Metabolic reprogramming in cardiometabolic syndrome: mechanisms, biomarkers, and therapeutic approaches

Cardiometabolic syndrome (CMS), a combination of central obesity, insulin resistance, dyslipidemia, and hypertension, accounts for a significant portion of the global incidence of type 2 diabetes and cardiovascular disease. Traditionally, hormonal and hemodynamic dysregulation have been considered the primary causes of CMS. However, increasing evidence shows that metabolic reprogramming, which involves long-lasting, tissue-specific changes in cellular metabolism, is a common cause of the initiation and progression of CMS. This review examines the systemic metabolic alterations, the molecular pathways facilitating these modifications, and the transformative impact of multiomics platforms on the discovery of novel biomarkers and therapeutic targets. We also discuss drugs that can help restore metabolic flexibility and stop disease progression.