Cardiometabolic diseases remain the leading cause of morbidity and mortality worldwide. Arterial hypertension, dyslipidemia, obesity, and type 2 diabetes mellitus represent the most prevalent and modifiable risk factors contributing to cardiovascular disease development. Importantly, growing epidemiological evidence suggests that the clustering of these risk factors often begins in early adulthood. Abdominal obesity is a key driver of early metabolic disturbances and plays a central role in the development of insulin resistance and cardiometabolic diseases. Increasing evidence indicates that these pathological processes begin at a young age, long before the clinical manifestation of cardiovascular disease. C-peptide, traditionally considered a marker of endogenous insulin secretion, has emerged as an important indicator of insulin resistance and metabolic stress[1]. This narrative review summarizes current evidence on the associations between abdominal obesity, C-peptide, insulin resistance, and inflammatory mechanisms in young adults. Particular attention is given to the role of low-grade inflammation and gut-derived hormones in the early stages of cardiometabolic risk formation. Understanding these mechanisms may facilitate the identification of early biomarkers and support the development of preventive strategies targeting young populations. Insulin resistance represents a central mechanism linking abdominal obesity to cardiometabolic disorders[2]. Visceral adiposity promotes macrophage infiltration of adipose tissue and increased secretion of proinflammatory cytokines, including IL-6 and TNF-α. These cytokines interfere with insulin receptor signaling and exacerbate metabolic dysregulation.

arterial hypertension; dyslipidemia; cardiometabolic risk; abdominal obesity; visceral adipose tissue; insulin resistance; C-peptide; atherosclerosis;

Okazaki S., Yokoyama T., Miyauchi K. Et al. Early statin treatmentin patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study. Circulation. 2004;110(9):1061-8. Https:// doi.org/10.1161/01.CIR.0000140261.58966.A4

Newman C.B., Palmer G., Silbershatz H., Szarek M. Safety of atorvastatin derived from analysis of 44 completed trials in 9,416 patients. Am J Cardiol. 2003;92(6):670-676. Https://doi.org/10.1016/ S0002-9149(03)00820-8

Fiorentino R., Chiarelli F. Statins in Children, an Update. Int J Mol Sci. 2023;24(2):1366. Https://doi.org/10.3390/ijms24021366

Ferrari F., Martins V.M., Rocha V.Z., Santos R.D. Advances with lipidlowering drugs for pediatric patients with familial hypercholesterolemia. Expert Opin Pharmacother. 2021;22(4):483-495. Https://doi.org/10.10 80/14656566.2020.1832991

Ivanovic B., Tadic M. Fixed combination of amlodipine/atorvastatin: from mechanisms to trials. J Cardiovasc Pharmacol Ther. 2013;18(6):544-549. Https://doi.org/10.1177/1074248413492907

Erdine S., Ro Y.M., Tse H.F. et al. Single-pill amlodipine/atorvastatin helps patients of diverse ethnicity attain recommended goals for blood pressure and lipids (the Gemini-AALA study). J Hum Hypertens. 2009;23(3):196-210. Https://doi.org/10.1038/jhh.2008.114

Ference B.A., Bhatt D.L., Catapano A.L. et al. Association of Genetic Variants Related to Combined Exposure to Lower Low-Density Lipoproteins and Lower Systolic Blood Pressure With Lifetime Risk of Cardiovascular Disease. JAMA. 2019;322(14):1381-1391. Https://doi. Org/10.1001/jama.2019.14120

21. Messerli F.H., Bakris G.L., Ferrera D. Et al. Efficacy and safety of coadministered amlodipine and atorvastatin in patients with hypertension and dyslipidemia: results of the AVALON trial. J Clin Hypertens (Greenwich). 2006;8(8):571-583. Https://doi.org/10.1111/ j.1524-6175.2006.05636.x