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Mohite SH, Suragimath G, Varma S, Zope SA, Sr A. Assessment and Comparison of N-Terminal-Probrain Natriuretic Peptide (NT-proBNP) in Saliva and Serum of Healthy Subjects, Periodontitis Patients, and Periodontitis Patients With Myocardial Infarction. Cureus 2024; 16:e67441. [PMID: 39310529 PMCID: PMC11415603 DOI: 10.7759/cureus.67441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Introduction Periodontitis is a multifactorial oral disease causing destruction of the periodontium. Systemic diseases can exacerbate periodontal inflammation through immune dysregulation. N-terminal-probrain natriuretic peptide (NT-proBNP) a prohormone, released by myocardial cells is a known biomarker for cardiovascular disease (CVD). Existing literature discloses a bidirectional relationship between periodontitis and CVD. NT-proBNP release can be regulated by mediators of the systemic inflammation. Cardiocyte NT-proBNP release might get stimulated through proinflammatory cytokines. NT-proBNP levels can also be influenced by systemic inflammation in the absence of cardiac dysfunction. Accordingly, we postulated that the inflammation of periodontium could aid in increased levels of NT-proBNP in serum and saliva in participants without cardiovascular disorders. Saliva is said to be the mirror of the body. Assessing NT-pro BNP in saliva allows for a non-invasive method. The present research evaluated the salivary and serum concentrations of NT-proBNP in a healthy group, patients suffering from periodontal disease and periodontal disease along with myocardial infarction (MI). Material and method A total of 90 patients, 30 in each group i.e., healthy group, periodontitis patients and patients suffering from periodontitis with myocardial infarction, were enrolled. The periodontitis patients were selected according to the Classification of Periodontal and Peri-implant Diseases and Conditions 2017. Patients clinically diagnosed with MI by the physician were selected following World Health Organization criteria for detection of MI. Case history was recorded and periodontal parameter analysis like plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL) were measured. Salivary and serum samples were collected from the participants after obtaining informed consent. The samples were subjected to human NT-proBNP sandwich type enzyme-linked immunosorbent assay (ELISA) for quantitative evaluation. The obtained data was analysed and compared using ANOVA, Tukey's post hoc test and Pearson's correlation. The p-value<0.05 was considered statistically significant. Result PI and GI were highest in subjects with periodontitis only (p<0.05). Patients suffering from periodontitis with MI exhibited significantly higher PPD and CAL values (p<0.05). Salivary and serum concentrations of NT-proBNP were significantly higher with p-value=0.000 in subjects suffering from periodontitis with MI. The salivary NT-proBNP levels were significantly higher than serum NT-proBNP levels in periodontitis and periodontitis with MI patients. The levels of NT-proBNP in periodontitis along with MI patients were 1.570 pg/mL in serum and 1.694 pg/mL in saliva. Conclusion Salivary NT-proBNP levels were highest in subjects affected from periodontitis along with MI. Elevated salivary NT-proBNP levels can be due to systemic inflammation and cardiovascular stress linking periodontitis to MI. The positive correlation between periodontal parameters and NT-proBNP levels validates the biomarker's role in reflecting the extent of periodontal destruction and its association with cardiovascular stress. Salivary NT-proBNP can be used as a non-invasive diagnostic marker for diagnosing periodontitis and MI. Future research could explore targeted therapies for the shared inflammatory pathways between periodontitis and MI.
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Affiliation(s)
- Shraddha H Mohite
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Girish Suragimath
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Siddhartha Varma
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Sameer A Zope
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Ashwinirani Sr
- Oral Medicine and Radiology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
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Jung Y, Kim JH, Shin AR, Song KB, Amano A, Choi YH. Association of Adiposity with Periodontitis and Metabolic Syndrome: From the Third National Health and Nutrition Examination Survey of United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032533. [PMID: 36767897 PMCID: PMC9916149 DOI: 10.3390/ijerph20032533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 05/31/2023]
Abstract
This study explored the epidemiological role of central adiposity and body mass index (BMI) in terms of clinical attachment loss (CAL)/pocket depth (PD) and metabolic syndrome components. This study included data from the National Health and Nutrition Examination Survey III of America on 12,254 adults aged 20 years of age or older with a blood sample, anthropometric measurements, and a periodontal examination. Clinical periodontitis measurements, including CAL and PD, were classified into quintiles or quartiles and compared. CAL was positively associated with central adiposity, hypertension, and hyperglycemia; the relationship between CAL and diabetes was stronger when central adiposity was absent (odds ratio [OR] and 95% confidence interval: 6.33, 2.14-18.72 vs. 3.14, 1.78-5.56). The relationship between CAL and impaired fasting glucose (IFG) differed slightly with BMI. The IFG ORs for normal, overweight, and obese patients were 1.63 (1.08-2.45), 1.76 (1.05-2.97), and 1.43 (0.88-2.30), respectively. CAL was positively correlated with all metabolic syndrome components except hypertriglyceridemia. Associations between CAL, diabetes, and IFG significantly varied with BMI. Periodontitis in individuals without central obesity or with normal bodyweight may independently indicate diabetes and IFG. Therefore, preventive measures against periodontitis without obesity are necessary to improve general and oral health.
