The Association Between High Cholesterol Levels and Severity of Periodontitis

High Cholesterol Levels and Severity of Periodontitis

Authors

  • Rashid Javaid Department of Oral Biology, De' Montmorency College of Dentistry, Lahore, Pakistan
  • Sana Mukhtar Department of Periodontology, Foundation University College, Lahore, Pakistan
  • Ambreen Nawaz Department of General Pathology and Microbiology, Azra Naheed Dental College, Lahore, Pakistan
  • Anila Errum Department of Pharmacology, Azra Naheed Dental College, Lahore, Pakistan
  • Bakhtawar Arslan Department of Prosthodontics, Liaquat Institute of Medical and Health Sciences, Thatta, Pakistan
  • Anum Fatima Department of Dentistry Surgeon, Islamabad Medical and Dental College, Islamabad, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i11.2201

Keywords:

Periodontitis, Dyslipidemia, Triglycerides, Cardiovascular Disease

Abstract

Periodontitis is a common inflammatory condition affecting tooth-supporting structures, leading to tooth loss and is linked to systemic diseases, including cardiovascular disease. Objectives: To examine the association between high cholesterol levels and periodontitis severity in a sample from Lahore, Pakistan. Methods: A cross-sectional study was conducted at De' Montmorency College of Dentistry, Lahore, over six months. A total of 154 participants aged ≥40 years with periodontitis symptoms and without any systemic diseases were included. Participants were grouped based on the severity of periodontal disease status into no periodontitis group, mild disease group, moderate disease group, and severe periodontitis. Blood samples were collected and analyzed for lipid profile parameters. Multivariable regression analyses were performed, adjusting for age, gender, BMI, smoking, alcohol use, and exercise, to evaluate associations between lipid levels and periodontitis severity. Results: Severe periodontitis was found in 58 participants (37.7%). Multivariable regression indicated an inversely associated link between high-density lipoprotein cholesterol in blood and disease severity (p<0.05). Lower total cholesterol and higher triglyceride levels were associated with severe periodontitis (p<0.05). Logistic regression showed that participants with severe periodontitis had significantly higher values of the odds ratio of decreased high-density lipoprotein cholesterol (OR 1.34, 95% CI 1.05–1.72), total cholesterol (OR 1.26, 95% CI 1.02–1.55), and triglyceride levels (OR 1.48, 95% CI 1.12–1.96). Conclusions: It was concluded that severe periodontitis is greatly linked with lower high-density lipoprotein cholesterol and elevated triglyceride and total cholesterol levels, suggesting that periodontal health may influence lipid profile and increase cardiovascular disease risk.

References

Kwon T, Lamster IB, Levin L. Current Concepts in the Management of Periodontitis. International Dental Journal. 2021 Dec; 71(6): 462-76. doi: 10.1111/idj.12630.

Al‐Nasser L and Lamster IB. Prevention and Management of Periodontal Diseases and Dental Caries in the Older Adults. Periodontology 2000. 2020 Oct; 84(1): 69-83. doi: 10.1111/prd.12338.

Khan TZ and Mobin T. Unraveling the Link Between Periodontal Disease and High Cholesterol: A Cross-Sectional Study. Cureus. 2023 Aug; 15(8). doi: 10.7759/cureus.43463.

Fahim A, Shakeel S, Shahid TN, Anwar HM, Raja AA, Khan A. Prevalence of periodontitis in Pakistan: A systematic review. Journal of University College of Medicine and Dentistry. 2022 Jan 18:30-4. 10.51846/jucmd.v1i1.1375.

Aravindraja C, Jeepipalli S, Vekariya KM, Botello-Escalante R, Chan EK, Kesavalu L. Oral spirochete Treponema denticola intraoral infection reveals unique mir-133a, mir-486, mir-126-3p, mir-126-5p miRNA expression kinetics during periodontitis. International Journal of Molecular Sciences. 2023 Jul 28;24(15):12105. 10.3390/ijms241512105

Martínez-García M and Hernández-Lemus E. Periodontal Inflammation and Systemic Diseases: An Overview. Frontiers in Physiology. 2021 Oct; 12: 709438. doi: 10.3389/fphys.2021.709438.

Isola G, Santonocito S, Lupi SM, Polizzi A, Sclafani R, Patini R et al. Periodontal Health and Disease in the Context of Systemic Diseases. Mediators of Inflammation. 2023; 2023(1): 9720947. doi: 10.1155/2023/9720947.

Rahimi A and Afshari Z. Periodontitis and Cardiovascular Disease: A Literature Review. ARYA Atherosclerosis. 2021 Sep; 17(5): 1. doi: 10.22122/arya.v17i0.2362.

Hansen PR and Holmstrup P. Cardiovascular Diseases and Periodontitis. Periodontitis: Advances in Experimental Research. 2022 May: 261-80. doi: 10.1007/978-3-030-96881-6_14.

