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Hou K, Song W, He J, Ma Z. The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and prevalence of periodontitis among US adults: a cross-sectional NHANES study. Sci Rep 2024; 14:5558. [PMID: 38448487 PMCID: PMC10918089 DOI: 10.1038/s41598-024-56276-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/04/2024] [Indexed: 03/08/2024] Open
Abstract
The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a recently developed lipid parameter, but there is currently a lack of research exploring its relationship with periodontitis. This study aims to identify the potential association between NHHR and periodontitis. The association between NHHR and periodontitis were examined through univariate and multivariate weighted logistic regression utilizing the National Health and Nutrition Examination Survey data from 2009 to 2014. The participants were grouped based on the type of periodontitis. This study included a total of 9023 participants, with 1947 individuals having no periodontitis, and an additional 7076 individuals suffering from periodontitis. Patients in periodontitis group demonstrated a statistically significant elevation in NHHR values 2.82 (2.05-3.80) compared to those in no periodontitis group (p < 0.001). Logistic regression analysis of variables demonstrated a positive association between NHHR and periodontitis [1.07 (1.02, 1.12) p = 0.0067]. The study revealed a positive association between NHHR and an elevated prevalence of periodontitis development. For each unit increase in NHHR, there is a 7% increase in the prevalence of periodontitis. Further investigations into NHHR may enhance our understanding of preventing and treating periodontitis. However, additional studies are required to validate these findings.
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Affiliation(s)
- Kegui Hou
- Beijing Shunyi District Hospital, Beijing, 101300, China
| | - Wenpeng Song
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
| | - Jun He
- Beijing Shunyi District Hospital, Beijing, 101300, China
| | - Zhaofeng Ma
- Beijing Shunyi District Hospital, Beijing, 101300, China.
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2
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Sun J, Guo G. Association between atherogenic index of plasma and periodontitis among U.S. adults. BMC Oral Health 2023; 23:166. [PMID: 36949430 PMCID: PMC10035221 DOI: 10.1186/s12903-023-02853-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/02/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Serum lipids have been proven to influence periodontitis. The atherogenic index of plasma (AIP) is an important marker of lipid levels. The purpose of this study was to investigate the association between periodontitis and AIP in adults. METHODS The study included participants from the 2009-2014 National Health and Nutrition Examination Survey who received a complete periodontal exam and a complete record of AIP. AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). Periodontitis can be classified into four categories based on attachment loss and probing depth (no periodontitis, moderate periodontitis, mild periodontitis, and severe periodontitis). Multivariable logistic regression after adjusting and hierarchical analysis were conducted to investigate the relationship between periodontitis and AIP in adults. RESULTS The final sample included 4,371 participants, representing approximately 60 million people in the United States. Periodontitis among the AIP groups (quartile, Q1-Q4) was statistically significant (P < 0.05). Univariate analysis showed that AIP was associated with the incidence of periodontitis (P < 0.05), but not with the severity of periodontitis (P > 0.05) in participants. Multifactorial logistic regression analysis showed no correlation between the incidence of periodontitis and AIP among all participants (the trend P-value = 0.341), but a significant association with AIP in the non-smoking participants (the trend P-value = 0.031). CONCLUSION There was a significant correlation between periodontitis and AIP in the non-smoking population.
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Affiliation(s)
- Jing Sun
- Changsha Stomatological Hospital, 389 Youyi Road, Changsha, Hunan Province, 410000, China
| | - Ge Guo
- Changsha Stomatological Hospital, 389 Youyi Road, Changsha, Hunan Province, 410000, China.
