Related Experiment Videos
The global cardiovascular-kidney-liver-metabolic burden from 1990 to 2023
Jayanth Jayabaskaran1, Haryo Raden Himan2, Srinithy Nagarajan1
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Background:
The cardiovascular-kidney-liver-metabolic (CKLM) framework represents the multi-organ interplay of systemic metabolic disorders that drive the global burden of cardiovascular diseases (CVD).
Methods:
This study is a descriptive epidemiological analysis of the Global Burden of Disease Study 2023 that examines the trends in mortality and disability-adjusted life years (DALYs) associated with atherosclerotic CVD, chronic kidney disease (CKD), type 2 diabetes (T2D), obesity and metabolic dysfunction-associated steatotic liver disease (MASLD), from 1990 to 2023, across 204 countries and territories. Epidemiological trends were stratified by age, sex, region, and sociodemographic index (SDI).
Findings:
In 2023, the global CKLM burden contributed to 626.7 million DALYs, with an age-standardized DALY rate of 6944.3 per 100,000 population. Atherosclerotic CVD was the largest contributor to the CKLM burden (3924.2 [95% Uncertainty Interval {UI}: 3666.9-4181.4]), followed by obesity (1500.0 [95% UI: 730.4-2206.5]), T2D (956.7 [95% UI: 794.4-1142.4]), CKD (523.8 [95% UI: 468.0-590.1]), and MASLD (39.6 [95% UI: 31.2-49.9]). From 1990 to 2023, CKLM-related age-standardized DALYs fell 24.4%, primarily driven by improvements in atherosclerotic CVD (41.5% decrease), while rapid increases were seen in T2D (37.5% increase) and obesity (23.3% increase). Disparities in CKLM burden exist across SDI, geography, and age-sex categories.
Interpretation:
Improvements in the global CKLM burden, driven by gains in CVD prevention, are offset by the rising burden of upstream CKLM drivers including obesity, T2D, CKD and MASLD. Population-focused strategies for prevention need to target shared risk factors driving the CKLM syndemic to achieve the greatest reduction in overall morbidity and mortality.
Funding:
This research was supported by the NMRC Research Transition Award and the CSDU Clinician-Scientist Grant.
Related Concept Videos
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Chronic Kidney Disease II: Clinical Manifestations
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Hypertension II: Pathophysiology
Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug