Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries

Dutt, C and Nunes Salles, J E and Joshi, S and Nair, T and Chowdhury, S and Mithal , A and Mohan, V and Kasliwal, R and Sharma, S and Tijssen, J and Tandon, N (2022) Risk Factors Analysis and Management of Cardiometabolic-Based Chronic Disease in Low- and Middle-Income Countries. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 15 . p. 451. ISSN 1178-7007



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.

Item Type:Article
Official URL/DOI:http://dx.doi.org/10.2147/DMSO.S333787
Uncontrolled Keywords:apolipoprotein B; diabetes mellitus; dyslipidemia hypertension; insulin resistance; mitochondrial modulator; non-high-density lipoprotein-cholesterol; triglycerides.
Subjects:Genetics and Diabetes > Genetic Risk Factors
Diabetology > Cardiovascular Diabetology
Divisions:Department of Epidemiology
Department of Diabetology
ID Code:1291
Deposited By:surendar radha
Deposited On:08 Mar 2022 11:49
Last Modified:08 Mar 2022 11:49

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