Measurement of atherosclerosis markers in subjects with periodontitis

Abstract

Background: The prevalence of periodontitis was 71.1% in the Mongolian population in 2013. The inflammatory response due to inflammatory mediators and bacterial etiologies, and the altered lipid metabolism in patients with periodontitis suggest 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. Materials and Methods: In this case-control study, a total of 30 systemically healthy adults (15 with periodontitis and 15 without periodontitis) aged over 40 years were studied. The stage and grading of periodontitis were determined by measuring the clinical attachment level (CAL) and radiographic bone loss (RBL). Traditional cardiovascular risk factors, such as body-mass index, serum levels of total cholesterol (TCH), triglycerides (TG), high-density and low-density lipoprotein (HDL, LDL) were evaluated. Carotid artery intima-media wall thickness (IMT) was assessed by ultrasonography. The individual’s risk of 10-year absolute atherosclerotic vascular disease (ASCVD) was estimated by the American Heart Association Guideline on the Primary Prevention of Cardiovascular Disease. Results: Generalized periodontitis; stage III/grade B occurred in 66.7% of subjects with periodontitis. The mean of CAL and carotid IMT were 5.02±0.9 mm, 0.084±0.01 cm versus 1.6±0.61 mm, 0.072±0.02 cm in the periodontal disease and control groups, respectively, with statistically significant differences (p=0.001, p=0.037). There were statistically significant differences in the serum levels of TCH, TG, LDL, and the 10-year risk of ASCVD between the two groups (p=0.017). The CAL and RBL were positively associated with carotid IMT and serum cholesterol levels except for HDL, whereas the tooth loss was not associated with any markers (p<0.05). Compared to healthy, periodontitis subjects have 2.09 times higher odds (95% CI=1.22-3.59) to have subclinical atherosclerosis. Conclusions: Among periodontitis patients, the serum levels of TCH, TG, LDL, and carotid IMT were significantly high compared to healthy subjects.