In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.

2nd Department of Internal Medicine St Anne's University Hospital in Brno and Faculty of Medicine Masaryk University 65691 Brno Czech Republic

Center for Research in Diabetes Metabolism and Nutrition 2nd Department of Internal Medicine 3rd Faculty of Medicine University Hospital Královské Vinohrady 10000 Prague Czech Republic

Department of Epidemiology and Public Health University College London London WC1E6BT UK

Department of Global Health and Population Harvard TH Chan School of Public Health Harvard University Boston MA 02115 USA

Department of Health Support Faculty of Sport Studies Masaryk University 62500 Brno Czech Republic

Department of Internal Medicine Charles University 2nd Faculty of Medicine 10506 Prague Czech Republic

Department of Public Health Faculty of Medicine Masaryk University 62500 Brno Czech Republic

Division of Endocrinology Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai New York NY 10029 USA

Division of Preventive Cardiology Department of Cardiovascular Medicine Mayo Clinic Rochester MN 55905 USA

Foundation for Clinic Public Health and Epidemiology Research of Venezuela Barquisimeto 3001 Lara Venezuela

International Clinical Research Centre 65691 Brno Czech Republic

LifeDoc Health Memphis TN 38119 USA

Marriott Heart Disease Research Program Mayo Clinic Rochester MN 55905 USA

Research Centre for Toxic Compounds in the Environment Masaryk University 62500 Brno Czech Republic

The Marie Josée and Henry R Kravis Center for Cardiovascular Health at Mount Sinai Heart Icahn School of Medicine at Mount Sinai New York NY 10029 USA

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The Influence of Adiposity Levels on the Relation between Perfluoroalkyl Substances and High Depressive Symptom Scores in Czech Adults

Trends in obesity-related cancer burden in Czechia

Association of Self-Reported Depression Symptoms with Physical Activity Levels in Czechia

The Combined Effects of Television Viewing and Physical Activity on Cardiometabolic Risk Factors: The Kardiovize Study

Prediction of Cardiorespiratory Fitness in Czech Adults: Normative Values and Association with Cardiometabolic Health