Association between apical periodontitis lesions and plasmatic levels of C-reactive protein, interleukin 6 and fibrinogen in hypertensive patients

Int Endod J. 2016 Dec;49(12):1107-1115. doi: 10.1111/iej.12567. Epub 2015 Nov 20.

Abstract

Aim: To test the null hypothesis of association between chronic apical periodontitis (CAP) and plasmatic levels of the C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen in a population of severely hypertensive patients.

Methodology: One hundred and seventy patients with severe refractory hypertension were selected. All patients were submitted to radiographic, clinical and periodontal evaluation. Plasmatic levels of CRP, IL-6 and fibrinogen were measured on the morning of the first periodontal appointment using commercially available kits. Multiple linear regression analyses were carried out to appraise the effect of the co-variables on the plasmatic levels of the inflammatory markers assessed.

Results: Of the 170 subjects who participated, 105 (61.8%) were females and the median age of the participants was 53 years (range: 40-78). The adjusted multiple linear analyses demonstrated that plasmatic levels of CRP levels were associated with the body mass index (BMI) (r = 0.259, P < 0.001) and residual tooth roots (RTR) (r = 0.191, P = 0.041). IL-6 and fibrinogen levels showed associated with BMI (r = 0.400, P < 0.001 and r = 0.214, P = 0.002 respectively). CAP correlated weakly with CRP (r = 0.250, P = 0.005), IL-6 (r = 0.174, P = 0.020) and fibrinogen (r = 0.393, P < 0.001) levels.

Conclusion: The null hypothesis was rejected in favour of the alternative hypothesis. In other words, the presence of chronic apical periodontitis was associated with higher plasmatic levels of CRP, IL-6 and fibrinogen, in a population of severely hypertensive patients. However, the weak association between CAP and each dependent variable suggests a modest participation of endodontic infection on the plasmatic levels of biomarkers.

Keywords: C-reactive protein; apical periodontitis; fibrinogen; interleukin 6.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Fibrinogen / analysis*
  • Humans
  • Hypertension / blood
  • Hypertension / complications*
  • Interleukin-6 / blood*
  • Male
  • Middle Aged
  • Periapical Periodontitis / blood
  • Periapical Periodontitis / complications*
  • Periapical Periodontitis / diagnostic imaging
  • Radiography, Dental

Substances

  • Biomarkers
  • Interleukin-6
  • Fibrinogen
  • C-Reactive Protein