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Affiliation(s)
- YunSook Jung
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju 37224, Republic of Korea
| | - Ji-Hye Kim
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Ah-Ra Shin
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Keun-Bae Song
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
- Craniofacial Nerve-Bone Network Research Center, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan
| | - Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
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Kim CM, Lee S, Hwang W, Son E, Kim TW, Kim K, Kim YH. Obesity and periodontitis: A systematic review and updated meta-analysis. Front Endocrinol (Lausanne) 2022; 13:999455. [PMID: 36353241 PMCID: PMC9637837 DOI: 10.3389/fendo.2022.999455] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background A previous 2014 meta-analysis reported a positive association between obesity and periodontitis. It was considered necessary to update the recently published papers and to analyse subgroups on important clinical variables that could affect the association between obesity and periodontitis. Therefore, we updated the latest studies and attempted to derive more refined results. Methods All observational studies were eligible for inclusion. The Newcastle-Ottawa scale was used to qualitatively evaluate the risk of bias. Subgroup analyses were conducted for patients aged 18-34, 35-54, and 55+ years and the countries (European countries, USA, Brazil, Japan, Korea, and other Asian countries). Results Thirty-seven full-text articles were included. Obesity conferred increased odds of periodontal disease with an odds ratio (1.35, 95% CI: 1.05-1.75). In the subgroup analysis by age, the odds ratio was the highest in the 18-34 years group (2.21, 95% CI: 1.26-3.89). In the subgroup analysis by country, European countries had the highest odds ratio (2.46, 95% CI: 1.11-5.46). Conclusion Despite the differences in degree, a positive association between obesity and periodontitis was found regardless of country or age. Therefore, medical professionals should try to prevent periodontitis by controlling patient weights, and more studies should be conducted to determine the association between obesity and oral health. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022301343.
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Affiliation(s)
- Chang Min Kim
- School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Soobin Lee
- School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Wonjun Hwang
- School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Eunjeong Son
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Tae Woo Kim
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Kihun Kim
- Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, South Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, South Korea
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Campos JR, Martins CC, Faria SFS, Carvalho AP, Pereira AG, Costa FO, Cota LOM. Association between components of metabolic syndrome and periodontitis: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:5557-5574. [PMID: 35716205 DOI: 10.1007/s00784-022-04583-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/09/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the role of metabolic syndrome (MetS) components in the association with periodontitis (PE) (#CRD42020218310). MATERIALS AND METHODS A systematic electronic search was performed in PUBMED, Scielo and Lilacs databases up to April 2022. Cross-sectional, case-control, and cohort studies presenting data on the association between MetS and PE in the adult and elderly populations were included. A random effect meta-analysis was performed to determine association effect estimates. Results interpretation followed the assessment of methodological quality (Joana Briggs Institute tool) together with the certainty of evidence (GRADE approach). RESULTS This review included 52 studies, totalling 140,434 participants, and 38 studies were meta-analyzed. Association between PE and MetS was observed (ORadj from 1.27 to 1.90; PRajd = 1.19; RRadj from 1.10 to 1.37) (low and very low certainty of evidence). Hyperglycaemia (OR = 1.18), HDL (OR = 1.16), obesity (OR = 1.08), and hypertension (OR = 1.11) were associated with PE, except triglycerides (low and very low certainty of evidence). There was a dose-response gradient between the number of MetS components and PE, with a gradual increase in the effect magnitude for 1 (OR = 1.14), 2 (OR = 1.52), 3 or more (OR = 1.79), and 4 or 5 components (OR = 2.02) (low to high certainty of evidence). CONCLUSIONS MetS was associated with PE, with a dose-response gradient between the number of MetS components and the occurrence of PE, with an increasing effect magnitude according to an increasing number of components. CLINICAL RELEVANCE Periodontal examination should be part of a comprehensive propaedeutic approach of MetS patients, particularly those presenting a great number of components.
