Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.

A large body of evidence underlines an association between periodontal disease and cardiovascular disease. In contrast, data on its relation with endothelial dysfunction as a marker of early subclinical atherosclerosis is inconclusive and limited to patient-cohort studies. We therefore investigated...

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Autores principales:	Birte Holtfreter, Klaus Empen, Sven Gläser, Roberto Lorbeer, Henry Völzke, Ralf Ewert, Thomas Kocher, Marcus Dörr
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/379fa0d9a5c346168dd1a4b2c3d764c9
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spelling	oai:doaj.org-article:379fa0d9a5c346168dd1a4b2c3d764c92021-11-18T08:40:15ZPeriodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.1932-620310.1371/journal.pone.0084603https://doaj.org/article/379fa0d9a5c346168dd1a4b2c3d764c92013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24386401/?tool=EBIhttps://doaj.org/toc/1932-6203A large body of evidence underlines an association between periodontal disease and cardiovascular disease. In contrast, data on its relation with endothelial dysfunction as a marker of early subclinical atherosclerosis is inconclusive and limited to patient-cohort studies. We therefore investigated the association between periodontal disease and flow-mediated dilation of the brachial artery (FMD) as a measure of endothelial dysfunction in a general population, and also addressed a possible mediation via inflammation. The study population comprised 1,234 subjects (50.5% men) aged 25-85 years from the 5-year follow-up of the Study of Health in Pomerania, a population-based cohort study. Clinical attachment loss (CAL) and pocket probing depth (PPD) as measures of periodontal disease were assessed half-mouth at four sites per tooth. Subjects were classified according to the periodontitis case definition proposed by Tonetti and Claffey (2005). Measurements of FMD and nitroglycerin-mediated dilation (NMD) were performed using standardized ultrasound techniques. High-sensitive C-reactive protein, fibrinogen and leukocyte count were measured. Fully adjusted multivariate linear regression analyses revealed significant associations of the percentage of sites with PPD ≥ 6 mm with FMD (p(trend)=0.048), with subjects within the highest category having a 0.74% higher FMD compared to subjects within the lowest category (p<0.05). Consistently, FMD values increased significantly across categories of the percentage of sites with CAL ≥ 6 mm (p(trend)=0.01) and the periodontitis case definition (p(trend)=0.006). Restrictions to subjects without antihypertensive or statin medication or current non-smokers confirmed previous results. Systemic inflammation did not seem to mediate the relation. Both PPD and CAL were not consistently associated with NMD. In contrast to previous studies, high levels of periodontal disease were significantly associated with high FMD values. This association was not mediated via systemic inflammation. This study revives the discussion on whether and how periodontitis contributes to endothelial dysfunction.Birte HoltfreterKlaus EmpenSven GläserRoberto LorbeerHenry VölzkeRalf EwertThomas KocherMarcus DörrPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 12, p e84603 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Birte Holtfreter Klaus Empen Sven Gläser Roberto Lorbeer Henry Völzke Ralf Ewert Thomas Kocher Marcus Dörr Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.
description	A large body of evidence underlines an association between periodontal disease and cardiovascular disease. In contrast, data on its relation with endothelial dysfunction as a marker of early subclinical atherosclerosis is inconclusive and limited to patient-cohort studies. We therefore investigated the association between periodontal disease and flow-mediated dilation of the brachial artery (FMD) as a measure of endothelial dysfunction in a general population, and also addressed a possible mediation via inflammation. The study population comprised 1,234 subjects (50.5% men) aged 25-85 years from the 5-year follow-up of the Study of Health in Pomerania, a population-based cohort study. Clinical attachment loss (CAL) and pocket probing depth (PPD) as measures of periodontal disease were assessed half-mouth at four sites per tooth. Subjects were classified according to the periodontitis case definition proposed by Tonetti and Claffey (2005). Measurements of FMD and nitroglycerin-mediated dilation (NMD) were performed using standardized ultrasound techniques. High-sensitive C-reactive protein, fibrinogen and leukocyte count were measured. Fully adjusted multivariate linear regression analyses revealed significant associations of the percentage of sites with PPD ≥ 6 mm with FMD (p(trend)=0.048), with subjects within the highest category having a 0.74% higher FMD compared to subjects within the lowest category (p<0.05). Consistently, FMD values increased significantly across categories of the percentage of sites with CAL ≥ 6 mm (p(trend)=0.01) and the periodontitis case definition (p(trend)=0.006). Restrictions to subjects without antihypertensive or statin medication or current non-smokers confirmed previous results. Systemic inflammation did not seem to mediate the relation. Both PPD and CAL were not consistently associated with NMD. In contrast to previous studies, high levels of periodontal disease were significantly associated with high FMD values. This association was not mediated via systemic inflammation. This study revives the discussion on whether and how periodontitis contributes to endothelial dysfunction.
format	article
author	Birte Holtfreter Klaus Empen Sven Gläser Roberto Lorbeer Henry Völzke Ralf Ewert Thomas Kocher Marcus Dörr
author_facet	Birte Holtfreter Klaus Empen Sven Gläser Roberto Lorbeer Henry Völzke Ralf Ewert Thomas Kocher Marcus Dörr
author_sort	Birte Holtfreter
title	Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.
title_short	Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.
title_full	Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.
title_fullStr	Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.
title_full_unstemmed	Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.
title_sort	periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/379fa0d9a5c346168dd1a4b2c3d764c9
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Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study.

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