Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients.
BACKGROUND
Periodontitis is a common, often undiagnosed, chronic infection of the supporting tissues of the teeth, epidemiologically associated with cardiovascular diseases. Since C-reactive protein (CRP) and other systemic markers of inflammation have been identified as risk factors for cardiovascular diseases, we investigated whether these factors were elevated in periodontitis.


METHODS
Consecutive adult patients with periodontitis (localized n = 53; generalized n = 54), and healthy controls (n = 43), all without any other medical disorder, were recruited and peripheral blood samples were taken.


RESULTS
Patients with generalized periodontitis and localized periodontitis had higher median CRP levels than controls (1.45 and 1.30 versus 0.90 mg/L, respectively, P = 0.030); 52% of generalized periodontitis patients and 36% of the localized periodontitis patients were sero-positive for interleukin-6 (IL-6), compared to 26% of controls (P= 0.008). Plasma IL-6 levels were higher in periodontitis patients than in controls (P = 0.015). Leukocytes were also elevated in generalized periodontitis (7.0 x 10(9)/L) compared to localized periodontitis and controls (6.0 and 5.8 x 10(9)/L, respectively, P= 0.002); this finding was primarily explained by higher numbers of neutrophils in periodontitis (P= 0.001). IL-6 and CRP correlated with each other, and both CRP and IL-6 levels correlated with neutrophils. The current findings for periodontitis were controlled for other known factors associated with cardiovascular diseases, including age, education, body mass index, smoking, hypertension, cholesterol, and sero-positivity for CMV, Chlamydia pneumoniae, and Helicobacter pylori.


CONCLUSIONS
Periodontitis results in higher systemic levels of CRP, IL-6, and neutrophils. These elevated inflammatory factors may increase inflammatory activity in atherosclerotic lesions, potentially increasing the risk for cardiac or cerebrovascular events.
Loos
B G
BG
Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), The Netherlands. B.G.Loos@acta.nl
Craandijk
J
J
Hoek
F J
FJ
Wertheim-van Dillen
P M
PM
van der Velden
U
U
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood* / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000276:immunology; D002784:Cholesterol / Q000097:blood; D003587:Cytomegalovirus / Q000276:immunology; D005260:Female; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000097:blood* / Q000276:immunology; D014280:Triglycerides / Q000097:blood
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D015415:Biomarkers; D007074:Immunoglobulin G; D015850:Interleukin-6; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol