Role of systemic markers in periodontal diseases: a possible inflammatory burden and risk factor for cardiovascular diseases?

Abstract

Background: Periodontitis is a local inflammatory process mediating destruction of periodontium triggered by bacterial insult leading to systemic inflammatory mayhem in the host. Epidemiologically, it has been modestly associated with cardiovascular diseases (CVD) with elevated acute‑phase reactant C‑reactive protein (CRP) and rheological variables such as total leukocyte count and differential leukocyte count (TLC and DLC), which are potential predictors of CVD.
Aim: The aim of this study was to investigate the serum CRP level, leukocyte count in chronic periodontitis patients and their relation to the severity of chronic periodontitis.
Subjects and Methods: This cross‑sectional study comprised 30 subjects, of which 20 were diagnosed as chronic periodontitis based on the Gingival index, probing depth and clinical attachment levels and 10 healthy subjects as controls. Following, which peripheral blood samples were drawn and serum CRP, TLC and DLC were quantified using the turbidimetric immunoassay. Data was analyzed using Intercooled Stata 9.2 version, (Stata corporation, LP, USA) ANOVA, Mann Whitney U test and Newman‑Keuls post hoc procedures. P values less than) 0.05 were considered as significant
Results: The mean serum CRP levels were statistically significant (P < 0.05) in severe and moderate periodontitis subjects when compared with healthy controls. Leukocytes were significantly elevated in severe periodontitis compared with moderate periodontitis and controls; this finding was primarily explained by the increase in number of neutrophils.
Conclusion: The increased serum CRP levels and neutrophils in chronic periodontitis subjects suggest an addition to the inflammatory burden of the individual potentially striking toward an increasing risk for cardiovascular events. Further research is needed to determine the specificity of these markers and their role in the inflammatory burden of one’s systemic health.

Keywords: Cardiovascular disease, C‑reactive protein, Leukocytes, Periodontitis, Risk factor