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3
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Taguchi A, Saito M, Shiraki M. Association of pentosidine and homocysteine levels with number of teeth present in Japanese postmenopausal women. J Bone Miner Metab 2022; 40:773-781. [PMID: 35697886 DOI: 10.1007/s00774-022-01343-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/11/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Little is known about whether substances inducing tissue protein degeneration in the oral cavity are associated with the number of teeth present in postmenopausal women. We sought to investigate the association of urinary pentosidine and serum homocysteine levels with the number of teeth and subsequent tooth loss in Japanese postmenopausal women. MATERIALS AND METHODS Among participants in the Nagano Cohort Study, 785 postmenopausal women (mean age, 68.1 years) participated in the present study. The number of teeth was re-counted at the time of follow-up in 610 women. Poisson regression analysis was used to investigate differences in the number of teeth among quartiles of pentosidine or homocysteine, adjusting for covariates that correlated with the number of teeth. A Cox proportional hazard model was used to evaluate the association of subsequent tooth loss with pentosidine or homocysteine levels. RESULTS Pentosidine quartiles were not associated with the number of teeth at baseline. Participants in the highest homocysteine quartile had significantly fewer teeth at baseline than those in the third and lowest quartiles (p < 0.001 for both). Those in the second quartile had fewer teeth than those in the third (p = 0.001) and lowest (p < 0.001) quartiles. An increased risk of tooth loss during follow-up was significantly associated with higher urinary pentosidine (hazard ratio = 1.073 for 10 pmol/mgCre; p = 0.001). CONCLUSION Postmenopausal women with higher homocysteine levels had fewer teeth at baseline. A higher pentosidine concentration increased the risk of subsequent tooth loss. High pentosidine or homocysteine concentrations may be associated with tooth loss in postmenopausal women.
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Affiliation(s)
- Akira Taguchi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano, 399-0781, Japan.
- Department of Hard Tissue Research, Graduate School of Oral Medicine, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano, 399-0781, Japan.
| | - Mitsuru Saito
- Department of Orthopaedic Surgery, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Masataka Shiraki
- Department of Internal Medicine, Research Institute and Practice for Involutional Diseases, 1610-1 Meisei, Misato, Azumino, Nagano, 399-8101, Japan
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Martínez-Lazcano JC, González-Guevara E, Boll C, Cárdenas G. Gut dysbiosis and homocysteine: a couple for boosting neurotoxicity in Huntington disease. Rev Neurosci 2022; 33:819-827. [PMID: 35411760 DOI: 10.1515/revneuro-2021-0164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/11/2022] [Indexed: 11/15/2022]
Abstract
Huntington's disease (HD), a neurodegenerative disorder caused by an expansion of the huntingtin triplet (Htt), is clinically characterized by cognitive and neuropsychiatric alterations. Although these alterations appear to be related to mutant Htt (mHtt)-induced neurotoxicity, several other factors are involved. The gut microbiota is a known modulator of brain-gut communication and when altered (dysbiosis), several complaints can be developed including gastrointestinal dysfunction which may have a negative impact on cognition, behavior, and other mental functions in HD through several mechanisms, including increased levels of lipopolysaccharide, proinflammatory cytokines and immune cell response, as well as alterations in Ca2+ signaling, resulting in both increased intestinal and blood-brain barrier (BBB) permeability. Recently, the presence of dysbiosis has been described in both transgenic mouse models and HD patients. A bidirectional influence between host brain tissues and the gut microbiota has been observed. On the one hand, the host diet influences the composition and function of microbiota; and on the other hand, microbiota products can affect BBB permeability, synaptogenesis, and the regulation of neurotransmitters and neurotrophic factors, which has a direct effect on host metabolism and brain function. This review summarizes the available evidence on the pathogenic synergism of dysbiosis and homocysteine, and their role in the transgression of BBB integrity and their potential neurotoxicity of HD.
