Association between markers of cardiovascular risk and clinical parameters of periodontitis
Associação entre marcadores do risco cardiovascular e parâmetros clínicos da periodontite
Domingues, José Eduardo Gomes; Vettore, Mario Vianna; Lima, Emerson Silva
Abstract
Introduction: Periodontal disease is an inflammatory response to bacteria that reside in the gum tissue and can have systemic repercussion. Objective: The aim of this study was to assess the relationship between periodontitis and markers of cardiovascular risk. Material and method: Ninety selected patients were assigned into two groups in accordance with their levels of probing pocket depth (PPD) and Clinical Attachment Level (CAL): control group, n= 45 (< 4 sites with PPD ≥ 4.0 mm and CAL ≥ 3.0 mm) and case group, n= 45 (≥ 30% of sites with PPD ≥ 4.0 mm and CAL ≥3.0 mm). Plasma concentrations of C-reactive protein, high sensitive CRP, high-density lipoproteins (HDL-c) and electronegative low density lipoproteins (LDL) were assessed in all participants. Data from medical history and socioeconomic level were also collected from patients. Result: Plasma levels of HDL-c were lower in subjects with periodontal disease (p = 0.016) and were inversely associated with the number of sites with PPD ≥ 3 mm (rho= –0.325) and number of sites with PPD ≥ 3 mm and CAL ≥ 3 mm (rho= –0.216). These associations remained significant after adjustments for dental plaque and smoking using Univariate Analysis of Covariance (p < 0.05). Adjusted odds ratio between periodontal disease and levels of HDL-c was 0.94 (CI95% 0.88–0.99) after adjusting for age, smoking and dental plaque. Other investigated markers of cardiovascular risk were not related to periodontal disease. Conclusion: Clinical parameters of periodontitis were inversely associated with plasma concentrations of HDL-c.
Keywords
Resumo
Introdução: A doença periodontal é uma resposta inflamatória a bactérias que residem no tecido gengival podendo apresentar repercussão sistêmica. Objetivo: O objetivo deste estudo foi conhecer a relação entre a periodontite e marcadores do risco cardiovascular. Material e método: Noventa pacientes selecionados foram divididos em dois grupos de acordo com os níveis de profundidade de sondagem (PS) e nível clínico de inserção (NCI). Grupo controle, n =45 (< 4 sítios com PS ≥ 4.0 mm e NCI ≥3.0 mm) e grupo casos, n =45 (≥30% dos sítios com PS ≥ 4.0 mm e NCI ≥ 3.0 mm). Todos os indivíduos foram submetidos a dosagens plasmáticas de Proteína C reativa de alta sensibilidade, HDL-c e Lipoproteína de baixa densidade eletronegativa (LDL–). Dados do histórico médico e nível socioeconômico foram também coletados. Resultado: Os níveis plasmáticos de HDL-c foram maiores nos indivíduos com doença periodontal (p = 0,016) e inversamente associados com o número de sítios periodontais com OS ≥ 3 mm (rho= –0.325) e números de sítio com OS ≥ 3 mm e NCI ≥ 3 mm (rho= –0.216). NCI ≥ 3 mm. Estas associações permaneceram após ajuste para biolfilme e uso de cigarro usando análise de covariância univariada (p < 0.05). O odds ratio ajustado entre a doença periodontal e os níveis de HDL-c foi 0.94 (CI95% 0.88–0.99) após ajuste para idade, fumo e biofilme. Os demais marcadores do risco vascular não foram relacionados com a doença periodontal. Conclusão: Os parâmetros clínicos da periodontite foram inversamente associados com as concentrações de HDL-c.
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References
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