A pilot study into measurements of markers of atherosclerosis in periodontitis.
BACKGROUND
Periodontitis may be a possible risk factor for atherosclerosis. The current pilot study explored arterial wall thickness and other variables associated with atherosclerosis in healthy subjects with and without periodontitis.


METHODS
Patients with moderate (N = 34) and severe periodontitis (N = 15) and controls (N = 14) were recruited. Intima media thickness (IMT) of the common carotid arteries (CCA), internal carotid arteries (ICA), and bifurcations of carotid arteries (BCA) was estimated bilaterally using B-mode ultrasound. An overall IMT was calculated as the mean of these six measurements. C reactive protein (CRP), fibrinogen, and von Willebrand factor (vWf) were measured in plasma as indicators of systemic inflammation and atherosclerotic disease. Microalbuminuria was determined as a marker of endothelial cell dysfunction.


RESULTS
IMT for CCA were 0.64, 0.68, and 0.69 mm for control, moderate, and severe periodontitis, respectively (not significant). IMT for BCA did not vary among groups. IMT of ICA was largest for severe periodontitis (0.81 mm); corresponding values for controls and moderate periodontitis were 0.58 and 0.55 mm, respectively (P= 0.023). Severe periodontitis patients had an overall IMT of 0.76 mm, while moderate periodontitis patients and controls had lower values (0.64 and 0.65 mm, respectively; P= 0.153). After adjusting for potential confounding factors, the increased IMT for ICA in severe periodontitis was also significant (Padj = 0.040). CRP (P= 0.020, Padj = 0.050) and vWf (P= 0.019, Padj = 0.013) were higher in periodontitis than controls; microalbuminuria was not different between groups. Power calculations suggest that a 4-fold expansion of the severe patient and control groups will result in a high chance (power level 80%) that a clinically significant association between the overall IMT and periodontitis will be observed.


CONCLUSIONS
The present pilot study indicates that a full study investigating the relationship between periodontitis and atherosclerosis is warranted.
Leivadaros
Efstratios
E
Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University, Amsterdam, The Netherlands.
van der Velden
Ubele
U
Bizzarro
Sergio
S
ten Heggeler
Johanna M A G
JM
Gerdes
Victor E A
VE
Hoek
Frans J
FJ
Nagy
Thomas O M
TO
Scholma
Jose
J
Bakker
Stephan J L
SJ
Gans
Rijk O B
RO
ten Cate
Hugo
H
Loos
Bruno G
BG
D000419:Albuminuria / Q000175:diagnosis; D000704:Analysis of Variance; D001161:Arteriosclerosis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D017536:Carotid Artery, Common / Q000648:ultrastructure*; D002343:Carotid Artery, Internal / Q000648:ultrastructure; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000097:blood / Q000150:complications*; D010865:Pilot Projects; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D014841:von Willebrand Factor; D005340:Fibrinogen; D002097:C-Reactive Protein