title: Periodontitis is characterized by elevated PAI-1 activity.
abstract: 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.
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University, Amsterdam, The Netherlands. s.bizzarro@acta.nl
authors.forename: S
authors.initials: S
authors.lastname: Bizzarro
authors.forename: U
authors.initials: U
authors.lastname: van der Velden
authors.forename: J M A G
authors.initials: JM
authors.lastname: ten Heggeler
authors.forename: E
authors.initials: E
authors.lastname: Leivadaros
authors.forename: F J
authors.initials: FJ
authors.lastname: Hoek
authors.forename: V E A
authors.initials: VE
authors.lastname: Gerdes
authors.forename: S J L
authors.initials: SJ
authors.lastname: Bakker
authors.forename: R O B
authors.initials: RO
authors.lastname: Gans
authors.forename: H
authors.initials: H
authors.lastname: Ten Cate
authors.forename: B G
authors.initials: BG
authors.lastname: Loos
mesh_terms: 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
chemical_list: 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