Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers JACC State-of-the-Art Review

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:75

Review

Mechanick, Jeffrey I.¹  Farkouh, Michael E.^2,3  Newman, Jonathan D.^4,5  Garvey, W. Timothy^6,7,8 

[1] Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, Marie Josee & Henry R Kravis Ctr Cardiovasc Hlth, New York, NY 10029 USA

[2] Univ Toronto, Peter Munk Cardiac Ctr, Toronto, ON, Canada

[3] Univ Toronto, Heart & Stroke Richard Lewar Ctr, Toronto, ON, Canada

[4] NYU, Med Ctr, Dept Med, Div Cardiol, New York, NY 10016 USA

[5] NYU, Med Ctr, Dept Med, Ctr Prevent Cardiovasc Dis, New York, NY 10016 USA

[6] Univ Alabama Birmingham, Dept Nutr Sci, Birmingham, AL 35294 USA

[7] Univ Alabama Birmingham, Diabet Res Ctr, Birmingham, AL USA

[8] Birmingham VA Med Ctr, Geriatr Res Educ & Clin Ctr, Birmingham, AL USA

关键词: adipokines;    adiposity;    atherosclerosis;    atrial fibrillation;    cardiomyopathy;    cardiovascular;    chronic disease;    dysglycemia;    insulin resistance;    obesity;    type 2 diabetes;   

DOI  :  10.1016/j.jacc.2019.11.044

来源: Elsevier

【 摘 要 】

A new cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for early and sustainable, evidence-based therapeutic targeting to promote cardiometabolic health and mitigate the development and ravages of cardiovascular disease. In the first part of this JACC State-of-the-Art Review, a framework is presented for CMBCD, focusing on 3 primary drivers (genetics, environment, and behavior) and 2 metabolic drivers (adiposity and dysglycemia) with applications to 3 cardiovascular endpoints (coronary heart disease, heart failure, and atrial fibrillation). Specific mechanistic pathways are presented configuring early primary drivers with subsequent adiposity, insulin resistance, beta-cell dysfunction, and metabolic syndrome, leading to cardiovascular disease. The context for building this CMBCD model is to expose actionable targets for prevention to achieve optimal cardiovascular outcomes. The tactical implementation of this CMBCD model is the subject of second part of this JACC State-of-the-Art Review. (C) 2020 by the American College of Cardiology Foundation.

【 授权许可】

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