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Affiliation(s)
- Juan Carlos Martínez-Lazcano
- Laboratorio de Neurofarmacología Molecular y Nanotecnología, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City 14629, Mexico
| | - Edith González-Guevara
- Laboratorio de Neurofarmacología Molecular y Nanotecnología, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City 14629, Mexico
| | - Catherine Boll
- Laboratorio de Investigación clínica, Clínica de Ataxias y Coreas, Enfermedades Neurodegenerativas Raras, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City 14629, Mexico
| | - Graciela Cárdenas
- Departamento de Neurología y Enfermedades Neuro-Infecciosas, Instituto Nacional de Neurología y Neurocirugía MVS, Mexico City 14629, Mexico
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Zhu H, Ye G, Xie Y, Zhu K, Zhu F, Chen Q. Association of high-density lipoprotein cholesterol and periodontitis severity in Chinese elderly: a cross-sectional study. Clin Oral Investig 2022; 26:4753-4759. [PMID: 35348881 DOI: 10.1007/s00784-022-04439-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/02/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Periodontitis is a local inflammatory disease of high prevalence worldwide. Increasing evidence has shown its association with cardiovascular diseases. While high-density lipoprotein is an important protective factor in preventing cardiovascular diseases, this study aims to examine whether high-density lipoprotein cholesterol (HDL-C) level is associated with different status of periodontitis. MATERIALS AND METHODS A total of 874 Chinese retirees (≥ 60 years of age) with different statuses of periodontitis were enrolled. Periodontal clinical data were collected to define periodontal disease severity (no, mild-moderate, severe). Peripheral blood was collected for serum lipid profile analysis. Linear and logistic regression analysis with adjustment for potential confounders (gender, age, BMI, alcohol intake, exercise frequency, smoking habits) were used to determine the association of periodontitis with HDL-C. RESULTS After adjustments for confounders, linear regression analyses revealed a significant relationship between the decreased HDL-C and periodontitis severity (p < 0.05). Although the multivariable-adjusted ORs of decreased HDL-C were not statistically significant, logistic regression analyses showed Chinese elderly with severe periodontitis had higher odds of exhibiting clinically abnormal HDL-C levels than those without periodontitis. CONCLUSIONS The elderly population with periodontitis showed HDL-C levels significantly lower than those without periodontitis. The severity of periodontitis was positively correlated with serum HDL-C levels. CLINICAL RELEVANCE Periodontitis reduces HDL-C level in the elderly population, indicating that oral health should be paid attention to in the prevention and treatment of dyslipidemia.
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Affiliation(s)
- Haihua Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China
| | - Guanchen Ye
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China
| | - Yanyi Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China
| | - Kangqi Zhu
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
| | - Fudong Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, Zhejiang, China.
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Teughels W, Celik GU, Tarce M, De Cock I, Persyn SM, Haytac MC. The effect of choline-stabilized orthosilicic acid in patients with peri-implantitis: an exploratory randomized, double-blind, placebo controlled study. BMC Oral Health 2021; 21:485. [PMID: 34587941 PMCID: PMC8480141 DOI: 10.1186/s12903-021-01817-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 09/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background Choline-stabilized orthosilicic acid (CS-OSA) was previously found to stimulate bone collagen formation in osteopenia and to improve biomarkers of cartilage degradation in knee osteoarthritis. The aim of the present study was to investigate the effect of oral administration of CS-OSA on clinical symptoms of peri-implantitis and the associated bone loss. Methods Twenty-one patients with peri-implantitis were randomized in CS-OSA or placebo groups. After initial clinical and cone beam computed tomography (CBCT) measurements [probing pocket depth (PPD), bleeding on probing (BOP), mucosal recession (REC), distance from implant shoulder to alveolar crest (IS-AC) and distance from implant shoulder to first bone-to-implant contact (IS-BIC)], flap operations were performed at the peri-implantitis sites. All patients were instructed to use either placebo or CS-OSA capsules twice a day for 1 year. Measurements were repeated 6 and 12 months after randomization. Results The data of 18 patients (36 implants) were used in the per protocol analysis. PPD and BOP improved significantly (p < 0.05) compared to baseline for both groups after 6 and 12 months. However, REC significantly increased in the placebo group but not in the CS-OSA group. The change in REC over 6 and 12 months was significantly different between groups (p < 0.01). IS-BIC and IS-AC measurements remained stable in the CS-OSA group whereas in the placebo group, both parameters increased significantly after 6 and 12 months. The change in IS-BIC over 12 months was significantly different between groups (p < 0.05). Conclusion The results of this preliminary study suggest that CS-OSA may stabilize and even prevent further bone loss after surgical peri-implantitis treatment and support mucosal tissue healing. Trial registration The trial was retrospectively registered at ISRCTN registry, registration number: ISRCTN14348802, registration date: 24/06/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01817-4.
