C-reactive Protein as Predict of Increased Carotid Intima Media Thickness in Patients with Chronic Periodontitis

C-reactive protein (CRP) - a prototypic marker of inflammation has been shown to be elevated in chronic periodontitis (CP) and also been shown to predict cardiovascular events. Increased carotid intima media thickness (CIMT) has been recently recognized as surrogate marker for atherosclerosis. In this context, we studied to correlate between CIMT and CRP in CP and to know whether CRP predicts the cardiovascular risk in CP.

The study consisted of 30 systemically healthy subjects aged over 40 years - 15 subjects with CP as cases and 15 subjects with no periodontitis as controls. All subjects were subjected to measurement of CRP levels and CIMT in addition to detailed periodontal evaluation. Quantitative determination of CRP was done by turbidimetric immunoassay. IMT of the common carotid arteries was estimated bilaterally using B-mode ultrasound at 6 sites. Positive CRP was defined as more than 10 mg/l.

Mean CRP levels were significantly higher in subjects with CP (19.58 ± 17.03), then in non CP (NCP) (5.54 ± 1.63, P < 0.004). Mean CIMT value was significantly higher in subjects with CP (1.09 ± 0.45) than in NCP (0.57 ± 0.06, P < 0.001) and all periodontal indices correlated well with CIMT. Further, there was significant correlation between CRP and increased CIMT in subjects with CP (r = 0.863, P < 0.001).

The present study indicates CRP as a possible underlying pathway in the association between periodontal disease and the observed CIMT. CRP can be used as a risk predictor for atherosclerosis in patients with CP.