Unpacking Metabolic Conditions: An Interdisciplinary Conversation

And I want to start by just laying the foundation for what we're going to discuss, which is these are complicated patients and these are complicated conditions.

And most of the patients that we see with these metabolic arrangements, have an underlying metabolic burden, which then starts to affect and recruit other organs.

So liver is involved, heart disease is involved, kidneys are involved.

So as we look across these metabolic conditions and we have a patient, what we see is that that same patient will have evidence of organ damage.

And this organ damage then tends to proceed over time.

But the clinical presentation of that same patient with these metabolic comorbidities is primarily determined by which of those organ gets the damage the fastest.

So if patient's liver is the one that's taking the most damage and progressing the fastest, we'll see end-stage liver disease.

Conversely, if it's the heart, they have heart failure, and if they have kidney issues or kidney progression, then they get end-stage renal disease.

But we see a significant overlap across the disease states and how metabolic disease then drives the clinical presentation.

So this is the foundation of what we want to talk about is what this is, how do we identify it, and how do we treat it, and focusing on liver disease because that is something that's becoming exceedingly common Whereas in the United States, we are seeing one in three patients who have non-alcoholic or metabolic dysfunction associated steatotic liver disease, or MAZELD for short.

Yeah,

I think that's a really important point that many of these patients, it's difficult to think about treating just one disease state because these patients have such an overlap and that will play a big role in our selection of treatment is how do we optimize these patients, not just from a unilateral approach of one disease state, but kind of how do we paint with a broader brush to treat multiple diseases when we're targeting the best treatments.

One of the biggest things when it comes to how we can treat these patients is really recognizing disease state really early on.

Dr. Siddiqui will spend some time kind of explaining to us what are the best ways that we can work to identify these patients, whether that be from imaging or laboratory results.

But early recognition is a huge part of making sure that these patients don't have disease that progresses to the point of end organ damage.

notably, you know, with our patients who experience Maslod, cardiovascular disease is actually the most frequent cause of death.

So these patients really, even though they're having significant liver disease, what's actually killing them is that cardiovascular piece.

You know, part of the reason why we want to identify the disease early is because, you know, when people get late stage disease, it's very hard to cure end stage renal disease or cirrhosis or heart failure.

So if we can identify it early, sometimes simplest things like lifestyle modification will work.

And then if we know that patient, then if that doesn't work, then we can move up to the next step.

And the whole goal is to, you know, prevent that late stage impact of the disease.

You know, underdiagnosis of Maslod is one of the huge things that impacts our patient and is a significant barrier to both medical treatment and the prevention of cardiometabolic disease.