时间标签：数据日期 2026-11-05 · 生成时间 2026-11-05 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/11/02 – 2026/11/06 ｜ 情报发生日期 2026-11-05
研究问题
Triple agonists (GLP-1/GIP/glucagon) such as retatrutide, lysophosphatidic acid receptor antagonists such as bexotegrast and second-generation mineralocorticoid receptor antagonists such as esaxerenone and balcinrenone have significant potential to transform the pathophysiological trajectory of CKM syndrome.20 Whether these agents, with their anti-inflammatory and antifibrotic properties, will complement existing therapies remains an open question.
方法
Cardiovascular–kidney–metabolic (CKM) syndrome is a term coined to highlight the close associations among type 2 diabetes mellitus (T2DM), obesity, renal disease and cardiovascular disease (CVD) and to enhance an integrated clinical care model for patients.；Robert Bright, in his Cases and Observations Illustrative of Renal Disease, described significant structural heart changes in patients with kidney disease.12 However, the most significant clinical advances were made in the early 21st century, supported by epidemiological data.12Figure 1:Stages of CKM syndrome Figure was made using Microsoft Powerpoint (Microsoft, Redmond, WA, USA) CKD = chronic kidney disease; CKM = cardiovascular-kidney-metabolic; CVD = cardiovascular disease; HbA1c = glycated haemoglobin.；Recently, the CKM syndrome has been introduced as a framework for a substantial global call to action, advocating for an interdisciplinary approach to address the growing number of patients that modern healthcare systems are facing.
核心结论
Beyond major CV events, HF and renal failure, the spectrum of CKM-related consequences includes obstructive sleep apnea syndrome,20 cognitive decline and dementia, with a higher odds ratio for male gender and older individuals.32,33 A recent study demonstrated that advancing CKM syndrome stages were associated with significant brain structural changes, including reductions in total brain, gray matter and hippocampal volumes, as well as increased white matter hyperintensity volumes.34 However, the progression along the CKM trajectory, from stage I to stage IV, is not inevitable.；Large CV outcome trials (CVOTs) consistently demonstrate a significant reduction of major adverse cardiovascular events (MACE) and improvements in kidney function.51 Although these agents predominantly reduce fat mass, concomitant reduction in lean body mass has been noted, highlighting the importance of adequate protein intake and resistance exercise.Aside from their glucose-regulating benefits mediated by promoting urinary glucose excretion, SGLT-2i exhibit pleiotropic effects, including a reduced risk of HF and slowing CKD progression.；Thus, an integrated approach to prevention, early detection and timely, interdisciplinary management aimed at promoting weight loss, improving metabolic control and addressing CVD risk factors has emerged as a goal to markedly reduce the consequences of CKM syndrome.Figure 3:Therapeutic targets and clinical benefits of GLP-1RA, SGLT-2i and their combination GLP-1RAs demonstrate particular benefits in reducing ASCVD, whereas SGLT-2i demonstrates particular benefits in HF, CV death and CKD progression.
局限
Robert Bright, in his Cases and Observations Illustrative of Renal Disease, described significant structural heart changes in patients with kidney disease.12 However, the most significant clinical advances were made in the early 21st century, supported by epidemiological data.12Figure 1:Stages of CKM syndrome Figure was made using Microsoft Powerpoint (Microsoft, Redmond, WA, USA) CKD = chronic kidney disease; CKM = cardiovascular-kidney-metabolic; CVD = cardiovascular disease; HbA1c = glycated haemoglobin.；Beyond major CV events, HF and renal failure, the spectrum of CKM-related consequences includes obstructive sleep apnea syndrome,20 cognitive decline and dementia, with a higher odds ratio for male gender and older individuals.32,33 A recent study demonstrated that advancing CKM syndrome stages were associated with significant brain structural changes, including reductions in total brain, gray matter and hippocampal volumes, as well as increased white matter hyperintensity volumes.34 However, the progression along the CKM trajectory, from stage I to stage IV, is not inevitable.；Similarly, the treatment of T2DM was also historically focused on glucose-lowering drugs, aiming for tight control, which, although effective in reducing microvascular complications, did not sufficiently lower the risk of macrovascular events.47 However, the cardiometabolic field has advanced rapidly in recent years, with a growing number of therapeutic options transforming the core approach to treating CKM syndrome.
对本项目的价值
中等价值：属「血管 / 心血管老化」方向；血管 / 心血管老化栏目可用作本项目文献库与综述素材。 ｜ 价值分 2.7/5（★★★☆☆）
全文来源
PubMed PMC JATS（正文 39,460 字符，题名指纹 0.93，已过 PubMed PMCID 官方关联 + 题名指纹 + 正文长度归属校验）
原文题录
- 中文题名：心血管-肾脏-代谢综合征的疾病修饰策略：GLP-1RA 联合 SGLT2i 的作用
- 英文标题：Disease-modifying approach to cardiovascular-kidney-metabolic syndrome: The role of combining GLP-1RAs and SGLT-2is.
- 期刊与标识：TouchREVIEWS in endocrinology · PMID 42979540 · DOI 10.17925/EE.2026.22.2.5 · PMC PMC13730172