Periodontal Disease in Young Adults as a Risk Factor for Subclinical Atherosclerosis: A Clinical, Biochemical and Immunological Study (original) (raw)
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Revista de Chimie
Studies on the link between periodontal disease and atherosclerosis have generated conflicting results and the mechanisms underlying this relationship are incompletely understood. Therefore, this study aimed to assess the levels in serum and in gingival crevicular fluid (GCF) of TNF-a, IL-1b and IL-6, to clarify the possible link between periodontitis and hyperlipidemia, as well as the effects of conventional periodontal treatment through scaling and root surfacing on these pro-inflammatory molecules. The study was carried out on a total of 40 subjects divided into two main groups: the study group (n=26) and control group (n=14). The cases included patients with atherosclerosis with prescribed diet (D) or antilipemic therapy with a drug from the statin group (S). Controls (C) were selected from systemically healthy subjects with chronic periodontitis. Samples were performed from crevicular fluid and serum, by determining the initial and post-treatment of TNF-a, IL-1b and IL-6. For a...
Is periodontitis an independent risk factor for subclinical atherosclerosis?
Singapore Dental Journal, 2016
The aim of this study was to assess the interrelationship between periodontitis and atherosclerosis by comparing the ultrasound and clinical markers of atherosclerosis in systemically healthy patients with and without periodontitis and whether periodontitis can be an independent risk factor for atherosclerosis. Materials and methods: Total 40 subjects, of same socioeconomic status, belonging to age group of 35-65 years, were recruited and divided into two groups-Group I (Chronic Generalised Periodontitis without any systemic disease: CP-SH), Group II (Normal healthy patients without periodontitis and any systemic disease-SH). Clinical measurements and ultrasound examinations were carried out. Qualitative variables were analyzed using Chi square test and qualitative variables using Unpaired Student t test. Statistical significance was accepted for p r0.05. Results: Carotid ultrasound revealed right and left intima media thickness (IMT) of 0.62670.016 mm and 0.71570.037 mm respectively in cases versus 0.49570.009 mm and 0.51870.009 mm respectively in controls, with the difference being statistically significant. In cases, mean diastolic blood pressure (DBP) was 83.4574.07 mmHg versus 79.2573.63 mmHg in controls, with the difference being statistically significant. Conclusion: In this study, we found statistically significant differences in carotid IMT and DBP values between cases and controls. These findings suggest independent role of periodontal disease in subclinical atherosclerosis.
Association Between Periodontal Disease and Atherosclerotic Cardiovascular Diseases: Revisited
Frontiers in Cardiovascular Medicine, 2021
Atherosclerotic cardiovascular disease (ACVD) is an inflammatory disease of the coronary arteries associated with atheroma formation, which can cause disability and often death. Periodontitis is ranked as the sixth most prevalent disease affecting humans affecting 740 million people worldwide. In the last few decades, researchers have focused on the effect of periodontal disease (PD) on cardiovascular disease. The aim of this review was to investigate the association between these two diseases. PD is a potential risk factor that may initiate the development, maturation, and instability of atheroma in the arteries. Two mechanisms were proposed to explain such association, either periodontal pathogens directly invade bloodstream or indirectly by increasing systemic level of inflammatory mediators. Interestingly, it has been suggested that improvement in the condition of one disease positively impact the condition of the other one. Highlighting the association between these two disease...
Periodontal disease and inflammatory blood cytokines in patients with stable coronary artery disease
Journal of applied oral science : revista FOB
This cross-sectional study included 91 patients with stable CAD who had been under optimized cardiovascular care. Blood levels of IL-1β, IL-6, IL-8, IL-10, IFN-γ, and TNF-α were measured by Luminex technology. A full-mouth periodontal examination was conducted to record probing depth (PD) and clinical attachment (CA) loss. Multiple linear regression models, adjusting for gender, body mass index, oral hypoglycemic drugs, smoking, and occurre:nce of acute myocardial infarction were applied. CAD patients that experienced major events had higher concentrations of IFN-γ (median: 5.05 pg/mL vs. 3.01 pg/mL; p=0.01), IL-10 (median: 2.33 pg/mL vs. 1.01 pg/mL; p=0.03), and TNF-α (median: 9.17 pg/mL vs. 7.47 pg/mL; p=0.02). Higher numbers of teeth with at least 6 mm of CA loss (R2=0.07) and PD (R2=0.06) were significantly associated with higher IFN-γ log concentrations. Mean CA loss (R2=0.05) and PD (R2=0.06) were significantly related to IL-10 concentrations. Elevated concentrations of TNF-α ...
