Statin use, Periodontal, Oral and Systemic Inflammation in Type-2 Diabetics

Objectives: Statins are cholesterol-lowering medications used to treat individuals at risk for cardiovascular disease. Statins may reduce periodontitis via their anti-inflammatory properties, but evidence is scarce. We assessed the effect of statin intensity based on low density lipoprotein cholesterol (LDL-C) lowering efficacy on clinical periodontitis and local and systemic inflammation in Hispanics with Type-2 diabetes (T2D).
Methods: This cross-sectional study involved 260 (44.6% males) Puerto Rican participants with T2D, aged 40-65 years. Participants were classified by statin intensity based on LDL-C reduction percent with daily dosing [none; low/moderate: reduction < 50%; high: reduction ≥ 50%). The outcomes were percent of sites with PPD ≥ 4mm or CAL ≥ 4mm (N= 234) and mediators in gingival-crevicular fluid (GCF, N=138-151) or serum (N= 181-233) (IL-1α, IL-1β, IL-6, IL-10, TNF-α, sVCAM-1, sICAM-1, RANKL, OPG). Generalized linear models were fitted to square-root transformed continuous outcomes while controlling for age, gender, education, smoking status, alcohol consumption, waist circumference, and plaque index.
Results: Statin intensity use was 39.5% low/moderate and 14% high. There were associations between high-intensity statin and lower percent of sites with PPD ≥ 4mm [β: -0.61(robust SE:0.30), p=0.040]; lower GCF levels of IL-1α [β:-5.03 (rSE: 2.40), p=0.036], sICAM-1 [β:-4.23 (rSE: 2.03), p=0.037], and sVCAM-1[β:-1.0 (rSE:0.65), p=0.031], and borderline significantly lower RANK/OPG [β: -0.07(rSE:0.04), p=0.072]. Low/moderate-intensity statin was associated with lower serum sVCAM-1 [β: -58.55 (rSE:23.64), p=0.013]. There was no association between intensity of statin use and percent of sites with CAL ≥ 4mm and GCF or serum levels of IL-1β, IL-6, IL-10, and TNF-α.
Conclusions: Our findings suggest that high-intensity statin use is associated with lower clinical periodontal parameters and reduced mediators associated with local and systemic inflammation in Hispanic individuals with T2D.