Cardiometabolic risk: New chronic care models.

Autor: Nieto-Martínez R; LifeDoc Health, Memphis, Tennessee, USA.; Department of Global Health and Population. Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.; Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela., González-Rivas JP; Department of Global Health and Population. Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.; Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela.; International Clinical Research Center (ICRC), St. Anne's University Hospital Brno (FNSUA), Brno, Czech Republic., Mechanick JI; The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA.; Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2021 Nov; Vol. 45 (S2), pp. 85-92.
DOI: 10.1002/jpen.2264
Abstrakt: Cardiometabolic risk factors, and the chronic cardiovascular diseases (CVDs) that result from them, are highly prevalent in the US and amenable to clinical nutrition interventions. This creates an urgency to develop comprehensive care models that incorporate prevention-based actions by improving lifestyle routines. Such care models should account for social determinants of health, ethnocultural variables, and challenges to sustainability. The relevance of these newly designed chronic care models is to inform and facilitate early intervention, primarily consisting of lifestyle changes and healthy nutrition, which mitigates progression from one stage to subsequent, higher morbidity stages to a greater extent than late intervention. In this article, the mechanistic drivers and ethnocultural validation of the Cardiometabolic-Based Chronic Disease (CMBCD) model are reviewed. Main findings are that in CMBCD, primary (genetics, environment, and behavior) and metabolic (obesity as Adiposity-Based Chronic Disease [ABCD], type 2 diabetes as Dysglycemia-Based Chronic Disease [DBCD], hypertension, and dyslipidemia) drivers initiate and perpetuate the progression of CVD. Epidemiological findings and molecular mechanisms support intra-ABCD/DBCD, as well as ABCD to DBCD stage progression culminating in CVD. The ABCD definition overcomes weight stigma and body mass index underperformance by considering adiposity amount, distribution, and function; and the DBCD definition overcomes criticisms of prediabetes and an exclusive glucocentric approach by considering insulin resistance and residual vascular risk along a clinical spectrum. In conclusion, clinicians should approach patients using the CMBCD model to incorporate lifestyle changes as early as possible to optimally mitigate the burden of CVD.
(© 2021 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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