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Relationship between periodontal disease and C-reactive protein among adults in the Atherosclerosis Risk in Communities study.

TitleRelationship between periodontal disease and C-reactive protein among adults in the Atherosclerosis Risk in Communities study.
Publication TypeJournal Article
Year of Publication2003
AuthorsSlade GD, Ghezzi EM, Heiss G, Beck JD, Riche E, Offenbacher S
JournalArch Intern Med
Date Published2003 May 26
KeywordsAcute-Phase Reaction, Aged, Arteriosclerosis, Body Mass Index, C-Reactive Protein, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Female, Humans, Male, Middle Aged, Periodontal Diseases, Regression Analysis, Risk Factors, United States

BACKGROUND: Moderately elevated serum C-reactive protein (CRP) concentration is a systemic marker of inflammation and a documented risk factor for cardiovascular disease in otherwise healthy persons. Unrecognized infections, such as periodontal disease, may induce an acute-phase response, elevating CRP levels. We evaluated the association between periodontal disease and CRP levels in adults in the Atherosclerosis Risk in Communities study.

METHODS: Oral examinations were conducted between January 1, 1996, and December 31, 1998, on 5552 ARIC participants (aged 52-74 years) from 4 US communities. Periodontal disease was quantified as the percentage of periodontal sites with pocket depth of 4 mm or more. Serum CRP concentration was quantified in milligrams per liter using an enzyme-linked immunosorbent assay.

RESULTS: Mean (SE) CRP level was 7.6 (0.6) mg/L among people with extensive periodontal pockets (>30% of sites with pocket depth > or =4 mm), approximately one-third greater than that for people with less extensive periodontal pockets (5.7 [0.1] mg/L). In a multivariable linear regression model that controlled for age, sex, diabetes mellitus, cigarette use, and nonsteroidal anti-inflammatory drug use, the association of extensive periodontal pockets with CRP concentration was modified by body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters). For people with a BMI of 20, the model predicted a 2-fold difference in mean CRP concentration between periodontal pocket groups (7.5 vs 3.6 mg/L), but the difference decreased with increasing BMI and was negligible when BMI equaled 35.

CONCLUSIONS: Extensive periodontal disease and BMI are jointly associated with increased CRP levels in otherwise healthy, middle-aged adults, suggesting the need for medical and dental diagnoses when evaluating sources of acute-phase response in some patients.

Alternate JournalArch Intern Med
PubMed ID12767953
Grant ListDE 00427 / DE / NIDCR NIH HHS / United States
DE 13079 / DE / NIDCR NIH HHS / United States
RR 00046 / RR / NCRR NIH HHS / United States