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Affiliation(s)
- Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, Leuven, Belgium
| | - Gizem Unal Celik
- Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Mihai Tarce
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, Leuven, Belgium
| | - Ine De Cock
- Research and Development, Bio Minerals NV, Zenderstraat 12, 9070, Destelbergen, Belgium
| | - Sara M Persyn
- Research and Development, Bio Minerals NV, Zenderstraat 12, 9070, Destelbergen, Belgium.
| | - Mehmet C Haytac
- Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Husseini B, Nehme E, Senni K, Ghorra CS, Younes K, Roffino S, Ghorra P, Changotade S, Younes R. Oral manifestations associated with inherited hyperhomocysteinemia: A first case description. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:e105-e112. [PMID: 34758936 DOI: 10.1016/j.oooo.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/09/2021] [Accepted: 09/09/2021] [Indexed: 02/08/2023]
Abstract
Hyperhomocysteinemia is a rare disease caused by nutritional deficiencies or genetic impairment of cysteine metabolism. To date, no oral manifestations of hyperhomocysteinemia have been described in humans. Therefore, to our knowledge, the present case report is the first description of a hyperhomocysteinemic patient showing oral tissue alterations leading to both early tooth loss and failed implant osseointegration. The patient presented with a methylenetetrahydrofolate reductase gene mutation (677T polymorphism) leading to mild hyperhomocysteinemia. The radiologic analysis showed hyperdense lesions scattered in the maxillae. The histologic observations indicated alterations in both collagen and elastic networks in the gingiva and dermis. Interestingly, the presence of ectopic mineralized inclusions was noted in both periodontal ligament and gingiva. Strong osteoclastic activity was associated with abnormal calcification of trabecular spaces. Uneven oral tissue remodeling due to high tissue levels of homocysteine could explain the pathologic manifestations observed in this case.
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Affiliation(s)
- Bachar Husseini
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon; Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Edgard Nehme
- Department of Oral Pathology, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Karim Senni
- Laboratoire EBInnov, École de Biologie Industrielle, Cergy, France
| | - Claude Sader Ghorra
- Department of Pathology, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Khalil Younes
- Department of Biochemistry, Hôpital Kremlin Bicêtre AP-HP, Paris, France
| | - Sandrine Roffino
- Institute of Movement Science - E.J. Marey, Aix-Marseille University, CNRS, Marseille, France
| | - Pierre Ghorra
- Flow Cytometry-HLA Laboratory, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Sylvie Changotade
- Unité de Recherche Biomatériaux Innovants et Interfaces, URB2I, UR 4462, F-93000, Université Sorbonne Paris Nord, UFR SMBH, Bobigny France
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon; Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Botelho J, Machado V, Leira Y, Proença L, Mendes JJ. Periodontal Inflamed Surface Area Mediates the Link between Homocysteine and Blood Pressure. Biomolecules 2021; 11:biom11060875. [PMID: 34204680 PMCID: PMC8231519 DOI: 10.3390/biom11060875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022] Open
Abstract
Here, we assess the association between homocysteine (Hcy) serum levels and periodontal status in a large representative sample of the National Health and Nutrition Examination Survey (NHANES). Using the 2001–2002 and 2003–2004 NHANES databases, participants with a periodontal examination, medical self-reported data, blood pressure (BP) and blood samples to determine complete blood count, C-reactive protein (CRP) and Hcy levels. We then calculated the periodontal inflamed surface area (PISA) and the periodontal epithelial surface area (PESA). Multivariable regression analysis explored the association between Hcy, periodontal measures and BP. Mediation analysis was performed to understand the effect of PISA and PESA in the link between Hcy and BP. 4021 participants fulfilled the inclusion criteria. Hcy levels showed significant correlations with systolic BP, diastolic BP, PISA, PESA and age. PESA showed to be significantly associated with Hcy both for the crude and adjusted models (p < 0.01), but not PISA (p > 0.05). In the association of Hcy with systolic BP, PISA significantly mediated 17.4% and PESA 0.9%. In the association of Hcy with diastolic BP, PISA significantly mediated 16.3% and PESA 47.2%. In conclusion, Hcy and periodontitis are associated. Further, both PISA and PESA significantly mediated the association of Hcy with systolic BP and diastolic BP. Future studies shall deepen the mechanisms by which Hcy levels increase in a clinical situation of periodontitis.
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Affiliation(s)
- João Botelho
- Clinical Research Unit (CRU), Egas Moniz Interdisciplinary Research Center, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.J.M.)
