Cortisol and periodontitis: Prospective observational and Mendelian randomization studies

Sebastian-Edgar Baumeister; Stefan Lars Reckelkamm; Hans-Jörgen Grabe; Matthias Nauck; Johanna Klinger-König; Henry Völzke; Thomas Kocher; Nele Friedrich; Birte Holtfreter

doi:10.3389/fendo.2023.1100985

Cortisol and periodontitis: Prospective observational and Mendelian randomization studies

Front Endocrinol (Lausanne). 2023 Mar 15:14:1100985. doi: 10.3389/fendo.2023.1100985. eCollection 2023.

Authors

Affiliations

¹ Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany.
² Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
³ Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
⁴ DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany.
⁵ Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
⁶ Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany.

Abstract

Purpose: Cortisol has obesogenic, hyperglycemic and immunomodulating effects. Preclinical and observational research suggested that it is associated with periodontitis but the evidence for potential causality in humans is sparse. We triangulated results from prospective observational and Mendelian randomization (MR) analyses to further explore this.

Methods: Using pooled data from 3,388 participants of two population cohort studies embedded in the Study of Health in Pomerania (SHIP) project, we associated serum cortisol levels with periodontal outcomes measured after a median follow-up time of 6.9 years, adjusting for confounding and selection bias using propensity score weighting and multiple imputation. We further examined the effect of genetically proxied plasma morning cortisol levels on periodontitis using two-sample MR of 17,353 cases and 28,210 controls.

Results: In SHIP, we found that cortisol levels were positively associated with follow-up levels of mean clinical attachment level (CAL), deep interdental CAL and bleeding on probing but were unrelated to mean probing pocket depth and deep periodontal pockets. In MR analysis, cortisol was not associated with periodontitis.

Conclusion: The observational study revealed a prospective association of spot cortisol with makers of periodontitis. Contrary to observational studies, genetically instrumented, long-term cortisol was unrelated to periodontitis. Our results find no univocal evidence that cortisol plays a role in periodontitis pathology, casting doubt on cortisol-related pathways.

Keywords: cortisol; hypothalamus-pituitary-adrenal (HPA) axis; mendelian randomization; observational study; periodontitis.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Hydrocortisone* / metabolism
Mendelian Randomization Analysis
Periodontitis* / genetics

Substances

Hydrocortisone

Grants and funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The work is part of the Community Medicine Research (CMR) net of the University Medicine Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grants ZZ9603,01ZZ0103, 01ZZ0403), the Ministry of Cultural Affairs, and the Social Ministry of the Federal State of Mecklenburg–West Pomerania. The CMR encompasses several research projects that are sharing data of the population-based Study of Health in Pomerania (SHIP; http://ship.community-medicine.de).