The Heart and Medicine: Exploring the Interconnectedness of Cardiometabolic-related Concerns Through a Systems Biology Approach

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                               The Heart and Medicine: Exploring the Interconnectedness
                               of Cardiometabolic-related Concerns Through a Systems
                               Biology Approach
                               Joseph Lamb, MD; Jeffrey Bland, PhD, FACN, FACB

       Author Affiliations     ABSTrACT                                                 摘要                                                              existe una fase preclínica larga
     Joseph Lamb, MD, is
      director, Intramural
                               Patients do not just wake up one                         罹患心脏病并非一夜之间。相反,                                                 durante la cual la elección del esti-
          Clinical Research,   morning with cardiac disease.                            这是一个潜伏期漫长的过程,在此                                                 lo de vida determina los resultados.
 Metagenics, Gig Harbor,       Instead there is an extended pre-                        期间生活方式的选择具有决定性的                                                 Los avances recientes en nuestro
    Washington; adjunct
                               clinical phase during which life-                        作用。近期我们对氧化应激反应、                                                 entendimiento sobre el estrés oxi-
      faculty, Institute for
Functional Medicine, Gig
                               style choices determine outcome.                         内分泌信号、免疫/炎症平衡及能                                                 dativo, las señales endocrinas, el
     Harbor; and medical       Recent advances in our understand-                       量产生的理解更进一步,让我们看                                                 equilibrio inflamatorio/inmune y
           director, KinDex    ing of oxidative stress, endocrine                       到有效干预的机会。对这些病理生                                                 la producción energética abren las
   Therapeutics, Seattle,
     Washington. Jeffrey
                               signaling, immune/inflammatory                           理学方面的彻底探究将让医生有机                                                 oportunidades para una interven-
Bland, PhD, FACN, FACB,        balance, and energy production                           会为他们的患者提供远离疾病保持                                                 ción eficaz. Una exploración minu-
  is chief science officer,    illuminate opportunities for effica-                     健康的保健之道。                                                        ciosa de estas patofisiologías per-
         Metagenics; chief     cious intervention. A thorough                                                                                           mitirá a los médicos ofrecer a los
          executive officer
             and president,
                               exploration of these pathophysiol-                                                                                       pacientes la oportunidad de un
    MetaProteomics, Gig        ogies will allow physicians the                          SInopSIS                                                        viaje lejos de su enfermedad hacia
Harbor; and chief execu-       opportunity to offer their patients a                    Los pacientes no se levantan de                                 un bienestar óptimo.
       tive officer, KinDex
                               journey away from illness and dis-                       repente una mañana con una
                               ease to optimal wellness.                                enfermedad coronaria. En cambio,
        Joseph Lamb, MD


                                      he currently accepted understanding of cardio-                                    lin resistance, elevated blood pressure, atherogenic dys-
               Citation               vascular disease views the signs and symptoms                                     lipidemia, a proinflammatory state, and a prothrombot-
Global Adv Health Med.
                                      of angina, congestive heart failure, myocardial                                   ic state.3 Though controversy still exists as to whether or
                               infarction (MI), and sudden death as acute episodes                                      not the diagnosis of cardiometabolic syndrome allows
               Key Words       marking a disease process. A systems biology approach                                    for a differentiation of risks beyond the individual fea-
 Cardiometabolic, heart,       provides a different view, one in which there is an                                      tures, this diagnosis is useful in helping identify all the
          systems biology,     overlap among many conditions affecting many organ                                       pathophysiologies that underlie the condition. We must
 dyslipidemia, hyperten-
     sion, atherosclerosis,
                               systems mediated by oxidative stress and immune/                                         consider that beyond the dyslipidemia, hypertension,
 diabetes, cardiovascular      inflammatory dysregulation that contribute to the                                        atherosclerosis, and progression to type 2 diabetes, cere-
        disease, metabolic     development of comorbidities.                                                            bral vascular disease, and cardiovascular disease, the
    syndrome, functional
                                    It has been noted that rheumatoid arthritis and                                     consequences of cardiometabolic syndrome include
             medicine and
      emotional learning,
                               autoimmune inflammatory disease are associated with                                      type 3 diabetes, sleep apnea, malignancies, erectile dys-
        neuropsychology,       an increased risk for cardiovascular disease.1 Sheng et al                               function, nonalcoholic fatty liver disease, end-stage
       psychophysiology,       note in their 2012 Journal of Rheumatology article that                                  renal disease, and osteoporosis.
                               treatment with 3-hydroxy-3-methylglutaryl-coenzyme                                             Though conventional wisdom frequently postu-
                               A (HMG-CoA) reductase inhibitors (statins) were associ-                                  lates that obesity is a cause for heart disease and diabe-
                               ated with reduced total cholesterol levels in patients                                   tes, evidence would suggest instead that obesity may be
                               with osteoarthritis and rheumatoid arthritis.2 More                                      a coexisting sign or indeed even a symptom of the
                               importantly, however, statins were associated with                                       underlying pathophysiology. It is very clear that meta-
                               reduced cardiovascular events and all-cause mortality in                                 bolic syndrome is correlated with the presence of obe-
                               rheumatoid arthritis patients and all-cause mortality in                                 sity. With an increase in the percentage of body fat and
                               osteoarthritis. Thus we would be well suited to think                                    body mass index (BMI) from the normal range to the
                               about cardiovascular disease not as an isolated condition                                moderately obese,
Description: Joseph Lamb, MD, is director, Intramural Clinical Research, Metagenics, Gig Harbor, Washington; adjunct faculty, Institute for Functional Medicine, Gig Harbor; and medical director, KinDex Therapeutics, Seattle, Washington. Jeffrey Bland, PhD, FACN, FACB, is chief science officer, Metagenics; chief executive officer and president, MetaProteomics, Gig Harbor; and chief executive officer, KinDex Therapeutics. 摘要 罹患心脏病并非一夜之间。相反,这是一个潜伏期漫长的过程,在此期间生活方式的选择具有决定性的作用。近期我们对氧化应激反应、内分泌信号、免疫/炎症平衡及能量产生的理解更进一步,让我们看到有效干预的机会。对这些病理生理学方面的彻底探究将让医生有机会为他们的患者提供远离疾病保持健康的保健之道。 Sinopsis Los pacientes no se levantan de repente una ma�ana con una enfermedad coronaria. En cambio, existe una fase precl�nica larga durante la cual la elecci�n del estilo de vida determina los resultados. Los avances recientes en nuestro entendimiento sobre el estr�s oxidativo, las se�ales endocrinas, el equilibrio inflamatorio/inmune y la producci�n energ�tica abren las oportunidades para una intervenci�n eficaz. Una exploraci�n minuciosa de estas patofisiolog�as permitir� a los m�dicos ofrecer a los pacientes la oportunidad de un viaje lejos de su enfermedad hacia un bienestar �ptimo.
PARTNER Lee Dixson