- Evidence-Based Hub, Egas Moniz Interdisciplinary Research Center, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal;
- Correspondence: ; Tel.: +351-212-946-800
| | - Vanessa Machado
- Clinical Research Unit (CRU), Egas Moniz Interdisciplinary Research Center, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.J.M.)
- Evidence-Based Hub, Egas Moniz Interdisciplinary Research Center, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal;
| | - Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre, University College London, London WC1E 6BT, UK;
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain
- Medical-Surgical Dentistry (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Luís Proença
- Evidence-Based Hub, Egas Moniz Interdisciplinary Research Center, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal;
- Quantitative Methods for Health Research (MQIS), Egas Moniz Interdisciplinary Research Center, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Egas Moniz Interdisciplinary Research Center, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal; (V.M.); (J.J.M.)
- Evidence-Based Hub, Egas Moniz Interdisciplinary Research Center, Egas Moniz–Cooperativa de Ensino Superior, 2829-511 Almada, Portugal;
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Stanisic D, Jovanovic M, George AK, Homme RP, Tyagi N, Singh M, Tyagi SC. Gut microbiota and the periodontal disease: role of hyperhomocysteinemia. Can J Physiol Pharmacol 2021; 99:9-17. [PMID: 32706987 DOI: 10.1139/cjpp-2020-0215] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Periodontal disease is one of the most common conditions resulting from poor oral hygiene and is characterized by a destructive process in the periodontium that essentially includes gingiva, alveolar mucosa, cementum, periodontal ligament, and alveolar bone. Notably, the destructive event in the alveolar bone has been linked to homocysteine (Hcy) metabolism; however, it has not been fully investigated. Therefore; the implication of Hcy towards initiation, progression, and maintenance of the periodontal disease remains incompletely understood. Higher levels of Hcy (also known as hyperhomocysteinemia (HHcy)) exerts deleterious effects on gum health and teeth in distinct ways. Firstly, increased production of proinflammatory cytokines such as TNF-α, IL-1β, IL-6, and IL-8 leads to an inflammatory cascade of events that affect methionine (Met) and Hcy metabolism (i.e., 1-carbon metabolism) leading to HHcy. Secondly, metabolic dysregulation during chronic medical conditions increases systemic inflammation leading to a decrease in vitamins, more specifically B6, B12, and folic acid, that play important roles as cofactors in Hcy metabolism. Also, given the folate level in the HHcy state that is important during dysbiosis, these two conditions appear to be intimately related, and in this context, HHcy-induced dysbiosis may be one of the potential causes of periodontal disease. This paper sums up the link between periodontitis and HHcy, with a special emphasis on the "oral-gut microbiome axis" and the potential probiotic intervention towards warding off some of the serious periodontal disease conditions.
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Affiliation(s)
- Dragana Stanisic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milica Jovanovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Akash K George
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Rubens P Homme
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Neetu Tyagi
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Mahavir Singh
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Suresh C Tyagi
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
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10
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Stanisic D, George AK, Smolenkova I, Singh M, Tyagi SC. Hyperhomocysteinemia: an instigating factor for periodontal disease. Can J Physiol Pharmacol 2020; 99:115-123. [PMID: 32721223 DOI: 10.1139/cjpp-2020-0224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Hyperhomocysteinemia (HHcy) affects bone remodeling, since a destructive process in cortical alveolar bone has been linked to it; however, the mechanism remains at large. HHcy increases proinflammatory cytokines viz. TNF-α, IL-1b, IL-6, and IL-8 that leads to a cascade that negatively impacts methionine metabolism and homocysteine cycling. Further, chronic inflammation decreases vitamins B12, B6, and folic acid that are required for methionine homocysteine homeostasis. This study aims to investigate a HHcy mouse model (cystathionine β-synthase deficient, CBS+/-) for studying the potential pathophysiological changes, if any, in the periodontium (gingiva, periodontal ligament, cement, and alveolar bone). We compared the periodontium side-by-side in the CBS+/- model with that of the wild-type (C57BL/6J) mice. Histology and histomorphometry of the mandibular bone along with gene expression analyses were carried out. Also, proangiogenic proteins and metalloproteinases were studied. To our knowledge, this research shows, for the first time, a direct connection between periodontal disease during CBS deficiency, thereby suggesting the existence of disease drivers during the hyperhomocysteinemic condition. Our findings offer opportunities to develop diagnostics/therapeutics for people who suffer from chronic metabolic disorders like HHcy.
