Elevated leukocyte count is associated with periodontitis in Korean adults: the 2012–2014 <scp>KNHANES</scp>

Kwon, Yu‐Jin; Jeon, Kug Jin; Chung, Tae-Ha; Lee, Yong-Jae

doi:10.1111/odi.12601

Cited by 6 publications

(8 citation statements)

References 31 publications

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“…With reference to periodontitis, group 3 (CP only) also had a statistically significant difference when compared with group 4 comprising of healthy subjects. These reiterate the results of Kwon et al., who associated an elevated WBC count positively with periodontitis. Chronic periodontitis patients exhibit a significantly high WBC count, which is also a surrogate marker of the inflammatory response and a potential marker of plaque instability.…”

Section: Discussionsupporting

confidence: 86%

Dysregulation of miR‐146a by periodontal pathogens: A risk for acute coronary syndrome

Gita

George

Pavithra

et al. 2019

Journal of Periodontology

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Background: Periodontitis is a polymicrobial, chronic inflammatory disease leading to loss of tooth-supporting structures. The bacteremia, endotoxemia, and systemic low-grade inflammation associate periodontitis with systemic illnesses such as diabetes mellitus and coronary artery disease. Periodontal pathogens have been detected from atheromatous plaque by amplification of the genetic material by using specific oligonucleotide primers in polymerase chain reaction. Though the association between periodontitis and cardiovascular diseases has been ascertained by systematic reviews and meta-analyses, its pathophysiology is not lucid. MicroRNAs are currently implicated in the regulation of many cellular processes including inflammation and may play a vital role in our understanding of this disease association. In this casecontrol study, we explored the role of the inflammatory microRNA, miR-146a, in acute coronary syndrome (ACS) subjects with and without chronic periodontitis (CP) and its regulation of the innate immune host response to periodontal pathogens.Methods: Three groups each comprising 66 patients each, namely group 1 (ACS patients without CP), group 2 (ACS patients with CP) and group 3 (CP only) formed the study population. Subgingival plaque samples and serum samples were subjected to quantitative Polymerase Chain Reaction (qPCR) for detection of Porphyromonas gingivalis, a keystone pathogen and to assess the levels of circulating miR-146a and associated proinflammatory cytokines.Results: miR-146a associated significantly in group 2 subjects with an odds ratio 1.434, 95% confidence interval 1.013-2.030, P < 0.042, and a predictive percentage of 83.3% and group 1 with a predictive percentage of 76.0.% The associated cytokines interleukin-6 (IL-6), tumor necrosis factor-, and IL-1 also showed an upregulation with statistical significance (P < 0.05).Conclusion: microRNA-146a is a key molecule associating periodontitis with acute coronary syndrome. K E Y W O R D Sacute coronary syndrome, chronic inflammation, chronic periodontitis, immune subversion, miR-146a, Porphyromonas gingivalis756

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Section: Discussionsupporting

confidence: 86%

Dysregulation of miR‐146a by periodontal pathogens: A risk for acute coronary syndrome

Gita

George

Pavithra

et al. 2019

Journal of Periodontology

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“…This study further confirms that periodontitis is associated with leukocytosis, especially with increased numbers of neutrophils. This is in agreement with several studies, convincingly showing that elevations in neutrophils and often lymphocytes are a typical response to periodontitis . This is part of an inflammatory cascade, initiated by the accumulation of periodontopathogenic bacteria subgingivally and continued by a local inflammatory reaction and subsequently by an overall higher systemic inflammation, linked with vascular dysfunction and higher risk of cardiovascular events …”

Section: Discussionsupporting

confidence: 93%

“…This is in agreement with several studies, convincingly showing that elevations in neutrophils and often lymphocytes are a typical response to periodontitis. 8,18,24,25 This is part of an inflammatory cascade, initiated by the accumulation of periodontopathogenic bacteria subgingivally and continued by a local inflammatory reaction and subsequently by an overall higher systemic inflammation, linked with vascular dysfunction 26,27 and higher risk of cardiovascular events. 28,29 The main strengths of the present study are a larger sample size compared with previous studies, analysis of association with disease severity measured as PD ≥5 mm and sub-analysis in AgP and CP.…”

Section: Discussionmentioning

confidence: 99%

Anemia of inflammation associated with periodontitis: Analysis of two clinical studies

