Gender Differences in the Levels of Periodontal Destruction, Behavioral Risk Factors and Systemic Oxidative Stress in Ischemic Stroke Patients: A Cohort Pilot Study

Abstract

Background: Due to the higher frequency of ischemic stroke in men compared to women, we aimed to determine if gender differences exist regarding periodontal status and several plasma biomarkers in patients with a recent large artery atherosclerosis ischemic stroke (IS). Material and methods: Patients with their first IS within less than six weeks who were able to undergo periodontal examinations were evaluated. Demographic data, periodontal status, oxidative stress parameters/plasma antioxidant capacity, and C-reactive protein in patients who suffered a recent large artery atherosclerosis ischemic stroke were reccorded. Results: 93 patients were included in the study. More men were smokers (12/57 vs. 3/36) and consumed alcohol (17/57 vs. 3/36), and more women had higher glycemic values (p = 0.023), total cholesterol (p < 0.001), LDL (low-density lipoprotein)-cholesterol (p = 0.010), and HDL (high-density lipoprotein)-cholesterol (p = 0.005) levels. Significantly more men than women had moderate plus severe periodontal disease (p = 0.018), significantly higher levels of nitric oxide (p = 0.034), and significantly lower levels of total antioxidant capacity (p = 0.028). Conclusions: In this pilot study, men seem to be more prone to oxidative stress and to develop more severe forms of periodontitis among patients with stroke, but the results need validation on a larger sample.

Periodontitis in Ischemic Stroke Patients: Case Definition Challenges of the New Classification Scheme (2018)

“…A poor periodontal status of IS patients was recorded by both the 2012 CDC/AAP and the EFP/AAP classification systems, as revealed by the similarly high periodontitis burden: an overall periodontitis frequency of 98.5% and 97.8%, respectively, and a 75.89% and 96.45% frequency of severe cases, respectively. These results show a higher periodontitis burden compared with previous studies reporting a 79.6% [45] and 73.3% [55] periodontitis prevalence in stroke patients. However, it is important to acknowledge that previous reports were based on the 2012 CDC/AAP classification system [45] and the Community Periodontal Index for Treatment Needs (CPITN) criteria [55], respectively.…”

“…A poor periodontal status of IS patients was recorded by both the 2012 CDC/AAP and the EFP/AAP classification systems, as revealed by the similarly high periodontitis burden: an overall periodontitis frequency of 98.5% and 97.8%, respectively, and a 75.89% and 96.45% frequency of severe cases, respectively. These results show a higher periodontitis burden compared with previous studies reporting a 79.6% [45] and 73.3% [55] perio-…”

“…The sample size estimation was based on the worst-case scenario provided in our previous study, including 93 IS patients that reported a 79.6% periodontitis frequency [45]. A frequency of 86.5% was obtained when edentulous patients were excluded from the analysis.…”

“…Periodontitis case definitions were applied by four experienced, highly trained periodontologists (A.R., S , .I.S., I.C.M., P.D.M.) [45,52,53].…”

Interaction between and impact of IL‐6 genotype and alpha‐tocopherol levels on periodontal condition in aging individuals

“…A recent study indicated that female showed higher serum levels such as glycemic values, total cholesterol, and LDL levels which were related to periodontal disease. 39 It might be one reason why female showed high risk for periodontal disease.…”