These three disorders could really be “CKM syndrome,” which can be treated with drugs like Ozempic
Amy Bies was recovering in the hospital from injuries inflicted during a car accident in May 2007 when routine laboratory tests showed that her blood glucose and cholesterol were both dangerously high. Doctors ultimately sent her home with prescriptions for two standard drugs, metformin for what turned out to be type 2 diabetes and a statin to control her cholesterol levels and the heart disease risk they posed.
The combo, however, didn’t prevent a heart attack in 2013. And by 2019 she was on 12 different prescriptions to manage her continued high cholesterol and her diabetes and to reduce her heart risk. The resulting cocktail left her feeling so terrible that she considered going on medical leave from work. “I couldn’t even get through my day. I was so nauseated,” she said. “I would come out to my car in my lunch hour and pray that I could just not do this anymore.”
Medical researchers now think Bies’s conditions were not unfortunate co-occurrences. Rather they stem from the same biological mechanisms. The medical problem frequently begins in fat cells and ends in a dangerous cycle that damages seemingly unrelated organs and body systems: the heart and blood vessels, the kidneys, and insulin regulation and the pancreas. Harm to one organ creates ailments that assault the other two, prompting further illnesses that circle back to damage the original body part.
On supporting science journalism
If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.
Diseases of these three organs and systems are “tremendously interrelated,” says Chiadi Ndumele, a preventive cardiologist at Johns Hopkins University. The ties are so strong that in 2023 the American Heart Association grouped the conditions under one name: cardio-kidney-metabolic syndrome (CKM), with “metabolic syndrome” referring to diabetes and obesity.
The good news, says Ndumele, who led the heart association group that developed the CKM framework, is that CKM can be treated with new drugs. The wildly popular GLP-1 receptor agonists, such as Wegovy, Ozempic and Mounjaro, target common pathology underlying CKM. “The thing that has really moved the needle the most has been the advances in treatment,” says Sadiya Khan, a preventive cardiologist at Northwestern University. Although most of these drugs come only in injectable forms that can cost several hundred dollars a week, pill versions of some medications are up for approval, and people on Medicare could pay just $50 a month for them under a new White House pricing proposal. The appearance of these drugs on the scene is fortunate because researchers estimate that 90 percent of Americans have at least one risk factor for the syndrome.
More than a century before Bies entered the hospital, doctors had noticed that many of the conditions CKM syndrome comprises often occur together. They referred to the ensemble by terms such as “syndrome X.” People with diabetes, for instance, are two to four times more likely to develop heart disease than those without diabetes. Heart disease causes 40 to 50 percent of all deaths in people with advanced chronic kidney disease. And diabetes is one of the strongest risk factors for developing kidney conditions.
At present, around 59 million adults worldwide have diabetes, about 64 million are diagnosed with heart failure, and approximately 700 million live with chronic kidney disease.
... continue reading