At the 2025 Peking University Diabetes Forum & Coastal Long Bridge Symposium on Metabolic Diseases (Season 1, Quanzhou), Dr. Lin Chu of Peking University People’s Hospital pointed out that anti-inflammatory therapy has important clinical value, aiming to provide a reference for clinical practice.
In 2023, the President of the American Heart Association (AHA) formally proposed the concept of cardiorenal-metabolic (CKM) syndrome and published a related presidential advisory article in Circulation. This article systematically elaborated the staging, pathophysiological mechanisms, and comprehensive management strategies of diseases involving the cardiovascular‑renal‑metabolic axis, marking a major upgrade in the concept of multidisciplinary comorbidity management.
The concept of CKM arose from advances in clinical and scientific understanding: cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic diseases such as diabetes do not exist independently. They share a common pathogenic background and overlapping pathophysiological mechanisms. Clinically, it has been observed that patients with diabetes have a significantly elevated risk of cardiovascular and renal events, indicating that these three conditions should no longer be managed in isolation, but rather treated as an interconnected and interactive whole — a major innovation in therapeutic philosophy.
For a long time, the treatment of cardiovascular disease, diabetes, and kidney disease has focused mainly on controlling traditional risk factors such as blood glucose, blood pressure, and blood lipids. However, even when these metabolic parameters are controlled and relevant medications are adequately used, patients still carry a high residual cardiorenal risk. This suggests that current interventions do not address the full spectrum of mechanisms driving disease progression.
From a pathophysiological perspective, three core pathways drive the development and progression of these three categories of diseases:metabolic disturbance, hemodynamic abnormality, and chronic inflammation/fibrosis.Among them, inflammation remains a relatively weak area in current treatment and a major contributor to residual risk. Metabolic disorders and hemodynamic changes induce persistent chronic inflammation, which in turn worsens metabolic abnormalities, creating a vicious cycle.
For this reason, chronic inflammation is regarded as a key link connecting the cardiovascular, renal, and metabolic systems. Anti-inflammatory intervention has attracted increasing attention and emerged as a novel mechanistic target in the management of CKM syndrome, offering a new therapeutic direction to further improve patient prognosis.