Brain natriuretic peptide serum levels in periodontitis

N-terminal-pro-brain natriuretic peptide (NT-proBNP) is expressed during inflammation and considered to be a biomarker of cardiovascular disease (CVD). In the last decade, evidence has suggested that periodontitis is associated with CVD. However, little is known of the potential role of this peptide in periodontal disease. The aims of this study were to examine whether the levels of NT-proBNP in serum are increased in periodontal disease and if there is a relationship to severity of periodontitis.

A case-control study was carried out, in which serum samples were collected from 40 patients with periodontitis and from 40 nonperiodontitis individuals. Full periodontal examination was performed in all subjects. Demographic information, and clinical and history of certain diseases were also recorded. Determinations of serum NT-proBNP and high-sensitivity C-reactive protein concentrations were carried out in an independent laboratory.

The levels of NT-proBNP in serum were significantly higher in patients with periodontitis compared with controls (87.9 pg/mL vs 29.9 pg/mL, P < .0001). In addition, as periodontal disease progressed, the levels of NT-proBNP increased. Multivariable regression analysis showed that the periodontal inflamed surface area, a measure of periodontal inflammation and disease activity, was the only periodontal parameter significantly associated with elevated concentrations of NT-proBNP in serum (R²  = .777, P < .0001).

In periodontitis, increased serum NT-proBNP levels are observed in comparison with individuals without periodontitis. Moreover, the greater the degree of periodontal destruction, the higher the levels of NT-proBNP in serum.