Poor oral hygiene correlates with maximal cIMT and atherosclerotic plaqueYu H et al., J Dent Res. 2014 - J Dent Res. 2014 Jun 16
Association of Carotid Intima-media Thickness and Atherosclerotic Plaque with Periodontal Status
Yu H, Qi LT, Liu LS, Wang XY, Zhang Y, Huo Y.
|J Dent Res. 2014 Jun 16. [Epub ahead of print]|
BackgroundChronic inflammatory reaction occurs throughout atherogenesis, and both epidemiological and microbiological studies have shown a possible association between clinical/subclinical atherosclerosis and chronic periodontitis [1-4]. Mechanisms linking the two diseases remain to be determined.
Hyperglycaemic individuals are at higher risk of both atherosclerosis and chronic periodontitis, which further suggests a link between the two conditions [5,6].
In China, chronic periodontitis is a public oral health problem. This study aimed to investigate the association between subclinical atherosclerosis and periodontal status in China. 434 men and 413 women were included in this study. 245 of 847 participants were regarded as having atherosclerosis plaque (maximal carotid intima media thickness (cIMT) >1.2 mm).
- Over the whole sample, cIMT was significantly correlated with mean plaque index (PLI), in a multiple linear regression model adjusting for multiple traditional risk factors (nonstandardised β: 0.068 (95%CI: 0.033-0.103, P<0.001). Euglycaemic participants showed a similar correlation.
- In hyperglycaemic patients, a correlation was found between mean attachment loss (AL) and cIMT, such that each 1-mm increment in mean AL corresponded to a 0.018-mm increase in maximal cIMT after adjustment (95%CI: 0.005-0.031, P=0.006).
- In multiple logistic regression, the whole sample showed a greater risk of atherosclerotic plaque with increased mean PLI (adj OR: 2.051, 95%CI: 1.410-2.982) after adjusting for traditional risk factors. A similar OR was seen in euglycaemic participants.
- In hyperglycaemic participants, the prevalence of atherosclerotic plaque was significantly correlated with mean AL (adj OR: 1.183, 95%CI: 1.021-1.371, P=0.025), and AL 3% (meaning sites with AL >3mm), AL 4% and AL 5% were also all mildly but significantly correlated with increased risk of atherosclerotic plaque.
ConclusionThis study shows that mean PLI, an important indicator of oral hygiene, was correlated with cIMT and atherosclerotic plaque in the total study sample, and in euglycaemic participants. Clinical AL, which reflects the extent of periodontal tissue destruction, was associated with maximal cIMT in a dose-dependent manner and atherosclerotic plaque in hyperglycaemic participants.
Find this article on Pubmed
1. Ford PJ, Gemmell E, Chan A et al. (2006). Inflammation, heat shock proteins and periodontal pathogens in atherosclerosis: an immunohistologic study. Oral Microbiol Immunol 21:206-211.
2. Hayashida H, Saito T, Kawasaki K, et al. (2013). Association of periodontitis with carotid artery intimamedia thickness and arterial stiffness in community-dwelling people in Japan: the Nagasaki Islands study. Atherosclerosis 229:186-191.
3. Jung YS, Shin MH, Kim IS, et al. (2013). Relationship between periodontal disease and subclinical atherosclerosis: the Dong-gu Study. J Clin Periodontol 41:262-268.
4. Tonetti MS, Van Dyke TE (2013). Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Clin Periodontol 40(Suppl 14):24-29.
5. Chistiakov DA, Sobenin IA, Bobryshev YV, Orekhov AN (2012). Mitochondrial dysfunction and mitochondrial DNA mutations in atherosclerotic complications in diabetes. World J Cardiol 4:148-156.
6. Southerland JH, Moss K, Taylor GW, et al. (2012). Periodontitis and diabetes associations with measures of atherosclerosis and CHD. Atherosclerosis 222:196-201.