title: Prospective Analysis of the Relationship Between the State of Periodontal Tissues and Changes in Selected Cardiovascular Parameters in Patients with Type 2 Diabetes.
abstract: BACKGROUND
  Periodontitis is considered a risk factor in many systemic diseases, including cardiovascular pathologies and diabetes. Diabetes can also exacerbate early vascular changes, mainly due to the synthesis of advanced glycosylation end-products and oxidative stress. It has not yet been fully explained whether the additional presence of periodontal disease can affect the course of atherosclerosis and left ventricle hypertrophy in diabetic patients.
  
  
  OBJECTIVE
  The aim of the study was to assess the relationship between periodontal and cardiovascular diseases and their progression in patients with type 2 diabetes.
  
  
  METHODS
  The study included 119 patients diagnosed with type 2 diabetes. Periodontal pocket depth (PD), clinical attachment loss (CAL), plaque index (PI) and bleeding index (BOP) were determined. Basic laboratory tests were performed. The intima-media thickness (IMT) and the left ventricular mass index (LVMI) were determined by means of ultrasonography. After one year the examinations were repeated. The statistical analysis included the 84 patients who took part in both the first and second examinations.
  
  
  RESULTS
  A positive correlation between the number of deep and active periodontal pockets and LVMI value was observed in men. The IMT value correlated with the mean CAL, PI and BOP, while a negative correlation was found between the IMT and the number of deep pockets, as well as between the IMT and the number of retained teeth. A multivariate analysis demonstrated a significant correlation between CAL and both IMT and LVMI change after one year.
  
  
  CONCLUSIONS
  A relationship between periodontitis and cardiovascular diseases has been confirmed in diabetic patients. The most significant periodontal parameter in relation to the progression of atherosclerosis and left ventricle hypertrophy was shown to be clinical attachment loss - a measure of the history of periodontal disease during the patient's lifetime.
authors.affiliation: Department of Oral Medicine and Periodontal Diseases, Medical University of Warsaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Napora
authors.affiliation: Department of Oral Medicine and Periodontal Diseases, Medical University of Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Grabowska
authors.affiliation: Department of Oral Medicine and Periodontal Diseases, Medical University of Warsaw, Poland.
authors.forename: Renata
authors.initials: R
authors.lastname: Górska
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D010519:Periodontium / Q000473:pathology*; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric
keywords: atherosclerosis; diabetes; left ventricular hypertrophy; periodontitis