Nibali

Darbar

Rakmanee

et al. 2019

Journal of Periodontology

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Background While leukocytosis is a common feature of severe periodontitis, a smaller amount of evidence has been produced on erythrocytes counts in periodontitis, suggesting a possible tendency to anemia. The aim of this study was to investigate the associations between periodontitis and circulating leukocytes, erythrocytes, and platelets. Methods The study included 471 patients with periodontitis (including aggressive periodontitis [AgP], and chronic periodontitis [CP]) and periodontal health. A separate sample of 333 patients from a previous study (127 AgP and 206 periodontally healthy) was used as replication. Periodontal clinical data were collected and a blood sample was obtained from each participant for hematological analysis of leukocytes, erythrocytes and platelets. Results Adjusted linear regression analyses revealed associations between periodontitis and total leukocytes counts (p < 0.001), neutrophil counts (P <0.001) and hematocrit (HCT) levels (P = 0.045). Sub‐analysis revealed no statistically significant differences between AgP and CP. Disease severity was correlated with total leukocyte and neutrophil counts and HCT (P <0.001, P <0.001 and P = 0.004, respectively). In the replication sample, adjusted linear regression analysis revealed associations between periodontitis and decreased hemoglobin (HB) (P = 0.009), mean corpuscular hemoglobin (MCH) (P = 0.023), and MCH concentration (P <0.001). A subset of patients included in these studies (14% to 15.7% of periodontitis versus 8.4% to 10.2% of healthy, respectively, in the two cohorts) were anemic based on the World Health Organization criteria. Conclusion This paper, reporting results of periodontal examination and blood sampling in over 800 patients, suggest that not just leukocytosis but also tendency to “anemia of inflammation” are typical features of periodontitis.

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“…Emerging evidence supports the idea that low-grade inflammation is closely related to the initiation and progression of periodontitis and osteoarthritis. Kwon et al reported that leukocyte count, a nonspecific marker of systemic inflammation, was elevated in the presence of periodontitis in 9,391 Korean adults (27). Levels of proinflammatory cytokines such as IL-6 and TNF are elevated in the synovial fluid and cartilage of patients with osteoarthritis (6), while chronic cytokine elevation is associated with an increased risk of osteoarthritis, according to a prospective study (11).…”

Section: Discussionmentioning

confidence: 99%

Association Between the Severity of Periodontitis and Osteoarthritis in Middle‐Aged and Older Patients With Type 2 Diabetes Mellitus: A Nationwide Population‐Based Study

Kim

Park

Kim

et al. 2022

Arthritis Care & Research

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Objective. Periodontitis and osteoarthritis are major public health concerns that result in decreased quality of life among middle-aged and older adults. We sought to examine whether the severity of periodontitis is related to osteoarthritis according to the presence of type 2 diabetes mellitus.Methods. This study included 3,527 participants age ≥50 years from the Korean National Health and Nutrition Examination Survey. Periodontitis was assessed using the Community Periodontal Index; severe periodontitis was defined as periodontal tissue forming deep periodontal pockets ≥6-mm depth. Osteoarthritis was defined as Kellgren/Lawrence grade ≥2 on radiographic images of the knee or hip area with joint pain. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for osteoarthritis according to the severity of periodontitis, stratified by type 2 diabetes mellitus, were calculated using multiple logistic regression analyses.Results. Participants with type 2 diabetes mellitus were more likely to have osteoarthritis as the severity of periodontitis increased (nonsevere periodontitis OR 1.23 [95% CI 0.67-2.32]; severe periodontitis OR 3.01 [95% CI 1.51-5.84]) after adjusting for age, sex, body mass index, smoking status, alcohol consumption, regular exercise, education level, household income, hypertension, and frequent tooth-brushing. However, this positive association was not found in individuals without type 2 diabetes mellitus after adjusting for the same covariables.Conclusion. Severe periodontitis was positively and significantly associated with osteoarthritis in middle-aged and older individuals with type 2 diabetes mellitus. Our findings suggest that the oral inflammation manifesting in periodontitis may be at least partly involved in the pathogenesis of osteoarthritis, particularly in patients with type 2 diabetes mellitus.

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Elevated leukocyte count is associated with periodontitis in Korean adults: the 2012–2014 KNHANES

Abstract: An elevated leukocyte count was positively associated with the presence of periodontitis.

Cited by 6 publications

References 31 publications

Dysregulation of miR‐146a by periodontal pathogens: A risk for acute coronary syndrome

Dysregulation of miR‐146a by periodontal pathogens: A risk for acute coronary syndrome

Anemia of inflammation associated with periodontitis: Analysis of two clinical studies

Association Between the Severity of Periodontitis and Osteoarthritis in Middle‐Aged and Older Patients With Type 2 Diabetes Mellitus: A Nationwide Population‐Based Study

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