title: Associations between periodontal disease and cardiovascular surrogate measures among Indigenous Australians.
abstract: OBJECTIVE
  Inflammation is a key pathogenetic factor in atherogenesis. Periodontitis is a chronic inflammatory source which can have systemic impacts. Indigenous Australians have a higher prevalence of periodontal disease and experience cardiovascular disease earlier than non-Indigenous Australians. The aim was to describe the association between severity of periodontal inflammatory disease and measures of arterial structure and function.
  
  
  METHODS
  Periodontal disease in a convenience sample of Indigenous Australians was assessed clinically; for those with periodontal disease, the extent of periodontal pockets ≥ 4 mm was stratified into quartiles. Vascular health was measured non-invasively via carotid-dorsalis pedis pulse-wave velocity (PWV), and via B-mode ultrasound of the common carotid intima-media (IMT). Non-fasting blood samples were collected for lipid and inflammatory marker evaluation. Linear regression models were constructed to determine the associations between extent of periodontal pocketing and vascular health, adjusting for traditional cardiovascular common risk factors.
  
  
  RESULTS
  273 Indigenous Australian adults were recruited and complete data was available for 269 participants (154 males), median age 39 years. Arterial stiffness (PWV) significantly increased with increasing extent of periodontal pocketing (p trend=0.001). By contrast, carotid IMT did not differ across quartiles.
  
  
  CONCLUSIONS
  Periodontal pocketing was associated with central arterial stiffness, a marker of presymptomatic arterial dysfunction, in Indigenous Australian adults with periodontal disease.
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia; Menzies School of Health Research, Charles Darwin University, Darwin, Australia. Electronic address: kostas.kapellas@adelaide.edu.au.
authors.forename: Kostas
authors.initials: K
authors.lastname: Kapellas
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Jamieson
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia.
authors.forename: Loc G
authors.initials: LG
authors.lastname: Do
authors.affiliation: Colgate Australian Clinical Dental Research Centre, School of Dentistry, University of Adelaide, Adelaide, Australia.
authors.forename: P Mark
authors.initials: PM
authors.lastname: Bartold
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Australia; Division of Medicine, Royal Darwin Hospital, Darwin, Australia.
authors.forename: Louise J
authors.initials: LJ
authors.lastname: Maple-Brown
authors.affiliation: Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Sullivan
authors.affiliation: Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
authors.forename: Kerin
authors.initials: K
authors.lastname: O'Dea
authors.affiliation: Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Brown
authors.affiliation: Department of Medicine, University of Sydney, Sydney, Australia.
authors.forename: David S
authors.initials: DS
authors.lastname: Celermajer
authors.affiliation: Department of Dental Ecology, University of North Carolina at Chapel Hill, USA.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Slade
authors.affiliation: Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Skilton
mesh_terms: D000328:Adult; D000368:Aged; D044362:Australasia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000276:immunology*; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000208:ethnology* / Q000276:immunology*; D015995:Prevalence; D011673:Pulsatile Flow; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology; D059289:Vascular Stiffness; D055815:Young Adult
keywords: Aboriginal; Arterial stiffening; Periodontal disease; Smoking; Type 2 diabetes