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Affiliation(s)
- Julya Ribeiro Campos
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue 6627, Pampulha. PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Carolina Castro Martins
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sandro Felipe Santos Faria
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue 6627, Pampulha. PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Ana Paula Carvalho
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue 6627, Pampulha. PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Alexandre Godinho Pereira
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue 6627, Pampulha. PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue 6627, Pampulha. PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue 6627, Pampulha. PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
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Foratori-Junior GA, Máscoli LS, Marchese CC, Orenha ES, Sales-Peres SHDC. Association Between Arterial Hypertension and Periodontal Status in Morbidly Obese Patients Who Are Candidates for Bariatric Surgery. Int Dent J 2021; 71:242-249. [PMID: 34024333 PMCID: PMC9275335 DOI: 10.1111/idj.12625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective This study aimed to compare the systemic and periodontal conditions between morbidly obese patients with and without hypertension who were candidates for bariatric surgery. Methods The study cohort had 111 morbidly obese patients stratified into two groups: patients with (G1 = 54) and without (G2 = 57) arterial hypertension. The following characteristics were compared between the two groups: (i) education level; (ii) anthropometric parameters [weight, height, body mass index (BMI), waist and hip circumferences and waist-to-hip ratio (WHR)]; (iii) risk of developing cardiovascular diseases (based on patients’ sex, age and WHR); (iv) behaviours regarding oral hygiene; and (v) periodontal status. The t-test, Mann–Whitney U-test, chi-square test and logistic regression were applied, with a significance level of 5%. Results Patients in G1 had a lower level of education (P = 0.002). There were no intergroup differences for weight (P = 0.211), height (P = 0.126), BMI (P = 0.551), waist circumference (P = 0.859) and WHR (P = 0.067); however, patients in G2 had a smaller hip circumference (P = 0.029), and 78% of patients in G1 had a high/very high risk of developing cardiovascular diseases. The prevalence of periodontitis was 72.2% (n = 39) in G1 and 38.6% (n = 22) in G2. On logistic regression analysis, age [adjusted odds ratio (OR) = 1.07; 95% CI = 1.01–1.13; P = 0.008) and the presence of arterial hypertension (OR = 2.77; 95% CI = 1.17–6.56; P = 0.019) were identified as the independent variables associated with periodontitis. Conclusion Morbid obesity and arterial hypertension are associated with a higher prevalence of cardiovascular diseases. Moreover, morbidly obese patients with hypertension have a higher prevalence of periodontitis and greater severity of periodontal disease than those without hypertension.
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Affiliation(s)
- Gerson Aparecido Foratori-Junior
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil; University of Integrated Faculties of Ourinhos, Ourinhos, Brazil
| | - Leonardo Silva Máscoli
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Carolina Cordeiro Marchese
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Eliel Soares Orenha
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Minty M, Canceil T, Serino M, Burcelin R, Tercé F, Blasco-Baque V. Oral microbiota-induced periodontitis: a new risk factor of metabolic diseases. Rev Endocr Metab Disord 2019; 20:449-459. [PMID: 31741266 DOI: 10.1007/s11154-019-09526-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
It has recently become evident that the periodontium (gingiva, desmodontal ligament, cementum and alveolar bone) and the associated microbiota play a pivotal role in regulating human health and diseases. The oral cavity is the second largest microbiota in the body with around 500 different bacterial species identified today. When disruption of oral cavity and dysbiosis occur, the proportion of strict anaerobic Gram-negative bacteria is then increased. Patients with periodontitis present 27 to 53% more risk to develop diabetes than the control population suggesting that periodontitis is an aggravating factor in the incidence of diabetes. Moreover, dysbiosis of oral microbiota is involved in both periodontal and metabolic disorders (cardiovascular diseases, dyslipidaemia …). The oral diabetic dysbiosis is characterized by a specific bacteria Porphyromonas, which is highly expressed in periodontal diseases and could exacerbate insulin resistance. In this review, we will address the nature of the oral microbiota and how it affects systemic pathologies with a bidirectional interaction. We also propose that using prebiotics like Akkermansia muciniphila may influence oral microbiota as novel therapeutic strategies. The discovery of the implication of oral microbiota for the control of metabolic diseases could be a new way for personalized medicine.
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Affiliation(s)
- Matthieu Minty
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Thibault Canceil
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Matteo Serino
- INSERM, INRA, ENVT, UPS, IRSD, Université de Toulouse, 31024, Toulouse, France
| | - Remy Burcelin
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - François Tercé
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France
| | - Vincent Blasco-Baque
- INSERM U1048, F-31432 Toulouse, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), F-31432, Toulouse, France.
- Université Paul Sabatier III (UPS), F-31432, Toulouse, France.
- CHU Toulouse, Service d'Odontologie Toulouse, F-3100, Toulouse, France.
- INSERM UMR1048-I2MC Team 2 « Intestinal Risk Factors, Diabetes and Dyslipidemia » Building L4, 1st floor, Hospital of Rangueil 1, Avenue Jean Poulhès, 84225 31432, Toulouse Cedex 4 Lab, BP, France.
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