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

Gary D Slade1, Elisa M Ghezzi, Gerardo Heiss

  • 1Center for Oral and Systemic Disease, Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA.

Archives of Internal Medicine
|May 28, 2003
PubMed

Insights

Periodontal disease and higher body mass index (BMI) are linked to elevated C-reactive protein (CRP) levels in middle-aged adults. This suggests a combined effect on inflammation markers, impacting cardiovascular health.

Area of Science:

  • Cardiovascular Health
  • Inflammation Markers
  • Periodontal Medicine

Background:

  • Elevated C-reactive protein (CRP) indicates systemic inflammation and cardiovascular disease risk.
  • Periodontal disease, an unrecognized infection, can trigger an acute-phase response and raise CRP levels.

Purpose of the Study:

  • To investigate the association between periodontal disease and serum CRP levels in adults.
  • To explore potential modifying factors in this relationship within the Atherosclerosis Risk in Communities study.

Main Methods:

  • Oral examinations assessed periodontal disease severity (percentage of sites with pocket depth ≥4 mm) in 5552 participants (aged 52-74).
  • Serum CRP concentrations were measured using enzyme-linked immunosorbent assay.
  • Multivariable linear regression analyzed associations, controlling for age, sex, diabetes, smoking, and NSAID use.

Main Results:

  • Individuals with extensive periodontal pockets (>30% sites with pocket depth ≥4 mm) had higher mean CRP levels (7.6 mg/L) compared to those with less extensive disease (5.7 mg/L).
  • The association between periodontal pockets and CRP was modified by body mass index (BMI).
  • A significant CRP difference was observed at lower BMIs (2-fold at BMI 20), diminishing at higher BMIs (negligible at BMI 35).

Conclusions:

  • Extensive periodontal disease and BMI are jointly associated with elevated CRP levels in healthy, middle-aged adults.
  • These findings highlight the need for integrated medical and dental evaluations to identify sources of acute-phase response.
Abstract

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