title: Association of simvastatin and hyperlipidemia with periodontal status and bone metabolism markers.
abstract: BACKGROUND
  The objective of this study is to determine whether simvastatin consumption and hyperlipidemia are associated with a worse periodontal condition and specific bone activity biomarkers.
  
  
  METHODS
  This cross-sectional and analytic study includes 73 patients divided into three groups: 1) simvastatin-treated patients with hyperlipidemia (n = 29); 2) patients with hyperlipidemia treated by diet alone (n = 28); and 3) normolipidemic patients (controls, n = 16). The periodontal clinical variables of all participants were gathered, a blood sample was drawn from each to determine the lipid profile (total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein), serum levels of acute-phase reactants (C-reactive protein), erythrocyte sedimentation rate, and bone metabolism markers (osteoprotegerin [OPG], osteocalcin, procollagen type I N-terminal propeptide, and C-terminal telopeptide of type I collagen).
  
  
  RESULTS
  The mean ESR was higher in the diet-treated patients with hyperlipidemia than in the normolipidemic controls (P = 0.04). Serum OPG concentrations were significantly higher in the simvastatin-treated patients with hyperlipidemia than in the diet-treated patients with hyperlipidemia (P = 0.05). Multivariable linear regression analysis adjusted for age, sex, tobacco, and alcohol revealed that, compared with the normolipidemic patients, the simvastatin-treated patients with hyperlipidemia showed a mean reduction of 0.8 mm (95% confidence interval = -1.5 to 0.0, P = 0.05) in clinical attachment loss.
  
  
  CONCLUSIONS
  Within the limits of this study, the findings suggest that the intake of simvastatin is associated with increasing serum OPG concentrations, and this could have a protective effect against bone breakdown and periodontal attachment loss. The baseline systemic inflammatory state of patients with hyperlipidemia is indicated by their increased erythrocyte sedimentation rate.
authors.affiliation: Department of Periodontology, School of Dentistry, University of Granada, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Magán-Fernández
authors.forename: Lara
authors.initials: L
authors.lastname: Papay-Ramírez
authors.forename: Juan
authors.initials: J
authors.lastname: Tomás
authors.forename: Rafael
authors.initials: R
authors.lastname: Marfil-Álvarez
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.forename: Manuel
authors.initials: M
authors.lastname: Bravo
authors.forename: Francisco
authors.initials: F
authors.lastname: Mesa
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D015415:Biomarkers / Q000032:analysis; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D024042:Collagen Type I / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000178:diet therapy / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D053244:Osteoprotegerin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D011347:Procollagen / Q000097:blood; D019821:Simvastatin / Q000627:therapeutic use*; D012907:Smoking; D014280:Triglycerides / Q000097:blood
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D024042:Collagen Type I; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D053244:Osteoprotegerin; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; D014280:Triglycerides; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D015675:Osteocalcin; D002097:C-Reactive Protein; D002784:Cholesterol; D019821:Simvastatin
keywords: Lipid metabolism disorders; osteoprotegerin; periodontitis; simvastatin