Oral infection, hyperglycemia, and endothelial dysfunction.
Metabolic syndrome and type 2 diabetes (T2DM) resulting from sustained hyperglycemia are considered as risk factors for cardiovascular disease (CVD) but the mechanism for their contribution to cardiopathogenesis is not well understood. Hyperglycemia induces nonenzymatic glycation of protein-yielding advanced glycation end products (AGE), which are postulated to stimulate interleukin-6 (IL-6) expression, triggering the liver to secrete tissue necrosis factor alpha (TNF-alpha) and C-reactive protein (CRP) that contribute to CVD pathogenesis. Although the high prevalence of periodontitis among individuals with diabetes is well known by dental researchers, it is relatively unrecognized in the medical community. The expression of the same proinflammatory mediators implicated in hyperglycemia (i.e., IL-6, TNF-alpha, and CRP) have been reported to be associated with periodontal disease and increased risk for CVD. We will review published evidence related to these 2 pathways and offer a consensus.
Janket
Sok-Ja
SJ
Department of General Dentistry, Boston University School of Dental Medicine, Boston, MA 02118, USA. skjanket@bu.edu
Jones
Judith A
JA
Meurman
Jukka H
JH
Baird
Alison E
AE
Van Dyke
Thomas E
TE
D050260:Carbohydrate Metabolism; D002318:Cardiovascular Diseases / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000209:etiology / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism*; D005491:Focal Infection, Dental / Q000150:complications* / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000378:metabolism*; D018836:Inflammation Mediators / Q000378:metabolism; D024821:Metabolic Syndrome / Q000150:complications / Q000378:metabolism; D009113:Muramidase / Q000378:metabolism; D010518:Periodontitis / Q000150:complications* / Q000378:metabolism; D012471:Salivary Proteins and Peptides / Q000378:metabolism
D017127:Glycation End Products, Advanced; D018836:Inflammation Mediators; D012471:Salivary Proteins and Peptides; D009113:Muramidase