Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 4, July-August, p. 625–630

doi: 10.17219/acem/62937

Publication type: original article

Language: English

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The Association Between Dental Status and Systemic Lipid Profile and Inflammatory Mediators in Patients After Myocardial Infarction

Bartłomiej Górski1,B,D, Ewa Nargiełło2,B,D, Grzegorz Opolski2,A,E, Ewa Ganowicz1,C, Renata Górska1,A,E,F

1 Department of Oral Medicine and Periodontal Diseases, Medical University of Warsaw, Poland

2 1st Department of Cardiology, Medical University of Warsaw, Poland


Background. Many epidemiological studies have proven that local infection may influence the levels of systemic lipid profile and inflammatory mediators.
Objectives. The aim of this research was to evaluate the association between the state of the oral cavity, lipids and inflammatory mediator concentrations in Poles after acute myocardial infarction (MI).
Material and Methods. A total of 134 subjects with a mean age of 54.3 years (± 8.1) were included in the study. Sociodemographic and cardiologic variables were gathered. Subsequently, serum samples were collected for estimation of total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), high-sensitivity C-reactive protein (hsCRP), fibrinogen and white blood cell counts (WBC). The periodontal parameters measured included bleeding on probing index (BoP), pocket depth (PD), clinical attachment level (CAL), the number of bleeding periodontal pockets (bPP) and the number of lost teeth.
Results. Overall, patients shared high levels of periodontal inflammation and tissue breakdown. Multivariate analysis revealed a significant association between the serum concentration of LDL-C and bPP (standardized coefficient b = 0.3179; p = 0.0009) and PD (b = 0.3186; p = 0.0015); the level of fibrinogen and the number of lost teeth (b = 0.3669; p = 0.0013); WBC and bPP (b = 0.2726; p = 0.0035) independent of age, sex, income, education, atherosclerotic disease in the family, tobacco smoking, arterial hypertension, diabetes mellitus and BMI. No correlations were found regarding hsCRP serum concentration.
Conclusion. To our knowledge, this study demonstrated for the first time that local inflammatory processes in the oral cavity are positively associated with the systemic levels of LDL-C, fibrinogen and WBC in adult Poles. This may underscore relationships between periodontitis and MI as well as potentially impinge on atherosclerotic processes and MI prognosis.

Key words

inflammation, fibrinogen, cardiovascular disease, lipid profile, C-reactive protein

References (30)

