Metabolic Institute of America, Tarzana, CA, USA.
The Frist Clinic, Nashville, TN, USA.
Metabolism. 2024 Oct;159:155931. doi: 10.1016/j.metabol.2024.155931. Epub 2024 Jun 7.
The spectrum of cardiorenal and metabolic diseases comprises many disorders, including obesity, type 2 diabetes (T2D), chronic kidney disease (CKD), atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), dyslipidemias, hypertension, and associated comorbidities such as pulmonary diseases and metabolism dysfunction-associated steatotic liver disease and metabolism dysfunction-associated steatohepatitis (MASLD and MASH, respectively, formerly known as nonalcoholic fatty liver disease and nonalcoholic steatohepatitis [NAFLD and NASH]). Because cardiorenal and metabolic diseases share pathophysiologic pathways, two or more are often present in the same individual. Findings from recent outcome trials have demonstrated benefits of various treatments across a range of conditions, suggesting a need for practice recommendations that will guide clinicians to better manage complex conditions involving diabetes, cardiorenal, and/or metabolic (DCRM) diseases. To meet this need, we formed an international volunteer task force comprising leading cardiologists, nephrologists, endocrinologists, and primary care physicians to develop the DCRM 2.0 Practice Recommendations, an updated and expanded revision of a previously published multispecialty consensus on the comprehensive management of persons living with DCRM. The recommendations are presented as 22 separate graphics covering the essentials of management to improve general health, control cardiorenal risk factors, and manage cardiorenal and metabolic comorbidities, leading to improved patient outcomes.
心肾代谢疾病谱包含多种疾病，包括肥胖、2 型糖尿病（T2D）、慢性肾脏病（CKD）、动脉粥样硬化性心血管疾病（ASCVD）、心力衰竭（HF）、血脂异常、高血压以及相关的合并症，如肺部疾病和代谢功能障碍相关的脂肪性肝病和代谢功能障碍相关的脂肪性肝炎（分别为 MASLD 和 MASH，以前称为非酒精性脂肪性肝病和非酒精性脂肪性肝炎[NAFLD 和 NASH]）。由于心肾代谢疾病具有共同的病理生理途径，因此两种或多种疾病通常同时存在于同一患者中。最近的结局试验结果表明，各种治疗方法在多种情况下均有益处，这表明需要制定实践建议，以指导临床医生更好地管理涉及糖尿病、心肾和/或代谢（DCRM）疾病的复杂情况。为了满足这一需求，我们成立了一个由领先的心脏病专家、肾脏病专家、内分泌学家和初级保健医生组成的国际志愿者工作组，制定了 DCRM 2.0 实践建议，这是对以前发表的关于综合管理 DCRM 患者的多专业共识的更新和扩展修订。这些建议以 22 个独立的图表呈现，涵盖了改善整体健康、控制心肾危险因素以及管理心肾代谢合并症的要点，从而改善患者的结局。
