Association between triglyceride glucose-body mass index and the trajectory of cardio-renal-metabolic multimorbidity: insights from multi-state modelling
Cardiovascular Diabetology,
Год журнала:
2025,
Номер
24(1)
Опубликована: Март 21, 2025
Although
some
studies
have
examined
the
association
between
triglyceride
glucose-body
mass
index
(TyG-BMI)
and
cardiovascular
outcomes
in
cardio-renal-metabolic
(CRM)
background,
none
explored
its
role
progression
of
CRM
multimorbidity.
In
addition,
prior
research
is
limited
by
small
sample
sizes
a
failure
to
account
for
competitive
effects
other
diseases.
this
study,
data
obtained
from
large-scale,
prospective
UK
Biobank
cohort
were
used.
multimorbidity
was
defined
as
new-onset
ischemic
heart
disease,
type
2
diabetes
mellitus,
or
chronic
kidney
disease
during
follow-up.
Multivariable
Cox
regression
used
analyse
independent
TyG-BMI
each
(first,
double,
triple
diseases).
The
C-statistic
calculated
model,
restricted
cubic
spline
applied
assess
dose–response
relationship.
A
multi-state
model
investigate
trajectory
(from
baseline
[without
disease]
first
double
disease),
with
disease-specific
analyses.
This
study
included
349,974
participants,
mean
age
56.05
(standard
deviation
[SD],
8.08),
55.93%
whom
female.
Over
median
follow-up
approximately
14
years,
56,659
(16.19%)
participants
without
developed
at
least
one
including
8451
(14.92%)
who
progressed
789
(9.34%)
further
disease.
crude
SD
increase
associated
47%
higher
risk
72%
95%
C-statistics
0.625,
0.694,
0.764,
respectively.
Multi-state
analysis
showed
32%
increased
new
24%
23%
those
significantly
onset
all
individual
diseases
(except
stroke)
transition
Significant
interactions
also
observed,
but
remained
across
subgroups.
Sensitivity
analyses,
varying
time
intervals
entering
states
an
expanded
definition
(including
atrial
fibrillation,
failure,
peripheral
vascular
obesity,
dyslipidaemia),
confirmed
these
findings.
remarkably
influences
Incorporating
it
into
prevention
management
could
important
public
health
implications.
Язык: Английский
Cardiovascular–Kidney–Metabolic Syndrome: A New Paradigm in Clinical Medicine or Going Back to Basics?
Journal of Clinical Medicine,
Год журнала:
2025,
Номер
14(8), С. 2833 - 2833
Опубликована: Апрель 19, 2025
Cardiovascular,
renal,
and
metabolic
diseases
are
pathophysiologically
interdependent,
posing
a
significant
global
health
challenge
being
associated
with
substantial
increase
in
morbidity
mortality.
In
2023,
the
American
Heart
Association
(AHA)
defined
this
complex
network
of
interconnected
conditions
as
cardiovascular–kidney–metabolic
(CKM)
syndrome.
This
syndrome
is
based
on
common
pathophysiological
mechanisms,
including
chronic
inflammation,
oxidative
stress,
hyperglycemia
insulin
resistance,
activation
renin–angiotensin–aldosterone
system
(RAAS),
neurohormonal
dysfunction,
which
trigger
vicious
cycle
where
impairment
one
organ
contributes
to
progressive
deterioration
others.
An
integrated
approach
these
conditions,
rather
than
treating
them
separate
entities,
supports
holistic
management
strategy
that
helps
reduce
burden
public
improve
patients’
quality
life.
Existing
focuses
lifestyle
modification,
glycemic
lipid
control,
use
nephroprotective
cardioprotective
therapies.
narrative
review
aims
synthesize
contextualize
existing
information
interactions
between
systems
diagnostic
approaches,
well
provide
an
overview
available
therapeutic
options.
Язык: Английский