Study finds interconnected role of abdominal obesity, visceral fat in driving metabolic syndrome, chronic disease risks

The prevalence of chronic metabolic diseases, including diabetes, obesity, fatty liver, and dyslipidemia, is rising rapidly in Korea, with researchers underscoring the interconnected nature of these conditions and their impact on public health. Currently, 6 million Koreans have diabetes, and about 30 percent of the population is overweight or obese.

A study led by Professor Lim Soo of Seoul National University Bundang Hospital’s (SNUBH) Department of Internal Medicine and Professor Jean-Pierre Després of Laval University’s Department of Kinesiology in Canada, consolidated the latest research on metabolic syndrome—encompassing hyperglycemia, hypertension, dyslipidemia, obesity, and arteriosclerosis. 

Published in Nature Reviews Disease Primers (IF: 76.9) in October, the study highlights how these components interact, rather than exist as isolated risk factors.

The research focuses on abdominal obesity and visceral fat accumulation, which trigger inflammation, worsen insulin resistance, and lead to hyperglycemia.

It also aligns with the “cardiovascular-kidney-metabolism” concept proposed by the American Heart Association, showing that metabolic syndrome significantly raises the risk of cardiovascular disease, type 2 diabetes, and chronic kidney disease (CKD).

The study examines drug therapies for metabolic syndrome, emphasizing glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose co-transporter 2 (SGLT2) nhibitors.

Researchers note that SGLT2 inhibitors reduce kidney events in CKD patients even without diabetes or albuminuria. Meanwhile, the non-steroidal mineralocorticoid receptor antagonist finerenone has shown efficacy in reducing kidney events in diabetic CKD patients, and the GLP-1 receptor agonist semaglutide improves both kidney and cardiovascular outcomes.

The article also references Professor Lim’s findings on semaglutide, including his leadership in East Asian phase 3 clinical trials. Notably, the FLOW trial—the first kidney outcomes study for GLP-1 receptor agonists—demonstrated significant reductions in adverse kidney events and cardiovascular deaths among type 2 diabetes patients with CKD.

“These conditions are interconnected through metabolic syndrome and require personalized, integrated treatment systems,” said Professor Lim. While drug advancements are important, he emphasized the role of lifestyle changes.

“Preventing chronic diseases starts with avoiding high-sugar and high-fat foods from a young age, maintaining a balanced diet, and exercising consistently at least three times a week,” he added.