Comparative evaluation of levels of C-reactive protein and PMN in periodontitis patients related to cardiovascular disease

Abstract

Background:Numerous cross-sectional studies have suggested that chronic periodontitis is a risk factor for cardiovascular diseases. There is evidence that periodontitis and cardiovascular diseases are linked by inflammatory factors including C-reactive protein. The purpose of the study was to investigate the levels of CRP and PNM cells as a marker of inflammatory host response in the serum of chronic periodontitis patients and in patients with CVD.Materials and Methods:Study population included 75 patients; both male and female above 35 years were included for the study. The patients were divided into three groups of 25 each – Group I: Chronic periodontitis patients with CVD, Group II: Chronic periodontitis patients without CVD and Group III: Control subjects (without chronic periodontitis and CVD). Patients with chronic periodontitis had ≥8 teeth involved with probing depth (PD) ≥5 mm involved. The control group had PD ≤ 3 mm and no CVD. Venous blood was collected from the patients and C-reactive protein levels were analyzed by immunoturbidimetry. PMN was recorded by differential count method.Results:On comparison, OHI-S Index, GI, mean PD, CRP and PMN values showed significant difference from Group I to III. CRP level was highly significant in Group I when compared with Group II and Group III. PMN level was highly significant in Group I when compared with Group III PMN level which was not significant.Conclusion:This study indicated that periodontitis may add the inflammation burden of the individual and may result in increased levels of CVD based on serum CRP levels. Thus, controlled prospective trials with large sample size should be carried out to know the true nature of the relationship if indeed one exists.

Evaluation of Association between CRP Levels in Chronic Periodontitis patients and Chronic Periodontitis with Cardiovascular Diseases

“…Periodontitis and CVD are strongly associated and they potentially share many risk factors like stress, smoking, diet, lack of physical exercise, obesity and atherosclerotic lesions 5 ; they share a common pathogenetic process like monocyte hyper responsiveness, formation of atheromas (atherosclerosis) and rise in systemic levels in CRP. 1,10 Moreover the CRP levels were increased in the chronic periodontitis patients with CVD when compared to chronic periodontitis patients without CVD or controls, our results were consistent with studies conducted by Malhotra S 1 , Anitha G et al 5 , Tuter G et al 16 , Glurich et al 17 , and Loesche 18 who found a positive correlation between the CRP levels in periodontitis patients with CVD. In addition it has certain limitations.…”

“…But chronic periodontitis show the rise of CRP levels in the blood, which is a risk indicator of cardiovascular disease. 5,6…”

Correlation Between Arteriosclerosis and Periodontal Condition Assessed by Lactoferrin and <i>α</i>1-Antitrypsin Levels in Gingival Crevicular Fluid

“…[16][17][18] Periodontal disease is similarly associated with increased systemic inflammatory markers, including C-reactive protein and interleukin-6. [18][19][20] Thus, the association between periodontal disease and atherosclerosis presented in previous reports 19,20) may not be a direct relationship; however, it may be a reflection of the increased levels of inflammatory markers in both diseases. Our results showing the nonexistence of a strong correlation between periodontal condition and arteriosclerosis severity were consistent with the recent American Heart Association statement.…”

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

“…One study suggested that the concentration of serum neutrophil markers, myeloperoxidase (MPO) and high matrix metalloproteinase (MMP)-8/tissue inhibitor of metalloproteinase (TIMP)-1 ratio increased the risk of recurrent acute coronary syndrome (ACS) [10]. Most recently, neutrophils have been implicated as mediators in periodontitis-myocardial infarction studies [6,11]. However, the scientific studies in this area are scarce.…”

“…In patients with stable coronary heart disease (CHD), a higher CRP concentration increases the risk of MI, whereas in patients with unstable CHD and MI history, it yields a worse prognosis and a higher risk of complications [5,6]. Even after taking into consideration other conventional risk factors, such as arterial hypertension or cholesterol level, CRP remains an independent predictor of coronary risk [7].…”