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Objective: The aim of this study was to identify the relationship between preventative dental practices and cardiometabolic health in adolescents. Method and materials: Analysis included children aged 13 to 17years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 who completed an Oral Health Examination and Questionnaire. Deferred dental care was defined as not having a dental visit in the past year. Financial barriers to seeking dental care (vs no financial barriers) were assessed among those with deferred dental care in the past year. Primary cardiometabolic outcomes included obesity, elevated blood pressure, and hypertensive blood pressure. Secondary outcomes included dyslipidemia, glucose intolerance, uric acid, glomerular hyperfiltration, and albuminuria. Regression models adjusted for age, sex, race/ethnicity, household income, food insecurity, health insurance status, household education, and body mass index z-score examined associations using complex survey design procedures. Results: Of 2,861 adolescents, 17.6% (SE 0.9%) did not receive dental care in the past year and 20.2% (SE 1.9%) had a financial barrier to accessing dental care. In adjusted regression models, adolescents with deferred dental care had higher odds of dyslipidemia (odds ratio [OR]= 1.51, 95% CI 1.07 to 2.11, P=.020). Having a financial barrier was associated with lower odds of dyslipidemia (0R=0.35, 95% CI 0.14 to 0.89, P= .03). Financial barriers were associated with lower non-high-density lipoprotein cholesterol (b=-7.95, 95% CI -14.87 to -1.05, P=.03) and higher high-density lipoprotein cholesterol (b=3.06, 95% CI 0.37 to 5.75, P= .03) in adjusted models. Deferred dental care and financial barriers were not associated with any other cardiometabolic parameters. Conclusion: In this nationally representative cohort of adolescents, there was an association between lack of preventative dental care and the cardiometabolic health marker of dyslipidemia. However, financial barriers to dental care were surprisingly associated with higher high-density lipoprotein cholesterol levels and lower odds of dyslipidemia. [ABSTRACT FROM AUTHOR]

BackgroundCardiac Allograft Vasculopathy (CAV) is a leading cause of morbidity and mortality after heart transplantation. There are limited contemporary studies examining post-transplant lipid management and cardiometabolic health.ObjectiveWe study the burden of cardiometabolic derangements post transplantation and its impact on CAV in a modern cohort of heart transplant recipients.MethodsAll heart transplant (HTx) recipients between January 2019 and December 2020, with two lipid assessments and angiographic surveillance were included. Logistic regression was used to assess association of lipid levels with cardiovascular outcomes and CAV.ResultsAmong 87 HTx recipients, atherogenic lipids were significantly elevated after Htx. Median LDL-C increased from a baseline level of 69.5 mg/dL to 86.5 mg/dL, p = 0.002, non-HDL-C 91.5 mg/dL to 118 mg/dL, p < 0.001, triglycerides 94.5 mg/dL to 133 mg/dL, p < 0.001, and remnant cholesterol 19 mg/dL to 27 mg/dL, p < 0.001. Increases in non-HDL-C, triglycerides, and remnant cholesterol were significantly associated with increased risk of CAV (Stanford Grade 4 and intimal thickness). Increases in triglycerides and remnant-C were associated with increased risk of composite major adverse cardiovascular events.ConclusionWe demonstrate a significant increase in atherogenic lipids two years following transplantation with low use (20 %) of high-intensity statin. Increase in atherogenic lipids was associated with increased risk of CAV and increase in triglycerides and remnant cholesterol with increased MACE. Future studies examining cardiometabolic consequences of heart transplantation and optimal treatment strategies to reduce risk of CAV and MACE are needed.

PURPOSE OF REVIEW: Cardiovascular disease is a leading cause of death worldwide. Dyslipidemia is a critical modifiable risk factor for the prevention of cardiovascular disease. Dyslipidemia affects a large population of women and is especially pervasive within racial/ethnic minorities. RECENT FINDINGS: Dyslipidemia in pregnancy leads to worse outcomes for patients and creates increased cardiovascular risk for women at an older age. However, women remain underscreened and undertreated compared to men. Females also comprise a small portion of clinical trial participants for lipid lowering agents with increased disease prevalence compared to trial representation. However, recent lipid trials have shown different efficacies of therapies such as ezetimibe, inclisiran, and bempedoic acid with a greater relative benefit for women. SUMMARY: Pathophysiology of dyslipidemia varies between men and women and across a womans lifetime. While increased lipid levels or lipid imbalances are more common in postmenopausal women over age 50, conditions such as PCOS and FH produce higher cardiovascular risk for young women.Best practices for management of women with dyslipidemia include early screening with lifestyle intervention and pharmacotherapy with statin and non-statin agents to achieve guideline directed LDL-C thresholds.

Diabetes mellitus (DM) is a chronic endocrine disorder that affects more than 20 million people in the United States. DM-related complications affect multiple organ systems and are a significant cause of morbidity and mortality among people with DM. Of the numerous acute and chronic complications, atherosclerosis due to diabetic dyslipidemia is a condition that can lead to many life-threatening diseases, such as stroke, coronary artery disease, and myocardial infarction. The nuclear erythroid 2-related factor 2 (Nrf2) signaling pathway is an emerging antioxidative pathway and a promising target for the treatment of DM and its complications. This review aims to explore the Nrf2 pathways role in combating diabetic dyslipidemia. We will explore risk factors for diabetic dyslipidemia at a cellular level and aim to elucidate how the Nrf2 pathway becomes a potential therapeutic target for DM-related atherosclerosis.

BACKGROUND: According to the Physical Activity Guidelines Advisory Committee Scientific Report, limited evidence is available on sedentary behaviors (screen time) and their joint associations with physical activity (steps) for cardiovascular health in adolescence. The objective of this study was to identify joint associations of screen time and physical activity categories with cardiovascular disease (CVD) risk factors (blood pressure, hemoglobin A1c, cholesterol) in adolescence. METHODS: This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, comprising a diverse sample of 4,718 U.S. adolescents aged 10-15 years between 2018 and 2021. Steps were measured by a Fitbit wearable device and levels were categorized as low (1,000-6,000), medium (> 6,000-12,000), and high (> 12,000) averaged daily step counts. Self-reported recreational screen time hours per day were classified as low (0-4), medium (> 4-8), and high (> 8) hours per day. CVD risk factors including blood pressure, hemoglobin A1c, and cholesterol (total and HDL) were measured. RESULTS: The analytical sample averaged 6.6 h of screen time per day and 9,722 steps per day. In models including both screen time and steps, the high screen time category was associated with a 4.27 higher diastolic blood pressure percentile (95% CI 1.83-6.73) and lower HDL cholesterol (B= -2.85, 95% CI -4.77 to -0.94 mg/dL) compared to the low screen time category. Medium (B = 3.68, 95% CI 1.24-6.11) and low (B = 7.64, 95% CI 4.07-11.20) step categories were associated with higher diastolic blood pressure percentile compared to the high step category. The medium step category was associated with lower HDL cholesterol (B= -1.99, 95% CI -3.80 to -0.19 mg/dL) compared to the high step category. Findings were similar when screen time and step counts were analyzed as continuous variables; higher continuous step count was additionally associated with lower total cholesterol (mg/dL). CONCLUSIONS: Combinations of low screen time and high steps were generally associated with favorable cardiovascular health markers including lower diastolic blood pressure and higher HDL cholesterol, which can inform future adolescent health guidelines.