Periodontitis is Associated with Systemic Inflammation and a Dysmetabolic Status

OBJECTIVES: A cluster of metabolic factors defines a syndrome, which predisposes to diabetes and cardiovascular disease. Chronic infections such as periodontitis might alter these individual metabolic factors and the systemic inflammatory burden. The aim of this study was to investigate the association between severe periodontitis and increase in inflammatory and metabolic risk factors for cardiovascular disease. METHODS: We examined clinically 485 individuals: 302 consecutive patients with severe periodontitis and 183 consecutive healthy controls. We collected a blood sample from each subject in order to investigate differences in inflammatory (leukocyte numbers and differential counts) and metabolic factors (lipids and glucose). RESULTS: After correcting for differences in age, gender, smoking and ethnicity, periodontitis subjects exhibited a low-grade systemic inflammation (increased white cell counts, 1.10±1.02 10^{9/L, 95%CI 1.05-1.15, p=0.0001), dyslipidemia (lower HDL cholesterol, 1.14±1.03 mmol/L, 95%CI 1.08-1.20, p<0.0001 and higher LDL cholesterol, 1.12±1.03 mmol/L, 95%CI 1.05-1.19, p<0.0001) and increased serum glucose levels (1.04±1.01 mmol/L, 95%CI 1.02-1.06, p=0.01) when compared to controls. The associations were confirmed in a subpopulation of Caucasian non smokers. A dose dependent effect of the number of periodontal pockets on the tested inflammatory and metabolic markers was observed. CONCLUSION: These data suggest a possible link between periodontitis, systemic inflammation and a dysmetabolic state in otherwise healthy individuals.}