title: A pilot study into measurements of markers of atherosclerosis in periodontitis.
abstract: 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.
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University, Amsterdam, The Netherlands.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Leivadaros
authors.forename: Ubele
authors.initials: U
authors.lastname: van der Velden
authors.forename: Sergio
authors.initials: S
authors.lastname: Bizzarro
authors.forename: Johanna M A G
authors.initials: JM
authors.lastname: ten Heggeler
authors.forename: Victor E A
authors.initials: VE
authors.lastname: Gerdes
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Hoek
authors.forename: Thomas O M
authors.initials: TO
authors.lastname: Nagy
authors.forename: Jose
authors.initials: J
authors.lastname: Scholma
authors.forename: Stephan J L
authors.initials: SJ
authors.lastname: Bakker
authors.forename: Rijk O B
authors.initials: RO
authors.lastname: Gans
authors.forename: Hugo
authors.initials: H
authors.lastname: ten Cate
authors.forename: Bruno G
authors.initials: BG
authors.lastname: Loos
mesh_terms: 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
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor; D005340:Fibrinogen; D002097:C-Reactive Protein