Hepcidin-regulated iron metabolism disorders in patients with stage III/IV periodontitis

/purposeThe disorders of iron metabolism in periodontal diseases have been reported, however, there is still lack of comprehensive and thorough analyses about the association between periodontitis and iron metabolism disorders. This study aimed to examine the association between periodontitis and iron metabolism disorders, and to analyze the characteristic changes of iron metabolism in periodontitis patients.

79 Stage III/IV periodontitis patients and 79 healthy controls were enrolled in this study. Periodontal clinical parameters, system inflammation markers, iron metabolism parameters and hematological parameters were collected and compared at baseline and 3 months after non-surgical periodontal therapy.

Stage III/IV periodontitis patients exhibited higher levels of systemic inflammatory markers including white blood cell (WBC) counts and high-sensitivity C-reactive protein (hs- CRP). Serum hepcidin and ferritin were significantly increased in the periodontitis group, meanwhile serum iron and transferrin were significantly decreased. Periodontal therapy attenuated the higher levels of hepcidin and ferritin, and the lower levels of Fe and transferrin in periodontitis patients at 3 months after therapy. Probing depth (PD), bleeding index (BI) and clinical attachment loss (CAL) were positively correlated with hepcidin and ferritin, and negatively correlated with Fe and transferrin respectively. Hepcidin was significantly negatively correlated with Fe and positively correlated with ferritin in periodontitis patients.

Our findings suggest the association between periodontitis and iron metabolism disorders and indicate that periodontitis-activated host responses may increase the risk of iron metabolism disorders, while meaningfully provide new insights into the systemic effects of periodontitis.