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Affiliation(s)
- Dragana Stanisic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Akash K George
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Irina Smolenkova
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Mahavir Singh
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Suresh C Tyagi
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
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11
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Xu J, Duan X. Association between periodontitis and hyperlipidaemia: A systematic review and meta-analysis. Clin Exp Pharmacol Physiol 2020; 47:1861-1873. [PMID: 32623762 DOI: 10.1111/1440-1681.13372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/19/2020] [Accepted: 06/26/2020] [Indexed: 12/17/2022]
Abstract
To date, it has been reported that periodontitis (PD) may be associated with hyperlipidaemia in clinical practice. However, data on this issue are inconsistent and controversial. The purpose of this meta-analysis was to identify the association between PD and hyperlipidaemia. Here, 21 case-control and eight cross-sectional studies on PD and hyperlipidaemia were included in the random-effects meta-analysis, involving 2060 patients with PD and 2776 healthy controls (HC). Meta-analysis showed that serum triglyceride (TG) and total cholesterol (TC) levels in the PD group were significantly higher than those in the HC group [TG, weighted mean difference (WMD) = 19.4 mg/dL, 95% confidence interval (CI) 13.3-25.5 mg/dL, P = .000; TC, WMD = 15.4 mg/dL, 95%CI 10.2-20.6 mg/dL, P = .000]. Subgroup analysis stratified by study design validated that PD was associated with higher serum TG and TC levels. In addition, compared with the HC group, serum low-density lipoprotein (LDL) in patients with PD showed a markedly higher level (WMD = 11.7 mg/dL, 95% CI 8.3-15.0 mg/dL, P = .000), whereas serum high-density lipoprotein (HDL) in PD group exhibited a significantly lower level (WMD = -4.5 mg/dL, 95%CI -6.4 - -2.7 mg/dL, P = .000). Finally, no significant publication bias was observed and sensitivity analysis also confirmed the stability of our meta-analyses. In conclusion, the accumulated evidence suggests that PD is indeed associated with hyperlipidaemia in humans. More interventions for lowering lipids or increasing HDL may benefit the patients with PD, which need be further investigated in prospective clinical trials.
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Affiliation(s)
- Jing Xu
- Department of Periodontology, Jinan Stomatological Hospital, Jinan, China
| | - Xiaoqi Duan
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
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Penmetsa GS, Bhaskar RU, Mopidevi A. Analysis of Plasma Homocysteine Levels in Patients with Chronic Periodontitis Before and After Nonsurgical Periodontal Therapy Using High-Performance Liquid Chromatography. Contemp Clin Dent 2020; 11:266-273. [PMID: 33776354 PMCID: PMC7989764 DOI: 10.4103/ccd.ccd_650_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/05/2018] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Homocysteine (Hcy), an inflammatory biomarker, is a sulfur-containing amino acid. Elevated levels of plasma Hcy are evident in various inflammatory conditions and have been described as an independent risk factor for cardiovascular disease. The literature has also stated that a similar association could exist between the chronic periodontitis and plasma-Hcy levels, in otherwise systemically healthy individuals. However, studies on Hcy levels in periodontitis are scarce. Hence, this study aimed to assess the levels of plasma Hcy in patients with chronic periodontitis before and after nonsurgical periodontal therapy. MATERIALS AND METHODS This longitudinal, case-control clinical study included a total of 60 patients who were divided into two groups. Periodontal parameters including Plaque Index, Gingival Index, Sulcus Bleeding Index, probing depth, and clinical attachment level were recorded at baseline and 12 weeks after periodontal therapy. A high-performance liquid chromatography analysis was performed to measure the Hcy levels. The results were evaluated statistically for intergroup pair-wise comparisons by Mann-Whitney U-test and intragroup comparison by Wilcoxon-matched pairs test. Correlation between the plasma-Hcy levels with other clinical parameters in all groups was done by Spearman's rank correlation method. RESULTS The Hcy was detectable in all the samples. At baseline, the mean levels of plasma Hcy were found to be low in the control group, whereas in the test group, it is found to be higher. These plasma-Hcy levels and all periodontal parameters were reduced significantly after nonsurgical periodontal therapy. CONCLUSION The results demonstrated that plasma-Hcy levels are reduced after nonsurgical periodontal therapy but not to the levels comparable with those found in healthy individuals. Therefore, nonsurgical periodontal therapy may be used as an adjunctive Hcy-lowering therapy, contributing toward primary prevention against cardiovascular diseases.
