title: Chronic periodontitis with multiple risk factor syndrome: a case report.
abstract: OBJECTIVE
  Multiple risk factor syndrome is a clustering of cardiovascular risk factors, such as diabetes, dyslipidemia, hypertension, and obesity associated epidemiologically with insulin resistance. This report describes the clinical course of a patient suffering from severe periodontitis with multiple risk factor syndrome, and discusses the association between periodontal infection and systemic health.
  
  
  METHODS
  The patient had a history of type 2 diabetes, dyslipidemia, and hypertension for over 10 years. At baseline, her hemoglobin A1 c was 8.1%. However, she had no diabetic complications except periodontitis. The IgG antibody titers against Porphyromonas gingivalis FDC 381 and SU63 were elevated above the mean of healthy subjects +2 standard deviations. Intensive periodontal treatment, including periodontal surgery, was performed to reduce periodontal infection and bacteremia. Her systemic and periodontal conditions were evaluated longitudinally for 10 years.
  
  
  RESULTS
  Following periodontal treatment, antibody titers against Porphyromonas gingivalis and hemoglobin A1c values were significantly improved. The other clinical data and medication for her systemic condition also remained stable during supportive periodontal therapy. However, she developed myocardial infarction, and showed continuous deterioration of hemoglobin A1 c level and periodontitis.
  
  
  CONCLUSIONS
  The long-term clustering of risk factors, such as diabetes, dyslipidemia, hypertension, and periodontitis, are associated with the development of myocardial infarction. Treatment of systemic conditions in combination with comprehensive periodontal treatment is important in management of patients with multiple risk factor syndrome.
authors.affiliation: Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shimoe
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Iwamoto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shiomi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maeda
authors.forename: Fusanori
authors.initials: F
authors.lastname: Nishimura
authors.forename: Shogo
authors.initials: S
authors.lastname: Takashiba
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000150:complications / Q000382:microbiology; D002318:Cardiovascular Diseases / Q000150:complications*; D055113:Chronic Periodontitis / Q000150:complications* / Q000601:surgery / Q000628:therapy*; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications; D007564:Japan; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage; D009203:Myocardial Infarction / Q000209:etiology*; D010508:Periodontal Abscess / Q000382:microbiology; D016966:Porphyromonas gingivalis / Q000276:immunology; D012307:Risk Factors; D013577:Syndrome; D014081:Tooth Extraction
chemical_list: D000900:Anti-Bacterial Agents; D006442:Glycated Hemoglobin; D008911:Minocycline