International Journal of Diabetes & its Complications
ISSN: 2573-8895 | DOI: 10.64030/2573-8895
Weizhi Luo, Xinyue Wang, Shihong Xiong, Ke Cheng, Shanshan Yang, Yuxin Wang, Na Gong and Canmin Zhu
Background: Cardiometabolic-kidney (CKM) syndrome represents a growing global health burden, with dysfunctional adipose tissue (DATA) serving as a central pathophysiological hub linking obesity, type 2 diabetes (T2D), and chronic kidney disease (CKD). The escalating prevalence of visceral adiposity (affecting 41.5% of obese populations) necessitates integrated organ protection strategies targeting adipose-driven cardiorenal metabolic dysregulation.
Objective: To establish a DATA-centric multidisciplinary intervention model for stage-specific CKM management, integrating adipose pathophysiology, pharmacotherapy, lifestyle modification, and clinical decision support systems (DSS).
Methods: This review synthesizes evidence from 49 peer-reviewed studies (2023–2025) using PRISMA guidelines. We propose a DATA-centric multidisciplinary framework integrating: Adipocyte pathophysiology (inflammatory cytokine release, TGF-β/ Smad3 fibrotic signaling). Pharmacotherapy (GLP-1RAs/SGLT2is for weight loss and cardiorenal protection), Lifestyle interventions (nutrition/exercise protocols), Decision support systems (DSS), with eGFR-stratified dosing algorithms. Clinical validation with data from Wuhan Union Hospital confirmed a 37% reduction in cardiorenal events (95% CI:29-45) in CKM Stage 3–4 patients under DSS-guided care.
Results: Key findings reveal: Mechanistic insights: Visceral adipose TGF-β1 release activates cardiac/renal Smad2/3 phosphorylation (3.1-fold ↑ fibrosis risk; P<0.01), while glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce body weight by 5-15% and CKD progression by 40% (P<0.001). Intervention efficacy: DSS-driven dynamic dosing (e.g., 50% SGLT2i reduction at eGFR 15–44 mL/min) prevented electrolyte imbalances in 89% of high-risk patients. Clinical outcomes: DATA- model implementation lowered all-cause mortality by 28% (HR 0.72, 95% CI 0.64–0.81) in CKM Stage 3–4 cohorts.
Conclusion: The DATA-centric framework enables precision management of CKM syndrome through stage-specific organ protection strategies. Multinational trials must validate DSS algorithms for future translation and addressing socioeconomic barriers to implementation.