Cardioprotective effect of periodontal therapy in metabolic syndrome: a pilot study in Indian subjects

Obesity, metabolic syndrome, and atherosclerosis are linked with an increased acute-phase response. Severe periodontal disease is associated with cardiovascular disease as sequelae of a systemic inflammatory response.

The aim of this study was to assess changes in measures of systemic inflammation induced by periodontal therapy in periodontally diseased individuals with metabolic syndrome, compared to those induced in a systemically healthy group.

A total of 31 subjects with chronic generalized periodontitis, including 16 subjects with metabolic syndrome (group A) and 15 systemically healthy subjects (group B), underwent nonsurgical periodontal therapy. Serum high-sensitivity C-reactive protein (hsCRP), total leukocyte count, and measures of lipid metabolism were measured at baseline and at 2 months after periodontal therapy. Baseline data for comparison was also obtained from 15 systemically and periodontally healthy individuals (group C).

Baseline periodontal parameters and serum CRP were significantly higher in group A than in group B. In group A, following periodontal therapy, a significant decrease was noted in mean serum CRP (3.28 +/- 1.4 mg/L to 2.6 +/- 1.5 mg/L), total leukocyte counts (8,322 +/- 1,888 cells/mm(3) to 6,361 +/- 1,426 cells/mm(3)), serum triglycerides (153.3 +/- 38 mg/dL to 121.0 +/- 28.57 mg/dL), along with a significant rise in serum high-density lipoprotein (HDL) (41.1 +/- 5.2 mg/dL to 44.37 +/- 6.7 mg/dL). In group B, changes in these parameters were not statistically significant. Mean serum low-density lipoprotein (LDL) and mean cholesterol levels did not change significantly in either group.

Periodontal therapy produced significant modulation of serum hsCRP, total leukocytes, serum triglycerides, and HDL, and thus may benefit individuals affected with both metabolic syndrome and advanced periodontal disease.