Here's another reason to watch your weight.
Experts at the American College of Cardiology have issued guidelines for the newly defined cardiovascular-kidney-metabolic syndrome, or CKM. It's a term for potentially life-threatening conditions you've heard of before, but the belief now is that they're all connected and that excess weight is a key risk factor.
Cardiologist Dr. Ashesh Parikh with Texas Health Plano and with Texas Health Physicians Group talks about this with KERA's Sam Baker.
Dr. Parikh: You know, you were treating diabetes separately, kidney disease separately, obesity separately, but now we know all three sort of combine.
Baker: What exactly does it do to the body?
Dr. Parikh: It's all based off of your adipose tissue. The waist circumference is the parameter that is used to assess for your risk factor. If you are overweight, for example, primary prevention measures are important to try to lose weight, eat better, exercise, et cetera.
But say if you don't do that, then essentially the extra adipose causes insulin resistance and higher inflammatory response in your body. Which then can lead to heart disease, it can lead to diabetes, and that can lead to you having what's called chronic kidney disease.
So, essentially we're trying to prevent with early prevention to not have a heart attack, to not having kidneys go bad and not have or develop diabetes.
Baker: So, it's not as if heart disease, diabetes, and kidney disease join forces...
Dr. Parikh: No, it's not like you develop all three at once. It's more so a process where we know now who are at risk for developing CKM. And it's something that we as cardiologists and a lot of doctors see on a day-to-day basis. High blood pressure, for example, is a risk factor for heart disease and stroke. So if we don't control your blood pressure, you will develop kidney disease. So we know that occurs. Same thing with diabetes. If you don't control your diabetes, when the sugars go so high, you will develop coronary artery disease.
So, we know independently that if you have one, you are at risk to develop the other. But now essentially it's an entity where you try to screen patients earlier because once you get one diagnosis of say heart disease, then kidney disease and or diabetes is not far behind.
Baker: The newly issued guidelines are aimed at what? Getting doctors to look closer and earlier?
Dr. Parikh: Yeah. So many years ago, colonoscopy screening guidelines was when you turned 50. Now that guideline has shifted earlier to the age of 45. Guidelines prior would say you would screen patients for kidney disease above the age 60. Screening for heart disease was at 40. But now if somebody is overweight by their BMI, you should start screening them at age 30.
That means you do do an EKG. You do a lab work to look at your cholesterol levels, you do lab work, to look at your diabetes levels and you do that work to look at your kidney levels. So now essentially you kind of screen it all together at a much younger age so you can tackle the problem sooner.
Baker: Are there ways to minimize risks for CKM?
Dr. Parikh: That kind of goes back to preventive measures, right? So if you're somebody who's 30, 35 years old, and if you are overweight, so by criteria, your BMI above 25 is overweight, and if your BMI is above 30, you're obese. And so you need to work on the weight loss aspect, and that's really the best preventive strategy.
And if you can maintain that, and if you do that, then your risk for CKM essentially is so low. Because A, you don't have the fat tissue that turns into inflammation and insulin, and then hence you won't develop or be at risk for developing diabetes or kidney disease.
Baker: But Dr. Parikh, you know very well, losing the belly fat is the hardest thing to do.
Dr. Parikh: It is the hardest thing, right? But I will say though, with the advent of all the GLP-1s and semaglutides that have been out, there's tons of them in the market now for the last several years and they are actually very, what we call, cardio protective. So they've actually shown good cardiovascular benefits of protecting you, especially if you're diabetic, from coronary artery disease. So, you know I think that's an open discussion anyone should have with their family doctor or cardiologist.
RESOURCES:
First ever guidelines released to screen for condition that impacts 9 in 10 Americans
Doctors Should Do More Screening for Excess Body Fat and Its Health Risks
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