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Affiliation(s)
- Gautami S. Penmetsa
- Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Rayapudi Uday Bhaskar
- Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Anudeep Mopidevi
- Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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Keceli HG, Ercan N, Karsiyaka Hendek M, Kisa U, Mesut B, Olgun E. The effect of the systemic folic acid intake as an adjunct to scaling and root planing on clinical parameters and homocysteine and C-reactive protein levels in gingival crevicular fluid of periodontitis patients: A randomized placebo-controlled clinical trial. J Clin Periodontol 2020; 47:602-613. [PMID: 32109317 DOI: 10.1111/jcpe.13276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 02/14/2020] [Accepted: 02/24/2020] [Indexed: 01/09/2023]
Abstract
AIM To evaluate clinical and biochemical effects of adjunctive systemic folic acid (FA) intake with scaling and root planing (SRP) in periodontitis treatment. MATERIALS AND METHODS Sixty periodontitis subjects (30 per group) were randomly assigned into study groups and treated with either SRP + placebo (SRP + P) or SRP + folic acid (SRP + F). In addition to clinical parameters (plaque index [PI], gingival index [GI], probing pocket depth [PPD], clinical attachment level [CAL] and gingival recession [GR]), gingival crevicular fluid (GCF) samples were obtained at baseline and post-treatment (PT) periods (one (PT-1), three (PT-3) and six (PT-6) months) for C-reactive protein (CRP) and homocysteine (Hcy) evaluation. RESULTS Significant time-dependent reduction was detected at all clinical parameters for both groups (p < .001). Compared to SRP + P, CAL was lower in SRP + F at PT-1 (p = .004) and PT-3 (p = .035), whereas GR was lower at only PT-1 (p = .015). GCF volume and CRP did not show inter-group differences, whereas Hcy was higher in SRP + F at PT-3 (p = .044) and PT-6 (p = .041). GCF volume and Hcy showed reduction after treatment in both groups (p < .001). CONCLUSION Both modalities exhibited clinical improvement and change in biochemical parameters. Adjunctive systemic FA intake may be recommended adjunctive to periodontitis treatment to reveal better outcomes. However, its impact mechanisms should be further enlightened.
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Affiliation(s)
- H Gencay Keceli
- Periodontology Department, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Nuray Ercan
- Oral Health and Dental Care Centre, Duzce, Turkey
| | | | - Ucler Kisa
- Biochemistry Department, Faculty of Medicine, Kirikkale University, Kırıkkale, Turkey
| | - Burcu Mesut
- Pharmaceutical Technology Department, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
| | - Ebru Olgun
- Periodontology Department, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
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Nepomuceno R, Pigossi SC, Finoti LS, Orrico SRP, Cirelli JA, Barros SP, Offenbacher S, Scarel-Caminaga RM. Serum lipid levels in patients with periodontal disease: A meta-analysis and meta-regression. J Clin Periodontol 2017; 44:1192-1207. [DOI: 10.1111/jcpe.12792] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Rafael Nepomuceno
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Suzane C. Pigossi
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Livia S. Finoti
- Department of Periodontics; University of Pennsylvania School of Dental Medicine; Philadelphia PA USA
| | - Silvana R. P. Orrico
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Joni A. Cirelli
- Department of Diagnosis and Surgery; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
| | - Silvana P. Barros
- Department of Periodontology; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC USA
| | - Steven Offenbacher
- Department of Periodontology; University of North Carolina at Chapel Hill School of Dentistry; Chapel Hill NC USA
| | - Raquel M. Scarel-Caminaga
- Department of Morphology; School of Dentistry at Araraquara; São Paulo State University - UNESP; Araraquara SP Brazil
