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Published on: November 1, 2013
The Influence of Triclosan on Biomarkers of Cardiovascular Risk in Patients in the Cardiovascular and Periodontal
Mary P Cullinan1,2, Janet E Palmer1, Malcolm J Faddy3
1School of Medicine, The University of Queensland, Brisbane, Australia.
Insights
Triclosan toothpaste may impact cardiovascular disease biomarkers and kidney function in diabetic patients, but its clinical significance remains uncertain. Further research is needed to confirm these findings.
Area of Science:
- Cardiovascular Medicine
- Oral Health
- Pharmacology
Background:
- Triclosan toothpaste effectively manages plaque, gingivitis, and periodontitis progression.
- The impact of triclosan on cardiovascular disease (CVD) inflammatory biomarkers, kidney, and liver function is not well-established.
Purpose of the Study:
- To investigate the effects of triclosan toothpaste on CVD inflammatory biomarkers, kidney function, and liver function over a 5-year period.
Main Methods:
- A 5-year randomized controlled trial involving 383 patients assigned to triclosan or placebo toothpaste.
- Biomarkers assessed included lipid profiles, C-reactive protein, erythrocyte sedimentation rate (ESR), white cell count (WCC), estimated glomerular filtration rate (eGFR), and liver function enzymes.
- Statistical analysis employed mixed models and transition modeling, accounting for covariates like age, sex, diabetes, and medication use.
Main Results:
- Triclosan toothpaste significantly decreased total cholesterol (TC), LDL cholesterol, and HDL cholesterol compared to placebo.
- ESR showed a slower rate of increase in the triclosan group, particularly in males on statins.
- Diabetic patients using placebo toothpaste were more likely to experience eGFR deterioration than those using triclosan.
Conclusions:
- Triclosan toothpaste may influence certain CVD inflammatory biomarkers and kidney function in diabetic individuals.
- No significant impact was observed on liver function.
- The clinical significance of these observed influences requires further investigation.
Background:
Triclosan toothpaste is effective in controlling plaque and gingivitis and slowing progression of periodontitis; however, its influence on inflammatory biomarkers of cardiovascular disease (CVD), as well as on kidney and liver function, is unknown.
Methods:
Patients recruited from the Cardiovascular Unit at Prince Charles Hospital, Brisbane, Australia, were randomized to triclosan (n = 193) or placebo (n = 190) groups and assessed for total cholesterol (TC), high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, triglycerides, C-reactive protein, erythrocyte sedimentation rate (ESR), hemoglobin, total white cell count (WCC), estimated glomerular filtration rate (eGFR), and liver function enzymes, annually for 5 years. A standard mixed model for each marker included group, sex, age, hypertension, diabetes, periodontal status, statin and anti-inflammatory drug use, and smoking as covariates. Changes in eGFR, WCC, and ESR were further analyzed using transition modeling.
Results:
Triclosan toothpaste led to a greater decrease in TC (P = 0.03), LDL cholesterol (P = 0.04), and HDL cholesterol (P = 0.05) than placebo toothpaste. ESR increased at a slower rate in the triclosan group (P ≈ 0.06) and was less likely to increase and more likely to improve in males on statins but not anti-inflammatory drugs in the triclosan group versus the placebo group. Markov modeling of the binary response for eGFR (greater than or less than/equal to the baseline median value) showed that patients with diabetes in the placebo group were significantly (P ≈ 0.05) more likely to deteriorate than either patients with diabetes in the triclosan group or patients without diabetes in each group.
Conclusions:
These data suggest that triclosan toothpaste may influence some inflammatory biomarkers of CVD, but not kidney or liver function. However, it is unclear if this influence is clinically significant.
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