Periodontitis is characterized by elevated PAI-1 activity.
OBJECTIVE
Periodontitis is a chronic infectious disease and has been associated with cardiovascular diseases (CVD). We investigated whether plasma levels of markers of a prothrombotic state were elevated in patients with periodontitis in comparison with healthy controls.


METHODS
Untreated patients with moderate (n=53) and severe periodontitis (n=38) and healthy controls (n=39) were recruited. Levels of von Willebrand factor (vWF), prothrombin fragment 1+2 (F1+2), plasminogen activator inhibitor-1 (PAI-1) activity and D-dimer were measured as markers of a prothrombotic state.


RESULTS
The erythrocyte sedimentation rate (ESR), plasma C-reactive protein (CRP) and leucocyte counts (WBC) were significantly higher in patients with periodontitis. No statistically significant difference was found among the three groups for vWF (p=0.264), F1+2 (p=0.295) and D-dimer (p=0.572). However, PAI-1 was clearly elevated in the severe periodontitis group (p=0.001), even after adjusting for potential confounding factors (p(adj)=0.004). Moreover, more patients than controls were having vWF and PAI-1 levels above the respective population medians.


CONCLUSIONS
In periodontitis, elevated levels of PAI-1 activity are observed compared with healthy controls. This may increase the potential for impaired fibrinolysis, a condition that results in a prothrombotic state. We suggest that this state, if left untreated, may contribute to an increased risk for CVD.
Bizzarro
S
S
Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University, Amsterdam, The Netherlands. s.bizzarro@acta.nl
van der Velden
U
U
ten Heggeler
J M A G
JM
Leivadaros
E
E
Hoek
F J
FJ
Gerdes
V E A
VE
Bakker
S J L
SJ
Gans
R O B
RO
Ten Cate
H
H
Loos
B G
BG
D000328:Adult; D016301:Alveolar Bone Loss / Q000145:classification; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D015986:Confounding Factors, Epidemiologic; D004198:Disease Susceptibility; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis; D010518:Periodontitis / Q000097:blood* / Q000145:classification; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011498:Protein Precursors / Q000032:analysis; D011516:Prothrombin / Q000032:analysis; D015842:Serine Proteinase Inhibitors / Q000097:blood*; D012907:Smoking; D013927:Thrombosis / Q000097:blood; D016388:Tooth Loss / Q000145:classification; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D017395:Plasminogen Activator Inhibitor 1; D011498:Protein Precursors; D015842:Serine Proteinase Inhibitors; C036309:fibrin fragment D; D014841:von Willebrand Factor; C029733:prothrombin fragment 1; C044183:prothrombin fragment 2; D011516:Prothrombin; D002097:C-Reactive Protein