Measurement of atherosclerosis markers in individuals with periodontitis
Journal of Periodontal & Implant Science
Purpose: The inflammatory response due to inflammatory cytokines, bacterial pathogens, and the altered lipoprotein metabolism in patients with periodontitis indicates that infection with periodontal anaerobic bacteria may influence atherogenesis in vitro and in vivo. We aimed to explore the effect of periodontitis concerning clinical and ultrasound markers of early atherosclerosis. Methods: In this case-control study, a total of 30 systemically healthy adults (15 with periodontitis and 15 without periodontitis) over 40 years of age were studied. Periodontitis was determined by measuring the clinical attachment level (CAL) and radiographic bone loss (RBL). Conventional cardiovascular risk factors, including body mass index, serum levels of total cholesterol (TCH), triglycerides (TG), and high-density and low-density lipoprotein (HDL and LDL, respectively) cholesterol were evaluated. Carotid artery intima-media thickness (IMT) was measured using ultrasonography. Results: The mean values of the CAL and carotid IMT were 5.02±0.9 mm and 0.084±0.01 cm vs. 1.6±0.61 mm and 0.072±0.02 cm in the periodontitis and healthy groups, respectively, reflecting statistically significant differences (P=0.001 and P=0.037, respectively). There were statistically significant differences in the serum levels of TCH, TG, and LDL between the 2 groups (P=0.017). The CAL and RBL were positively associated with carotid IMT and serum cholesterol levels, except for HDL, whereas tooth loss was not associated with any markers (P<0.05). Compared to the healthy group, participants with periodontitis exhibited 2.09 times higher odds (95% confidence interval, 1.22-3.59) of having subclinical atherosclerosis. Conclusions: The presence of periodontitis increased the risk of atherosclerosis.
Early Carotid Atherosclerosis in Subjects With Periodontal Diseases
Stroke, 2005
Background and Purpose— There is growing experimental evidence implicating chronic inflammation/infection as an atherosclerotic risk factor. In this study, the involvement of periodontal disease in the development of early atherosclerotic vascular lesions has been evaluated. Methods— In randomly chosen 82 patients with periodontal disease and 31 periodontally healthy individuals subjected to a clinical oral examination in 1985, atherosclerotic risk factor analysis and carotid ultrasonography was performed during reexamination 16 years later. Common carotid artery intima-media thickness (IMT) and lumen diameter were measured and intima-media area (cIMA) was calculated. The relationship between IMT and cIMA as dependent variables and periodontal disease, age, gender, body mass index, heredity for atherosclerosis, diabetes mellitus, hypertension, plasma cholesterol, smoking, and education as independent variables was evaluated in a multiple logistic regression model. Results— The mean ...
Circulation, 2012
A link between oral health and cardiovascular disease has been proposed for more than a century. Recently, concern about possible links between periodontal disease (PD) and atherosclerotic vascular disease (ASVD) has intensified and is driving an active field of investigation into possible association and causality. The 2 disorders share several common risk factors, including cigarette smoking, age, and diabetes mellitus. Patients and providers are increasingly presented with claims that PD treatment strategies offer ASVD protection; these claims are often endorsed by professional and industrial stakeholders. The focus of this review is to assess whether available data support an independent association between ASVD and PD and whether PD treatment might modify ASVD risks or outcomes. It also presents mechanistic details of both PD and ASVD relevant to this topic. The correlation of PD with ASVD outcomes and surrogate markers is discussed, as well as the correlation of response to PD therapy with ASVD event rates. Methodological issues that complicate studies of this association are outlined, with an emphasis on the terms and metrics that would be applicable in future studies. Observational studies to date support an association between PD and ASVD independent of known confounders. They do not, however, support a causative relationship. Although periodontal interventions result in a reduction in systemic inflammation and endothelial dysfunction in short-term studies, there is no evidence that they prevent ASVD or modify its outcomes. (Circulation. 2012;125:00-00.)
Role of Periodontal Infection, Inflammation and Immunity in Atherosclerosis
Current Problems in Cardiology, 2020
Background: Inflammation plays a major role in the development and progression of cardiovascular disease (CVD) morbidity and mortality. The well-established relationship between periodontal disease (PD) and CVD may be causal. Left untreated, PD can lead to high systemic inflammation, thus contributing to inflammatory CVD, such as atherosclerosis. Multiple mechanisms have been proposed to elucidate the causal relationship between PD and its contribution to CVD.
The American Journal of Cardiology, 2008
Periodontal disease has been associated with cardiovascular disease (CVD) and inflammation may represent a common pathophysiology. Oral health screening in the context of CVD risk assessment represents a potential opportunity to identify persons at risk for CVD. The purpose of this study was to determine if self-reported oral health status is independently associated with inflammatory markers and if oral health assessment as part of CVD risk screening can identify at-risk persons without traditional CVD risk factors. A baseline analysis was conducted among participants in the NHLBI Family Intervention Trial for Heart Health (F.I.T. Heart) (n=421; mean age 48±13.5y; 36% nonwhite) without CVD or diabetes who underwent standardized assessment of oral health, lifestyle, CVD risk factors and inflammatory markers high sensitivity c-reactive protein (hsCRP) and lipoprotein-associated phospholipase A 2 (Lp-PLA 2). Statistical associations between oral health, risk factors and inflammatory markers were assessed and logistic regression was used to adjust for effects of lifestyle and potential confounders. Periodontal disease was independently associated with being in the top Lp-PLA 2 quartile versus the lower three (OR=1.9; 95%CI=1.1-3.2) after adjustment for lifestyle and risk factors. History of periodontal disease was reported by 24% of non-overweight, non-hypertensive, non-hypercholesterolemic participants and among these participants, 37% had elevated hsCRP (≥ 3mg/L) or Lp-PLA 2 (≥ 215ng/mL). In conclusion, self-reported periodontal disease is independently associated with inflammation and common in persons without traditional CVD risk-factors.