages
preventing
further
damage.
addition,
highlight
advances
medical
management
target
shared
pathways,
offering
benefits
across
multiple
systems.
Viewing
whole,
rather
than
discrete
entities,
incorporating
into
framework
fosters
holistic
strategy
offers
promising
path
addressing
cardiometabolic
pandemic.
Язык: Английский
GDF-15 improves the predictive capacity of Steatotic liver disease non-invasive tests for incident morbidity and mortality risk for cardio-renal-metabolic diseases and malignancies
Metabolism,
Год журнала:
2024,
Номер
unknown, С. 156047 - 156047
Опубликована: Окт. 1, 2024
Язык: Английский