Comparative Evaluation of Lipid Profile and C-Reactive Protein in Chronic Periodontitis and Coronary Heart Disease
Lipid Profile and C-Reactive Protein in Periodontitis and Heart Disease
DOI:
https://doi.org/10.54393/pjhs.v5i11.2233Keywords:
Chronic Periodontitis, Coronary Heart Disease, C-Reactive Protein, Lipid Profile, Systemic InflammationAbstract
Epidemiological studies suggest local infections may elevate systemic inflammatory mediators and lipid levels, potentially promoting atherosclerosis. Objective: To investigate the correlation between Chronic Periodontitis (CP) and Coronary Heart Disease (CHD), assessing C-Reactive Protein (CRP) and lipid profile alterations in affected patients. Methods: This case-control study included 88 participants, divided into four groups: 22 with Chronic Periodontitis (CP), 22 with Coronary Heart Disease (CHD), 22 with both CP and CHD and 22 systemically healthy controls, aged 30-60 years, selected through consecutive sampling. Conducted at Bahria University Health Sciences and PNS Shifa Hospital from December 2022 to May 2023, the study assessed clinical and periodontal parameters, including probing depth and clinical attachment level. Fasting blood samples were analyzed for lipid profiles and C-Reactive Protein Levels. Statistical analysis included the Pearson Chi-square test for baseline demographics, the Kruskal-Wallis test for comparing biochemical and periodontal parameters, and the Spearman Rank Correlation. Results: Serum HsCRP levels were twice higher in participants with CP and CHD than in healthy individuals and three times higher in subjects with combined disorder (CP + CHD). Patients with both CP and CHD (CP + CHD) have the highest median CRP levels. C-reactive protein was negatively correlated with TC, LDL-C, HDL-C, and number of teeth, while positive correlations were demonstrated with PD, CAL, BoP%, and PI scores. Conclusion: Coronary heart disease and other inflammation driven atherosclerotic processes may be exacerbated by chronic infections, such as periodontitis, which can alter systemic levels of TC, HDL, LDL, and CRP.
References
Qasim SS, Al-Otaibi D, Al-Jasser R, Gul SS, Zafar MS. An evidence-based update on the molecular mechanisms underlying periodontal diseases. International Journal of Molecular Sciences. 2020 May; 21(11): 3829. doi: 10.3390/ijms21113829.
Könönen E, Gursoy M, Gursoy UK. Periodontitis: a multifaceted disease of tooth-supporting tissues. Journal of Clinical Medicine. 2019 Jul; 8(8): 1135. doi: 10.3390/jcm8081135.
Chen MX, Zhong YJ, Dong QQ, Wong HM, Wen YF. Global, regional, and national burden of severe periodontitis, 1990-2019: An analysis of the Global Burden of Disease Study 2019. Journal of Clinical Periodontology. 2021 Sep; 48(9): 1165-88. doi: 10.1111/jcpe.13506.
Fahim A, Shakeel S, Shahid TN, Anwar HM, Raja AA, Khan A. Prevalence of periodontitis in Pakistan: A systematic review. Journal of University College of Medicine and Dentistry. 2022 Jan: 30-4. doi: 10.51846/jucmd.v1i1.1375.
Vinay BC, Shastry CS, Kodangala S, Mateti UV, Bhat K. Association of diet and lipid profile among coronary heart disease patients. Clinical Epidemiology and Global Health. 2020 Dec; 8(4): 1321-4. doi: 10.1016/j.cegh.2020.05.004.
Giovanni A, Enrico A, Aime B, Michael B, Marianne B, Jonathan C et al. Global Burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. Journal of the American College of Cardiology. 2020 Dec; 76(25): 2982-3021. doi: 10.1016/j.jacc.2020.11.010.
Mohammed SM, Hasan AS, Al-Hindy HA, Mousa MJ. C-reactive protein is associated with the severity of periodontal disease-an observational study among acute myocardial infarction patients. Systematic Reviews in Pharmacy. 2020 Oct; 11(10): 252-7.
Dembowska E, Jaroń A, Gabrysz-Trybek E, Bladowska J, Trybek G. Evaluation of common factors of periodontitis and cardiovascular disease in patients with the acute coronary syndrome. International Journal of Environmental Research and Public Health. 2022 Jul; 19(13): 8139. doi: 10.3390/ijerph19138139.
Al-Saad RZ, Shaker AK, Dleikh FS, Al-Hindy HA. Is there any association between highly sensitive c-reactive protein and dental-status in ischemic heart diseases? A comparative study. Biochemical & Cellular Archives. 2020 Oct; 20(2).
Jain P, Hassan N, Khatoon K, Mirza MA, Naseef PP, Kuruniyan MS et al. Periodontitis and systemic disorder-an overview of relation and novel treatment modalities. Pharmaceutics. 2021 Jul; 13(8): 1175. doi: 10.3390/pharmaceutics13081175.
Vekic J, Zeljkovic A, Cicero AF, Janez A, Stoian AP, Sonmez A et al. Atherosclerosis development and progression: the role of atherogenic small, dense LDL. Medicina. 2022 Feb; 58(2): 299. doi: 10.3390/medicina58020299.
Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontology 2000. 2020 Jun; 83(1): 90-106. doi: 10.1111/prd.12304.
Wojtkowska A, Zapolski T, Wysokińska-Miszczuk J, Wysokiński AP. The inflammation link between periodontal disease and coronary atherosclerosis in patients with acute coronary syndromes: case–control study. BMC Oral Health. 2021 Dec; 21: 1-7. doi: 10.1186/s12903-020-01356-4.
Boyapati R, Vudathaneni V, Nadella SB, Ramachandran R, Dhulipalla R, Adurty C. Mapping the link between cardiac biomarkers and chronic periodontitis: A clinico-biochemical study. Journal of Indian Society of Periodontology. 2020 Jul; 24(4): 309-15. doi: 10.4103/jisp.jisp_417_19.
Sitompul SI, Pikir BS, Supandi SK, Sinta ME. Effect of CRP, IL-6, leukocytes, NLR on chronic periodontitis in acute coronary syndrome. Research Journal of Pharmacy and Technology. 2023; 16(1): 391-8. doi: 10.52711/0974-360X.2023.00067.
Aoyama N, Kobayashi N, Hanatani T, Ashigaki N, Yoshida A, Shiheido Y et al. Periodontal condition in Japanese coronary heart disease patients: A comparison between coronary and non‐coronary heart diseases. Journal of Periodontal Research. 2019 Jun; 54(3): 259-65. doi: 10.1111/jre.12626.
Esteves-Lima RP, Reis CS, Santirocchi-Júnior F, Abreu LG, Costa FO. Association between periodontitis and serum C - reactive protein levels. Journal of Clinical and Experimental Dentistry. 2020 Sep; 12(9): e838. doi: 10.4317/jced.57041.
Tayefi M, Tajfard M, Saffar S, Hanachi P, Amirabadizadeh AR, Esmaeily H et al. hs-CRP is strongly associated with coronary heart disease (CHD): A data mining approach using decision tree algorithm. Computer Methods and Programs in Biomedicine. 2017 Apr; 141: 105-9. doi: 10.1016/j.cmpb.2017.02.001.
Veljovic T, Djuric M, Mirnic J, Gusic I, Maletin A, Ramic B et al. Lipid peroxidation levels in saliva and plasma of patients suffering from periodontitis. Journal of Clinical Medicine. 2022 Jun; 11(13): 3617. doi: 10.3390/jcm11133617.
Abullais SS, Wykole Y, Khader MA, Shamsudeen SM, Alanazi S, Khateeb SU et al. Estimation of serum C-reactive protein activity in periodontal health and disease and response to treatment: a clinico-biochemical study. PeerJ. 2023 Dec; 11: e16495. doi: 10.7717/peerj.16495.
Dhivya K, Umaparvathy S, Jayaraj RR, Priya SM. The synergistic effect of oral antibiotic therapy on C-reactive protein and lipid profile in chronic periodontitis patients. Research Journal of Pharmacy and Technology. 2022; 15(5): 2172-5. doi: 10.52711/0974-360X.2022.00361.
KP A, Banala A, Masapu A, TSS MK, Gajjarapu S. Effect of periodontal inflammation on systemic inflammatory biomarkers and cardiac biomarkers in patients with coronary artery disease. Journal of Dr. NTR University of Health Sciences. 2023 Oct; 12(4).
Gupta S, Suri P, Patil PB, Rajguru JP, Gupta P, Patel N. Comparative evaluation of role of hs C-reactive protein as a diagnostic marker in chronic periodontitis patients. Journal of Family Medicine and Primary Care. 2020 Mar; 9(3): 1340-7. doi: 10.4103/jfmpc.jfmpc_1063_19.
Ashok KP, Banala A, Masapu A, Kumar TM, Gajjarapu S. Effect of periodontal inflammation on systemic inflammatory biomarkers and cardiac biomarkers in patients with coronary artery disease. Journal of Dr. YSR University of Health Sciences. 2023 Oct; 12(4): 337-45.
Kumar KR, Ranganath V, Naik R, Banu S, Nichani AS. Assessment of high‐sensitivity C‐reactive protein and lipid levels in healthy adults and patients with coronary artery disease, with and without periodontitis-a cross‐sectional study. Journal of Periodontal Research. 2014 Dec; 49(6): 836-44. doi: 10.1111/jre.12172.
Sanikop MV, Aspalli S, Nagappa G, Jabeen RN, Aspalli N, Babu CH. Assessment of serum parameters in stable coronary artery disease patients in correlation with healthy and chronic periodontitis patients. Contemporary Clinical Dentistry. 2022 Jan; 13(1): 50-5. doi: 10.4103/ccd.ccd_659_20.
Katz J, Flugelman MY, Goldberg A, Heft M. Association between periodontal pockets and elevated cholesterol and low density lipoprotein cholesterol levels. Journal of Periodontology. 2002 May; 73(5): 494-500. doi: 10.1902/jop.2002.73.5.494.
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