Cargando…
Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries
The epidemic of obesity or adiposity-based chronic diseases presents a significant challenge with the rising prevalence of morbidities and mortality due to atherosclerotic cardiovascular diseases (ASCVD), especially in low- and middle-income countries (LMIC). The underlying pathophysiology of metabo...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858768/ https://www.ncbi.nlm.nih.gov/pubmed/35210795 http://dx.doi.org/10.2147/DMSO.S333787 |
_version_ | 1784654306600812544 |
---|---|
author | Dutt, Chaitanya Nunes Salles, Joao Eduardo Joshi, Shashank Nair, Tiny Chowdhury, Subhankar Mithal, Ambrish Mohan, Viswanathan Kasliwal, Ravi Sharma, Satyawan Tijssen, Jan Tandon, Nikhil |
author_facet | Dutt, Chaitanya Nunes Salles, Joao Eduardo Joshi, Shashank Nair, Tiny Chowdhury, Subhankar Mithal, Ambrish Mohan, Viswanathan Kasliwal, Ravi Sharma, Satyawan Tijssen, Jan Tandon, Nikhil |
author_sort | Dutt, Chaitanya |
collection | PubMed |
description | The epidemic of obesity or adiposity-based chronic diseases presents a significant challenge with the rising prevalence of morbidities and mortality due to atherosclerotic cardiovascular diseases (ASCVD), especially in low- and middle-income countries (LMIC). The underlying pathophysiology of metabolic inflexibility is a common thread linking insulin resistance to cardiometabolic-based chronic disease (CMBCD), including dysglycemia, hypertension, and dyslipidemia progressing to downstream ASCVD events. The complex CMBCD paradigm in the LMIC population within the socio-economic and cultural context highlights considerable heterogeneity of disease predisposition, clinical patterns, and socio-medical needs. This review intends to summarize the current knowledge of CMBCD. We describe recently established or emerging trends for managing risk factors, assessment tools for evaluating ASCVD risk, and various pharmacological and non-pharmacological measures particularly relevant for LMICs. A CMBCD model positions insulin resistance and β-cell dysfunction at the summit of the disease spectrum may improve outcomes at a lower cost in LMICs. Despite identifying multiple pathophysiologic disturbances constituting CMBCD, a large percentage of the patient at risk for ASCVD remains undefined. Targeting dysglycemia, dyslipidemia, and hypertension using antihypertensive, statins, anti-glycemic, and antiplatelet agents has reduced the incidence of ASCVD. Thus, primordial prevention targeting pathophysiological changes that cause abnormalities in adiposity and primary prevention by detecting and managing risk factors remains the foundation for CMBCD management. Therefore, targeting pathways that address mitochondrial dysfunction would exert a beneficial effect on metabolic inflexibility that may potentially correct insulin resistance, β cell dysfunction and, consequently, would be therapeutically effective across the entire continuum of CMBCD. |
format | Online Article Text |
id | pubmed-8858768 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-88587682022-02-23 Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries Dutt, Chaitanya Nunes Salles, Joao Eduardo Joshi, Shashank Nair, Tiny Chowdhury, Subhankar Mithal, Ambrish Mohan, Viswanathan Kasliwal, Ravi Sharma, Satyawan Tijssen, Jan Tandon, Nikhil Diabetes Metab Syndr Obes Review The epidemic of obesity or adiposity-based chronic diseases presents a significant challenge with the rising prevalence of morbidities and mortality due to atherosclerotic cardiovascular diseases (ASCVD), especially in low- and middle-income countries (LMIC). The underlying pathophysiology of metabolic inflexibility is a common thread linking insulin resistance to cardiometabolic-based chronic disease (CMBCD), including dysglycemia, hypertension, and dyslipidemia progressing to downstream ASCVD events. The complex CMBCD paradigm in the LMIC population within the socio-economic and cultural context highlights considerable heterogeneity of disease predisposition, clinical patterns, and socio-medical needs. This review intends to summarize the current knowledge of CMBCD. We describe recently established or emerging trends for managing risk factors, assessment tools for evaluating ASCVD risk, and various pharmacological and non-pharmacological measures particularly relevant for LMICs. A CMBCD model positions insulin resistance and β-cell dysfunction at the summit of the disease spectrum may improve outcomes at a lower cost in LMICs. Despite identifying multiple pathophysiologic disturbances constituting CMBCD, a large percentage of the patient at risk for ASCVD remains undefined. Targeting dysglycemia, dyslipidemia, and hypertension using antihypertensive, statins, anti-glycemic, and antiplatelet agents has reduced the incidence of ASCVD. Thus, primordial prevention targeting pathophysiological changes that cause abnormalities in adiposity and primary prevention by detecting and managing risk factors remains the foundation for CMBCD management. Therefore, targeting pathways that address mitochondrial dysfunction would exert a beneficial effect on metabolic inflexibility that may potentially correct insulin resistance, β cell dysfunction and, consequently, would be therapeutically effective across the entire continuum of CMBCD. Dove 2022-02-16 /pmc/articles/PMC8858768/ /pubmed/35210795 http://dx.doi.org/10.2147/DMSO.S333787 Text en © 2022 Dutt et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Review Dutt, Chaitanya Nunes Salles, Joao Eduardo Joshi, Shashank Nair, Tiny Chowdhury, Subhankar Mithal, Ambrish Mohan, Viswanathan Kasliwal, Ravi Sharma, Satyawan Tijssen, Jan Tandon, Nikhil Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries |
title | Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries |
title_full | Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries |
title_fullStr | Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries |
title_full_unstemmed | Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries |
title_short | Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries |
title_sort | risk factors analysis and management of cardiometabolic-based chronic disease in low- and middle-income countries |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858768/ https://www.ncbi.nlm.nih.gov/pubmed/35210795 http://dx.doi.org/10.2147/DMSO.S333787 |
work_keys_str_mv | AT duttchaitanya riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT nunessallesjoaoeduardo riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT joshishashank riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT nairtiny riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT chowdhurysubhankar riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT mithalambrish riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT mohanviswanathan riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT kasliwalravi riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT sharmasatyawan riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT tijssenjan riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries AT tandonnikhil riskfactorsanalysisandmanagementofcardiometabolicbasedchronicdiseaseinlowandmiddleincomecountries |