Longitudinal effects of systemic inflammation markers on periodontitis

Aim Systemic low‐grade inflammation represents a central hallmark of chronic diseases and has been proposed as the underlying mechanism linking factors like obesity or diabetes with periodontitis. However, the impact of inflammatory markers on periodontitis has not yet been investigated. Materials a...

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Published in:Journal of clinical periodontology Vol. 42; no. 11; pp. 988 - 997
Main Authors: Pink, Christiane, Kocher, Thomas, Meisel, Peter, Dörr, Marcus, Markus, Marcello R. P., Jablonowski, Lukasz, Grotevendt, Anne, Nauck, Matthias, Holtfreter, Birte
Format: Journal Article
Language:English
Published: United States Blackwell Publishing Ltd 01.11.2015
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ISSN:0303-6979, 1600-051X, 1600-051X
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Summary:Aim Systemic low‐grade inflammation represents a central hallmark of chronic diseases and has been proposed as the underlying mechanism linking factors like obesity or diabetes with periodontitis. However, the impact of inflammatory markers on periodontitis has not yet been investigated. Materials and Methods The study population comprised 1784 subjects from the Study of Health in Pomerania with complete 11‐year follow‐up. Fibrinogen and white blood cell (WBC) counts were measured as markers of inflammation. Periodontitis was assessed by probing depth (PD), clinical attachment loss (CAL) and the CDC/AAP case definition. Results Multilevel regression analyses revealed significant coefficients for the impact of both inflammation markers on the percentage of sites with PD/CAL ≥ 3 mm. Increases in fibrinogen about 1 g/l were associated with 3.0% and 2.7% more sites with PD/CAL ≥ 3 mm respectively. Consistent associations were found using mean values of PD/CAL but not using missing teeth or caries. Regarding the CDC/AAP case definition, 11‐year changes in fibrinogen and WBC counts were significantly associated with ≥1 category progression (OR: 1.36 and 1.11). Conclusions Fibrinogen levels and WBC counts showed consistent long‐term associations with PD, CAL and the CDC/AAP case definition. Results indicate that systemic low‐grade inflammation might indeed represent one possible pathway for effects of obesity, diabetes or other chronic inflammatory conditions on periodontitis.
Bibliography:Ministry of Education
ArticleID:JCPE12473
Figure S1. The main directed acyclic graph (DAG) to evaluate the association between systemic inflammation and periodontitis. Table S1. Association between 11-year change in inflammation markers and 11-year change in extent PD ≥ 3 mm and in extent CAL ≥ 3 mm. Table S2. Multilevel logistic regression models evaluating the long-term association between inflammation markers and the prevalence of having at least two sites with PD ≥ 5 mm/CAL ≥ 6 mm. Table S3. Multilevel linear regression models evaluating the long-term association between inflammation markers and extent PD ≥ 3 mm and extent CAL ≥ 3 mm for those subjects without anti-inflammatory medication. Figure S2. Predicted mean values (with 95% CI) of probing depth (PD; grey circle) and clinical attachment loss (CAL; black triangle) according to quartiles of fibrinogen (A) and WBC count (B) resulting from fully adjusted multilevel analyses as well as predicted change in mean values (with 95% CI) of PD and CAL according to quartiles of change in fibrinogen (C) and WBC count (D) resulting from 11-year change-on-change analyses. Table S4. Comparison of the SHIP-0 participants who were included in the study and those who were excluded
Research and Cultural Affairs as well as the Ministry of Social Affairs of the Federal State of Mecklenburg-West Pomerania
istex:AC75041FA8FA1038C0058C1D0FDD22ACCE82503A
ark:/67375/WNG-5NGKVXPD-V
German Federal Ministry of Education and Research - No. 01ZZ96030; No. 01ZZ0701
of the University of Greifswald, Germany, which is funded by the German Federal Ministry of Education and Research (BMBF) (grant 01ZZ96030, 01ZZ0701), the Ministry of Education, Research and Cultural Affairs as well as the Ministry of Social Affairs of the Federal State of Mecklenburg‐West Pomerania. GABA, Switzerland, provided an unlimited educational grant to support B.H. and C.P.
SHIP is part of the Community Medicine Research net
The authors declare that there are no conflicts of interest in this study.
www.medizin.uni-greifswald.de/cm
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ISSN:0303-6979
1600-051X
1600-051X
DOI:10.1111/jcpe.12473