Association of Serum ADMA with Endothelial Dysfunction in Chronic Periodontitis and Coronary Heart Disease Patients

Asymmetric Dimethylarginine (ADMA), a natural NO production inhibitor, is a key indicator of endothelial dysfunction. ADMA damages vessels and endothelial function by inhibiting NO-mediated vasodilation. Periodontal disease and cardiovascular diseases, especially CHD, share risk factors and inflammatory pathways, suggesting a mechanistic relationship. ADMA may be a molecular mediator between periodontitis and cardiovascular disease. This study examines serum ADMA levels as a biomarker of endothelial dysfunction in periodontitis and CHD patients. The study also examines lipid profile and periodontal factors to better understand the complex relationship between dental and cardiovascular health.

In this case-control study, after the attainment of FRC and ERC approval, 22 subjects with Chronic Periodontitis (CP), 22 subjects with Coronary Heart Disease (CHD), 22 subjects with both periodontitis and Coronary Heart Disease (CHD), and 22 systemically healthy individuals aged between 30 and 60 years were recruited. All the male and female individuals were selected on the basis of inclusion criteria prior to taking written informed consent. The clinical and periodontal parameters (plaque index, probing depth, clinical attachment level, and bleeding on probing) were assessed in the participants of the study. The overnight fasting blood samples of patients were obtained for analysis of ADMA, C-reactive protein, and total cholesterol and triglycerides.

The results were analyzed with SPSS version 23.0. Adma was significant in all the groups (CP, CHD, CP+CHD, and controls). Subsequently, the levels of TC and hs-CRP were significantly different among the groups. The periodontal clinical parameters, which include the number of teeth, PD, CAL, BoP%, and PI, were also significant among all the groups (p<0.05). Multivariate regression analysis showed a significant positive association for the case groups (CP, CHD, and CP+CHD) for ADMA.

Chronic periodontitis patients, especially those with coronary heart disease, have raised ADMA levels and systemic inflammatory markers, according to the study. These data suggest that chronic periodontal inflammation may cause endothelial dysfunction, connecting oral and cardiovascular illness. The cumulative impact in the CP+CHD group shows that periodontal and vascular inflammation work together. Thus, elevated ADMA may identify cardiovascular-risk periodontitis patients.

Our results specified that serum ADMA levels may be a valuable measure of endothelial dysfunction in individuals with periodontal disease and coronary heart disease.