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Mallapragada S, Kasana J, Agrawal P. Effect of Nonsurgical Periodontal Therapy on Serum Highly Sensitive Capsule Reactive Protein and Homocysteine Levels in Chronic Periodontitis: A Pilot Study. Contemp Clin Dent 2017; 8:279-285. [PMID: 28839416 PMCID: PMC5551335 DOI: 10.4103/ccd.ccd_140_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The aim of the present study was to assess the effect of nonsurgical periodontal therapy on circulating serum high-sensitivity capsule reactive protein (hs-CRP) and homocysteine (Hcy) levels in patients with chronic periodontitis. MATERIALS AND METHODS The study involved fifty participants. The test group included 25 systemically healthy controls (mean age 38.44 ± 3.27 years) with severe chronic periodontitis and the control group (n = 25) included age- and sex-matched systemically and periodontally healthy controls. Clinical parameters were recorded, intraoral periapical radiographs were taken, hematological tests and assessment of serum hs-CRP levels and Hcy levels were performed at baseline and 3 months after completion of nonsurgical periodontal therapy. RESULTS Mean serum hs-CRP and Hcy concentration in patients with chronic periodontitis were 3.37 ± 0.54 mg/L and 21.47 ± 7.93 μmol/L, respectively, and was significantly higher than the controls (1.68 ± 0.71 mg/L and 13.93 ± 8.30 μmol/L, respectively) (P < 0.05). Posttreatment, the mean serum hs-CRP and Hcy concentration reduced significantly in both test and control groups (P < 0.05). CONCLUSION Chronic periodontitis leads to an increase in circulating levels of hs-CRP and Hcy in plasma and nonsurgical periodontal therapy decreases periodontal inflammation, which in turn reduces systemic inflammation and consequently decreases serum levels of hs-CRP and Hcy.
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Affiliation(s)
- Siddharth Mallapragada
- Department of Periodontology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Jyoti Kasana
- Department of Dentistry, Guru Teg Bahadur Hospital, New Delhi, India
| | - Pallavi Agrawal
- Department of Periodontology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
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Bhardwaj S, Prabhuji MLV, Karthikeyan BV. Effect of non-surgical periodontal therapy on plasma homocysteine levels in Indian population with chronic periodontitis: a pilot study. J Clin Periodontol 2015; 42:221-7. [PMID: 25644517 DOI: 10.1111/jcpe.12374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 01/07/2023]
Abstract
AIM Homocysteine (Hcy) is implicated in the development of cardiovascular diseases (CVD). The effect of periodontal disease and periodontal therapy on plasma Hcy remains controversial. Hence, in this pilot study we assessed the effect of periodontal disease and non-surgical periodontal therapy (NSPT) on plasma Hcy in systemically healthy Indian subjects. MATERIALS AND METHODS Forty participants (30 to 39 years) were enrolled in the study and were divided into two groups based on gingival index, probing depth, and clinical attachment level (CAL): Healthy (control group; n = 20) and Chronic Periodontitis (test group; n = 20). Plasma samples were collected and quantified at baseline and 12 weeks after scaling and root planing (SRP) for Hcy using High Performance Liquid Chromatography with fluorescent detection (HPLC-fld). RESULTS Plasma Hcy levels of chronic periodontitis (17.87 ± 1.21 μmol/l) subjects was significantly higher than healthy subjects (9.09 ± 2.11 μmol/l). Post-therapy, the plasma Hcy concentration reduced significantly (11.34 ± 1.87 μmol/l) (p < 0.05). CONCLUSION The rise and descent of plasma Hcy levels with periodontal inflammation and therapy, respectively, indicate a direct relationship of Hcy with chronic periodontitis. NSPT may be employed as an adjunctive Hcy Lowering Therapy, contributing towards primary prevention against CVD's.
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Affiliation(s)
- Smiti Bhardwaj
- Department of Periodontics, Krishnadevaraya College of Dental Sciences and Hospital, Bangalore, India
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Analysis of the relationship between periodontal disease and atherosclerosis within a local clinical system: a cross-sectional observational pilot study. Odontology 2014; 103:314-21. [DOI: 10.1007/s10266-014-0172-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/18/2014] [Indexed: 10/24/2022]
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