Beyond Labels: Integrating Metabolic, Cardiovascular, and Renal Care to Address Systemic Drivers of Cardiometabolic Disease
Original framing: “[Editorial] Who owns cardiometabolic disease?” — The Lancet
Robust epidemiological and mechanistic studies link excess adiposity to insulin resistance, chronic low‑grade inflammation, endothelial dysfunction, and ectopic fat deposition in liver and heart tissue. Integrated omics analyses demonstrate that these pathways converge on common molecular hubs such as NF‑κB and AMPK, offering targets for combined therapeutic strategies. The scientific consensus supports moving beyond organ‑specific guidelines toward a unified metabolic framework.
Cardiometabolic disease is not a collection of isolated organ failures but a systemic manifestation of entrenched metabolic imbalance amplified by historical, cultural, and structural forces.
Indigenous holistic health models, historical shifts in food production, and cross‑cultural dietary wisdom converge to illustrate that prevention must be rooted in community‑controlled food systems and integrated clinical pathways. Scientific evidence of shared molecular pathways validates the creation of multidisciplinary metabolic networks, while predictive modeling and policy reforms can operationalise early intervention. Elevating marginalised voices and employing a trickster lens destabilises the entrenched specialist hierarchy, opening space for a unified, equitable approach that aligns health outcomes with social and environmental justice.