Objective: To explore the association of systemic periodontal pathogen antibodies to cardiovascular predictors.
Methods: INVEST had 663 subjects (58% Women; 57% Hispanic, 22% Black, 18% White, 3% Other), mean age(± SD) 69(±9)yrs. Systemic antibody titers to Actinomyces actinomycetemcomitans (Aa), Bacteroides forsythus (Bf), Porphyromonas gingivalis (Pg), and Treponema denticola (Td) were measured using a checkerboard immunoassay. A Z-score estimated cumulative bacterial burden by summing titers across pathogens within each person; this variable has a standard normal distribution. Results were adjusted for age, gender, ethnicity, diabetes, smoking, and systolic blood pressure.
Results: Mean±SD ln transformed values of Aa, Bf, Pg and Td were 13.2±2.4, 10.9±4.1, 13.2±2.9, 10.6±4.1 ng/ml respectively. Tooth loss, smoking and lipids were inversely related to titers and to their cumulative sum.
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Dependent variables: pathogens |
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Aa |
Bf |
Pg |
Td |
Cumulative burden (Z-score) |
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Independent Variable (sd) |
Regression coefficient per sd of independent variable(p-value) |
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n teeth missing (9.4) |
-0.42(<0.01) |
-0.35(0.03) |
-0.26 (0.04) |
-0.26 (0.20) |
-0.14 (<0.01) |
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LDL-Chol (39 mg/dl) |
-0.20(0.06) |
-0.24(0.17) |
-0.20 (0.05) |
-0.12 (0.45) |
-0.09 (0.02) |
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HDL-Chol (25 mg/dl) |
-0.05(0.60) |
-0.53(<0.01) |
-0.43 (<0.01) |
-0.15 (0.36) |
-0.11 (<0.01) |
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Smoking (n) |
Mean ln(pathogen titer) |
Mean Z-score |
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Never (333) |
13.3 |
11.0 |
13.5 |
10.6 |
0.04 |
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Former (245) |
13.3 |
11.1 |
13.1 |
10.8 |
0.04 |
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Current (85) |
12.5 (<0.01)1 |
10.1 (0.14) |
12.5 (0.02) |
9.9 (0.23) |
-0.29 (<0.01) |
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1p for any difference by smoking status |
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Conclusion: Complex interrelations between CVD predictors and titers to periodontal pathogens were found. Lipid findings were consistent with reduced levels seen in acute phase responses. An impaired immune response among current smokers is suggested by their lower antibody titers. Reduced antibody titers corresponding to a greater number of missing teeth may reflect a reduced opportunity for exposure. Findings for smoking, LDL, and missing teeth are clearer for cumulative burden than for individual titers.
Supported by NIH grants: DE-13094, NS-29993, T32 HL-07779