Abdominal obesity modifies long-term associations between periodontitis and markers of systemic inflammation

Christiane Gocke; Birte Holtfreter; Peter Meisel; Anne Grotevendt; Lukasz Jablonowski; Matthias Nauck; Marcello Ricardo Paulista Markus; Thomas Kocher

doi:10.1016/j.atherosclerosis.2014.05.926

Abdominal obesity modifies long-term associations between periodontitis and markers of systemic inflammation

Atherosclerosis. 2014 Aug;235(2):351-7. doi: 10.1016/j.atherosclerosis.2014.05.926. Epub 2014 May 22.

Authors

Christiane Gocke¹, Birte Holtfreter¹, Peter Meisel¹, Anne Grotevendt², Lukasz Jablonowski¹, Matthias Nauck², Marcello Ricardo Paulista Markus³, Thomas Kocher⁴

Affiliations

¹ Unit of Periodontology, Department of Restorative Dentistry, Periodontology, and Endodontology, University Medicine Greifswald, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany.
² Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany.
³ Department Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany.
⁴ Unit of Periodontology, Department of Restorative Dentistry, Periodontology, and Endodontology, University Medicine Greifswald, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany. Electronic address: kocher@uni-greifswald.de.

PMID: 24926536
DOI: 10.1016/j.atherosclerosis.2014.05.926

Abstract

Objective: Periodontitis is considered to promote atherosclerosis and cardiovascular diseases through increased low-grade systemic inflammation. However, there is no information on the long-term impact of periodontitis on systemic inflammation from cohort studies. Thus, this study aims to assess the impact of periodontitis on systemic inflammation (fibrinogen and white blood cells (WBC)) in a population-based longitudinal survey in north-eastern Germany.

Methods: The study sample comprised 2622 subjects from the Study of Health in Pomerania with complete 5- and 11-year follow-ups. Periodontitis was assessed by probing depth and clinical attachment level. Multilevel regression analyses were applied to evaluate associations between periodontitis measures and i) fibrinogen/WBC count using 11-year follow-up data and ii) respective z-scores of fibrinogen/WBC count using 5- and 11-year follow-up data. We adjusted for common cardiovascular risk factors and stratified analyses by abdominal obesity (P for interaction <0.10).

Results: In lean subjects, beta-coefficients of mean probing depth were B = 0.13 (0.08-0.019; P < 0.001) for fibrinogen and B = 0.50 (0.37-0.64; P < 0.001) for WBC count using 11-year follow-up data only. For lean subjects, models using z-scores confirmed that increased mean probing depths were associated with increased fibrinogen z-scores (B = 0.14 (0.09-0.18; P < 0.001)) and increased WBC z-scores (B = 0.16 (0.11-0.20; P < 0.001)). Consistent results were found for mean clinical attachment levels. For abdominally obese subjects, relations between periodontitis measures and levels of inflammation markers were less pronounced or non-significant.

Conclusion: Modified by abdominal obesity, periodontitis affected systemic inflammation in a significant dose-dependent manner. Results contribute to the discussion on how periodontitis is linked to atherosclerosis and cardiovascular diseases.

Keywords: Cohort study; Fibrinogen; Obesity; Periodontitis; Study of health in Pomerania; Systemic inflammation; White blood cell count.

MeSH terms

Adult
Atherosclerosis / etiology*
Cardiovascular Diseases / etiology*
Female
Germany
Humans
Inflammation / blood
Longitudinal Studies
Male
Middle Aged
Obesity, Abdominal
Periodontitis / complications*
Risk Factors