Integrating Immunometabolism and Chronic Inflammation: A Systems-Based Approach to Multimorbidity in Internal Medicine

Chronic diseases in internal medicine have traditionally been approached as isolated entities; however, emerging evidence supports their interpretation as interconnected processes sustained by metabolic–inflammatory networks. This review aimed to analyze and integrate current high-impact evidence on immunometabolism, chronic inflammation, and systemic dysregulation in order to propose a systems-based framework applicable to clinical practice and medical education. A structured narrative review was conducted using 20 peer-reviewed references indexed in major biomedical databases. The analysis focused on key mechanisms including metaflammation, insulin resistance, adipose tissue inflammation, vascular dysfunction, gut microbiota interactions, skeletal muscle signaling, and ageing-related inflammatory changes. The results demonstrated a consistent convergence across mechanistic, biological, and clinical domains, highlighting chronic inflammation as a central driver linking obesity, type 2 diabetes mellitus, atherosclerosis, and multimorbidity. Furthermore, the evidence revealed that these processes are dynamically influenced by lifestyle factors, environmental exposures, and ageing. The integration of these findings supports a network-based model of disease that transcends traditional organ-specific approaches. This framework offers potential benefits in clinical reasoning, risk stratification, preventive strategies, and medical education, particularly in regions with a high burden of chronic disease such as Mexico, Colombia, and Ecuador. In conclusion, metabolic–inflammatory networks represent a fundamental organizing principle in chronic disease, providing a coherent and clinically relevant perspective for modern internal medicine.