  1. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvänne M, Scholte op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F: European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The fifth Joint task Force of the European Society of Cardiology and Other Societies on Cardiovascular Risk Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012, 33, 1635–1701.
  2. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 2004, 364, 937–952.
  3. Schenkein HA, Loos BG: Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases. J Periodontol 2013, 84, Suppl 4, 51–69.
  4. Kaess BM, Jóźwiak J, Nelson CP, Lukas W, Mastej M, Windak, A Tomasik T, Grzeszczak W, Tykarski A, Gąsowski J, Ślęzak-Prochazka I, Ślęzak A, Charchar FJ, Sattar N, Thompson JR, Samani NJ, Tomaszewski M: The relation of rapid changes in obesity measures to lipid profile – insights from a nationwide metabolic health survey in 444 Polish cities. PLoS One 2014, 9, e86837.
  5. Lubrano V, Balzan S: Consolidated and emerging inflammatory markers in coronary artery disease. World J Exp Med 2015, 5, 2–32.
  6. Anitha G, Nagaraj M, Jayashree A: Comparative evaluation of levels of C-reactive protein and PMN in periodontitis patients related to cardiovascular disease. J Indian Soc Periodontol 2013, 17, 330–332.
  7. Ndrepepa G, Braun S, Tada T King L, Cassese S, Fusaro M, Keta D, Kastrati A, Schmidt R: Comparative prognostic value of C-reactive protein & fibrinogen in patients with coronary artery disease. Indian J Med Res 2014, 140, 392–400.
  8. Bridge KI, Philippou H, Ariëns R: Clot properties and cardiovascular disease. Thromb Haemost 2014, 112, 901–908.
  9. Tadeusiewicz J, Nowak P: The role of post-translational modification of fibrinogen in the pathogenesis of thrombosis. Pol Merk Lek 2015, 38, 107–112.
  10. Alfakry H, Sinisalo J, Paju S, Nieminen MS, Valtonen V, Tervahartiala T, Pussinen PJ, Sorsa T: The association of serum neutrophil markers and acute coronary syndrome. Scand J Immunol 2012, 76, 181–187.
  11. Marfil-Álvarez R, Mesa F, Arrebola-Moreno A, Ramírez-Hernández JA Magán-Fernández A, O’Valle F, Galindo-Moreno P, Catena A: Acute myocardial infarct size is related to periodontitis extent and severity. J Dent Res 2014, 93, 993–998.
  12. Slots J: Periodontology: Past, present, perspectives. Periodontol 2000 2013, 62, 7–19.
  13. Lockhart PB, Bolger AF, Papapapanou PN, Osinbowale O, Trevisan M, Levison ME, Taubert KA, Newburger JW, Gornik HL, Gewitz MH, Wilson WR, Smith SC Jr, Baddour LM: Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation 2012, 125, 2520–2544.
  14. Tonetti MS, Van Dyke TE: Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP workshop on periodontitis and systemic diseases. J Periodontol 2013, 84, Suppl 4, 24–29.
  15. Górski B, Nargiełło E, Opolski G, Ganowicz E, Górska R: Association between periodontitis and risk of acute myocardial infarction among Poles – a case-control study. Adv Clin Exp Med [in press].
  16. Kumar KR, Ranganath V, Naik R, Banu S, Nichani AS: Assessment of high-sensitivity C-reactive protein and lipid levels in healthy adults and patients with coronary artery disease, with and without periodontitis – a crosssectional study. J Periodontal Res 2014, 49, 836–844.
  17. Sridhar R, Byakod G, Pudakalkatti P, Patil R: A study to evaluate the relationship between peridoontitis, cardiovascular disease and serum lipid levels. Int J Dent Hygiene 2009, 7, 144–150.
  18. Sangwan A, Tewari S, Singh H, Sharma RK, Narula SC: Periodontal status and hyperlipidemia: Statin users versus non-users. J Periodontol 2013, 84, 3–12.
  19. Magán-Fernández A, Papay-Ramirez L, Tomás J, Marfil-Álvarez R, Rizzo M, Bravo M, Mesa F: Association of simvastatin and hyperlipidemia with periodontal status and bone metabolism markers. J Periodontol 2014, 85, 1408–1415.
  20. Flores MF, Montenegro MM, Fyrtado MV, Polanczyk CA, Rösing CK, Haas AN: Periodontal status affects C-reactive protein and lipids in patients with stable heart disease from a tertiary care cardiovascular clinic. J Periodontol 2014, 85, 545–553.
  21. Seringec N, Guncu G, Arihan O, Avcu N, Dikmenoglu N: Investigation of hemorheological parameters in periodontal diseases. Clin Hemorheol Microcirc 2015, 61, 47–58.
  22. Bokhari SA, Khan AA, Butt AK, Hanif M, Izhar M, Tatakis DN, Ashfaq M: Periodontitis in coronary heart disease patients: strong association between bleeding on probing and systemic biomarkers. J Clin Periodontol 2014, 41, 1048–1054.
  23. Liu J, Wu Y, Ding Y, Meng S, Ge S, Deng H: Evaluation of serum levels of C-reactive protein and lipid profiles in patients with chronic periodontitis and/or coronary heart disease in an ethnic Han population. Quintessence Int 2010, 41, 239–247.
  24. Wożakowska-Kapłon B, Włosowicz M, Gorczyca-Michta I, Górska R: Oral health status and occurrence and clinical course of myocardial infarction in hospital phase: A case-control study. Cardiol J 2013, 20, 370–377.
  25. Paraskevas S, Huizinga JD, Loos BG: A systemic review and meta-analyses in C-reactive protein in relation to periodontitis. J Clin Periodontol 2008, 35, 277–290.
  26. Arregoces FE, Uriza CL, Porras JV, Camargo MB, Morales AR: Relation between ultra-sensitive C-reactive protein, diabetes and periodontal disease in patients with and without myocardial infarction. Arq Bras Endocrinol Metabol 2014, 58, 362–368.
  27. Itabe H: Oxidized low-density lipoprotein as a biomarker of in vivo oxidative stress: from atherosclerosis to periodontitis. J Clin Biochem Nutr 2012, 51, 1–8.
  28. Jia R, Kurita-Ochiai T, Oguchi S, Yamamoto M: Periodontal pathogen accelerates lipid peroxidation and atherosclerosis. J Dent Res 2013, 92, 2470252.
  29. Huda S, Doering H, Howard C, Whittle W, Sigal MJ, Glogauer M: Oral neutrophil levels: A screening test for oral inflammatory load in pregnancy in a medical setting. J Periodontol 2015, 86, 72–81.
  30. Taylor BA, Tofler GH, Carey HM, Morel-Kopp MC, Philcox S, Carter TR, Elliott MJ, Kull AD, Ward C, Schenck K: Full-mouth tooth extraction lowers systemic inflammatory and thrombotic markers of cardiovascular risk. J Dental Res 2006, 85, 74–78.