Metabolic Syndrome and Cardiovascular-Kidney-Metabolic Dysfunction: An Integrative Review of Pathophysiology and Clinical Outcomes
DOI:
https://doi.org/10.64784/209Palabras clave:
Metabolic syndrome, Cardiovascular disease, Chronic kidney disease, Insulin resistance, Obesity, Endothelial dysfunction, Oxidative stress, Cardiometabolic risk, Inflammation, Hypertension, Dyslipidemia, Cardiovascular-kidney-metabolic syndrome, Preventive medicine, Endocrinology, NephrologyResumen
Metabolic syndrome is currently recognized as a major multisystem disorder associated with significant cardiovascular, renal, endocrine, and inflammatory complications. The present review aimed to analyze the pathophysiological mechanisms, epidemiological characteristics, cardiovascular and renal outcomes, and current therapeutic perspectives associated with metabolic syndrome through an integrative analysis of recent scientific literature. A narrative and integrative review methodology based on the Scientific Method and a Process-Based Approach was employed using peer-reviewed publications indexed in PubMed, Scopus, and internationally recognized medical journals. The analyzed evidence demonstrated that insulin resistance, visceral obesity, chronic low-grade inflammation, oxidative stress, endothelial dysfunction, and neurohormonal activation constitute the principal mechanisms underlying multisystem deterioration in metabolic syndrome. Cardiovascular complications including coronary artery disease, heart failure, hypertension, and cerebrovascular disease were strongly associated with metabolic dysfunction. Additionally, chronic kidney disease progression appeared closely linked to glomerular hyperfiltration, fibrosis, inflammatory injury, and endothelial impairment. Epidemiological findings from Mexico, Colombia, and Ecuador revealed increasing prevalence patterns associated with obesity, sedentary lifestyles, nutritional transition, and socioeconomic disparities. The review also identified the importance of multidisciplinary therapeutic strategies involving lifestyle modification, cardiovascular risk reduction, glycemic control, renal protection, and emerging pharmacological therapies such as GLP-1 receptor agonists and SGLT2 inhibitors. Overall, metabolic syndrome should be understood as a systemic cardiometabolic disorder requiring comprehensive clinical management, preventive medicine strategies, and continued scientific investigation to reduce long-term morbidity and mortality.
Referencias
• Alberti, K. G. M. M., Zimmet, P., & Shaw, J. (2006). Metabolic syndrome—a new world-wide definition. Diabetic Medicine, 23(5), 469–480. https://doi.org/10.1111/j.1464-5491.2006.01858.x
• Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J. C., James, W. P. T., Loria, C. M., & Smith, S. C. Jr. (2009). Harmonizing the metabolic syndrome. Circulation, 120(16), 1640–1645. https://doi.org/10.1161/CIRCULATIONAHA.109.192644
• Arteaga, J. M., Rincón, C. J., & Gómez, L. F. (2024). Prevalence of type 2 diabetes, overweight, obesity, and metabolic syndrome in adults in Bogotá, Colombia, 2022–2023: A cross-sectional study. Diabetes, Metabolic Syndrome and Obesity, 17, 4395–4407. https://doi.org/10.2147/DMSO.S487610
• Dhondge, R. H., Agrawal, S., & Sharma, S. (2024). A comprehensive review of metabolic syndrome and its implications. Cureus, 16(9), e69470. https://doi.org/10.7759/cureus.69470
• Ferdinand, K. C., Nasser, S. A., & Clayton-Jeter, H. (2024). An overview of cardiovascular-kidney-metabolic syndrome. Cardiology Clinics, 42(4), 555–566. https://doi.org/10.1016/j.ccl.2024.06.001
• Handelsman, Y., Jellinger, P. S., Guerin, C. K., & Mechanick, J. I. (2024). Diabetes, cardiorenal, and metabolic multispecialty practice recommendations. Endocrine Practice, 30(12), 1234–1248. https://doi.org/10.1016/j.eprac.2024.10.002
• Márquez-Sandoval, F., Macedo-Ojeda, G., Viramontes-Hörner, D., Fernández Ballart, J. D., Salas Salvadó, J., & Vizmanos, B. (2011). The prevalence of metabolic syndrome in Latin America: A systematic review. Public Health Nutrition, 14(10), 1702–1713. https://doi.org/10.1017/S1368980010003320
