Luigi Nibali1, Nikos Donos2, Valentina Terranova3, Antonino Di Pino4, Salvatore Di Marca3, Viviana Ferrara4, Marcella Pisano3, Roberto Scicali4, Agata Maria Rabuazzo4, Francesco Purrello4, Lorenzo Malatino3. 1. Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Turner Street, London, E1 2AD, UK. l.nibali@qmul.ac.uk. 2. Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Turner Street, London, E1 2AD, UK. 3. Department of Clinical and Experimental Medicine, Ospedale Cannizzaro, University of Catania, Catania, Italy. 4. Department of Clinical and Experimental Medicine, Ospedale Garibaldi-Nesima, University of Catania, Catania, Italy.
Abstract
OBJECTIVE: The presence of periodontal disease (PD) in subjects affected by the metabolic syndrome (MetS) may affect their risk of developing cardiovascular disease. The aim of this cross-sectional study was to investigate the systemic impact of PD in MetS, by assessing measures of sub-clinical atherosclerosis and left ventricular mass and geometry. MATERIALS AND METHODS: A total of 103 patients undergoing treatment for MetS were examined for confirmation of diagnosis, blood sampling, and measures of pulse wave velocity (PWV), carotid intima-media thickness (c-IMT), left ventricular mass index (LVM), and relative wall thickness (RWT). All subjects underwent a detailed dental assessment, including measurements of DMFT (decayed-missing-filled teeth) and periodontal parameters. RESULTS: Ten patients (10%) were diagnosed with healthy-mild periodontitis, 38 patients (37%) were diagnosed in the moderate periodontitis group, and 55 (53%) had severe periodontitis. A total of 37% of subjects were affected by dental caries. Linear regression analysis revealed that patients with severe PD had increased average ventricular RWT (adjusted p = 0.032). Average full mouth probing pocket depth (PPD) was also associated with RWT (adjusted p = 0.006). No associations between PD and c-IMT, PWV, and LVM were detected after adjusted analyses. CONCLUSION: This study suggests that periodontitis may be associated with concentric left ventricular remodeling, a predictive index of cardiovascular events. CLINICAL RELEVANCE: The presence of periodontitis in patients with MetS might have an effect on left ventricular geometry. These findings stress the importance of prevention, diagnosis, and management of periodontitis in patients with MetS. TRAIL REGISTRATION: NCT03297749.
OBJECTIVE: The presence of periodontal disease (PD) in subjects affected by the metabolic syndrome (MetS) may affect their risk of developing cardiovascular disease. The aim of this cross-sectional study was to investigate the systemic impact of PD in MetS, by assessing measures of sub-clinical atherosclerosis and left ventricular mass and geometry. MATERIALS AND METHODS: A total of 103 patients undergoing treatment for MetS were examined for confirmation of diagnosis, blood sampling, and measures of pulse wave velocity (PWV), carotid intima-media thickness (c-IMT), left ventricular mass index (LVM), and relative wall thickness (RWT). All subjects underwent a detailed dental assessment, including measurements of DMFT (decayed-missing-filled teeth) and periodontal parameters. RESULTS: Ten patients (10%) were diagnosed with healthy-mild periodontitis, 38 patients (37%) were diagnosed in the moderate periodontitis group, and 55 (53%) had severe periodontitis. A total of 37% of subjects were affected by dental caries. Linear regression analysis revealed that patients with severe PD had increased average ventricular RWT (adjusted p = 0.032). Average full mouth probing pocket depth (PPD) was also associated with RWT (adjusted p = 0.006). No associations between PD and c-IMT, PWV, and LVM were detected after adjusted analyses. CONCLUSION: This study suggests that periodontitis may be associated with concentric left ventricular remodeling, a predictive index of cardiovascular events. CLINICAL RELEVANCE: The presence of periodontitis in patients with MetS might have an effect on left ventricular geometry. These findings stress the importance of prevention, diagnosis, and management of periodontitis in patients with MetS. TRAIL REGISTRATION: NCT03297749.
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