• Martemucci, G., Costagliola, C., Mariano, M., D’andrea, L., Napolitano, P., & D’Alessandro, A. G. (2023). Metabolic syndrome: A narrative review from the oxidative stress to the cardiometabolic risk. Antioxidants, 12(12), 2095. https://doi.org/10.3390/antiox12122095
• Masenga, S. K., Kabwe, L. S., Chakulya, M., & Kirabo, A. (2023). Mechanisms of oxidative stress in metabolic syndrome. International Journal of Molecular Sciences, 24(9), 7898. https://doi.org/10.3390/ijms24097898
• Ndumele, C. E., Neeland, I. J., Tuttle, K. R., Chow, S. L., Mathew, R. O., Khan, S. S., Coresh, J., Bakris, G., Carnethon, M. R., Després, J. P., Ho, J. E., Joseph, J. J., Kernan, W. N., Khera, A., Kosiborod, M. N., Landmesser, U., Lewis, E. F., Palaniappan, L. P., & Shlipak, M. G. (2023). Cardiovascular-kidney-metabolic health: A presidential advisory from the American Heart Association. Circulation, 148(20), 1606–1635. https://doi.org/10.1161/CIR.0000000000001184
• Ndumele, C. E., Rangaswami, J., Chow, S. L., Neeland, I. J., Tuttle, K. R., Khan, S. S., Coresh, J., Mathew, R. O., Baker-Smith, C. M., Carnethon, M. R., Després, J. P., Ho, J. E., Joseph, J. J., Kernan, W. N., Khera, A., Kosiborod, M. N., Landmesser, U., Lewis, E. F., Palaniappan, L. P., & Shlipak, M. G. (2023). Cardiovascular-kidney-metabolic syndrome: A synopsis of the evidence. Circulation, 148(20), 1636–1664. https://doi.org/10.1161/CIR.0000000000001186
• Noubiap, J. J., Nansseu, J. R., Lontchi-Yimagou, E., Nkeck, J. R., Nyaga, U. F., Ngouo, A. T., Tounouga, D. N., Tianyi, F. L., Foka, A. J., Ndoadoumgue, A. L., & Bigna, J. J. (2022). Geographic distribution of metabolic syndrome and its components: A meta-analysis of global data from 28 million individuals. Diabetes Research and Clinical Practice, 188, 109924. https://doi.org/10.1016/j.diabres.2022.109924
• Noubiap, J. J., Nansseu, J. R., Lontchi-Yimagou, E., Nkeck, J. R., Nyaga, U. F., Ngouo, A. T., Tounouga, D. N., Tianyi, F. L., Foka, A. J., Ndoadoumgue, A. L., & Bigna, J. J. (2022). Global, regional, and country estimates of metabolic syndrome burden in children and adolescents in 2020. The Lancet Child & Adolescent Health, 6(3), 158–170. https://doi.org/10.1016/S2352-4642(21)00374-6
• Ortiz-Rodríguez, M. A., Yáñez-Velasco, L., Carnevale, A., Romero-Hidalgo, S., Bernal, D., Aguilar-Salinas, C., & Rojas-Martínez, R. (2022). Prevalence of metabolic syndrome among Mexican adults. Metabolic Syndrome and Related Disorders, 20(2), 86–94. https://doi.org/10.1089/met.2021.0066
• Pérez-Galarza, J., Baldeón, L., Franco, O. H., Muka, T., Drexhage, H. A., Voortman, T., & Freire, W. B. (2021). Prevalence of overweight and metabolic syndrome, and associated sociodemographic factors among adult Ecuadorian populations. Diabetes, Metabolic Syndrome and Obesity, 14, 63–74. https://doi.org/10.2147/DMSO.S284795
• Rojas-Martínez, R., Aguilar-Salinas, C. A., Jiménez-Corona, A., Gómez-Pérez, F. J., Barquera, S., & Lazcano-Ponce, E. (2021). Trends in the prevalence of metabolic syndrome and its components in Mexican adults, 2006–2018. Salud Pública de México, 63(6), 713–724. https://doi.org/10.21149/12835
• Rossi, J. L. S., Barbalho, S. M., Reverete de Araujo, R., Bechara, M. D., Sloan, K. P., & Sloan, L. A. (2022). Metabolic syndrome and cardiovascular diseases: Going beyond traditional risk factors. *Diabetes/Metabolism Research and Reviews, 38*(3), e3502. https://doi.org/10.1002/dmrr.3502
• Scurt, F. G., Ganz, M. J., Herzog, C., Bose, B., Mertens, P. R., & Chertow, G. M. (2024). Association of metabolic syndrome and chronic kidney disease: Current evidence and clinical implications. Kidney International Reports, 9(1), 15–29. https://doi.org/10.1016/j.ekir.2023.10.003
• Valizadeh, A., Soltani, S., Larijani, B., & Esmaillzadeh, A. (2023). Metabolic syndrome as a risk factor for the development of chronic kidney disease: A systematic review and meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 17(7), 102799. https://doi.org/10.1016/j.dsx.2023.102799
• Yaribeygi, H., Farrokhi, F. R., Butler, A. E., & Sahebkar, A. (2019). Insulin resistance: Review of the underlying molecular mechanisms. Journal of Cellular Physiology, 234(6), 8152–8161. https://doi.org/10.1002/jcp.27603