Thomas H, Diamond J, Vieco A, Chaudhuri S, Shinnar E, Cromer S, Perel P, Mensah GA, Narula J, Johnson CO, Roth GA. Global atlas of cardiovascular disease. Glob Heart. 2018;13(3):143-63. 10.1016/j.gheart.2018.09.511

Casula M, Colpani O, Xie S, Catapano AL, Baragetti A. HDL in atherosclerotic cardiovascular disease: in search of a role. Cells. 2021 Jul 23;10(8):1869. 10.3390/cells10081869

Higashi Y. Endothelial Function in dyslipidemia: roles of LDL-cholesterol, HDL-cholesterol and triglycerides. Cells. 2023 May 1;12(9):1293. 10.3390/cells12091293

Gomes‐Filho IS, Oliveira MT, Cruz SS, Cerqueira ED, Trindade SC, Vieira GO et al. Periodontitis is a Factor Associated with Dyslipidemia. Oral Diseases. 2022 Apr; 28(3): 813-23. doi: 10.1111/odi.13779.

Liu X, Wang Z, Song W, Sun W, Hong R, Pothukuchi A et al. Systematically Transplanted Human Gingiva Derived Mesenchymal Stem Cells Regulate Lipid Metabolism and Inflammation in Hyperlipidemic Mice with Periodontitis. Experimental and Therapeutic Medicine. 2020 Jan; 19(1): 672-82. doi: 10.3892/etm.2019.8256.

Han SJ, Yi YJ, Bae KH. The Association Between Periodontitis and Dyslipidemia According to Smoking and Harmful Alcohol Use in A Representative Sample of Korean Adults. Clinical Oral Investigations. 2020 Feb; 24: 937-44. doi: 10.1007/s00784-019-02989-8.

Teixeira FC, Marin-Leon L, Gomes EP, Pedrao AM, Pereira AD, Francisco PM. Relationship Between Periodontitis and Subclinical Risk Indicators for Chronic Non-Communicable Diseases. Brazilian Oral Research. 2020 Jun; 34: e058. doi: 10.1590/1807-3107bor-2020.vol34.0058.

Germen M, Baser U, Lacin CC, Fıratlı E, İşsever H, Yalcin F. Periodontitis prevalence, severity, and risk factors: a comparison of the AAP/CDC case definition and the EFP/AAP classification. International journal of environmental research and public health. 2021 Mar 26;18(7):3459. 10.3390/ijerph18073459

Saher G. Cholesterol Metabolism in Aging and Age-Related Disorders. Annual Review of Neuroscience. 2023 Jul; 46(1): 59-78. doi: 10.1146/annurev-neuro-091922-034237.

Ciumărnean L, Milaciu MV, Negrean V, Orășan OH, Vesa SC, Sălăgean O, Iluţ S, Vlaicu SI. Cardiovascular risk factors and physical activity for the prevention of cardiovascular diseases in the elderly. International Journal of Environmental Research and Public Health. 2021 Dec 25;19(1):207. 10.3390/ijerph19010207

Gomes‐Filho IS, Santos PN, Cruz SS, Figueiredo AC, Trindade SC, Ladeia AM et al. Periodontitis and Its Higher Levels of Severity Are Associated with the Triglyceride/High-Density Lipoprotein Cholesterol Ratio. Journal of Periodontology. 2021 Nov; 92(11): 1509-21. doi: 10.1002/JPER.21-0004.

Gomes‐Filho IS, Santos PN, Cruz SS, Figueiredo AC, Trindade SC, Ladeia AM, Cerqueira EM, Passos‐Soares JS, Coelho JM, Hintz AM, Barreto ML. Periodontitis and its higher levels of severity are associated with the triglyceride/high density lipoprotein cholesterol ratio. Journal of periodontology. 2021 Nov;92(11):1509-21. 10.1002/jper.21-0004

Lee S, Im A, Burm E, Ha M. Association Between Periodontitis and Blood Lipid Levels in A Korean Population. Journal of Periodontology. 2018 Jan; 89(1): 28-35. doi: 10.1902/jop.2017.170111.

Bitencourt FV, Nascimento GG, Costa SA, Orrico SR, Ribeiro CC, Leite FR. The Role of Dyslipidemia in Periodontitis. Nutrients. 2023 Jan; 15(2): 300. doi: 10.3390/nu15020300.

Mikami R, Mizutani K, Matsuyama Y, Matsuura T, Kido D, Takeda K et al. Association Between Periodontal Inflammation and Serum Lipid Profile in A Healthy Population: A Cross‐Sectional Study. Journal of Periodontal Research. 2021 Dec; 56(6): 1037-45. doi: 10.1111/jre.12917.

Fentoglu O, Bozkurt FY. The bi-directional relationship between periodontal disease and hyperlipidemia. European journal of Dentistry. 2008 Apr;2(02):142-9. 10.1055/s-0039-1697370

Romano F, Perotto S, Castiglione A, Aimetti M. Prevalence of periodontitis: misclassification, under-recognition or over-diagnosis using partial and full-mouth periodontal examination protocols. Acta Odontologica Scandinavica. 2019 Apr 3;77(3):189-96. 10.1080/00016357.2018.1535136

Zhu H, Ye G, Xie Y, Zhu K, Zhu F, Chen Q. Association of High-Density Lipoprotein Cholesterol and Periodontitis Severity in Chinese Elderly: A Cross-Sectional Study. Clinical Oral Investigations. 2022 Jul; 26(7): 4753-9. doi: 10.1007/s00784-022-04439-4.

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Published

2024-11-30
CITATION
DOI: 10.54393/pjhs.v5i11.2201
Published: 2024-11-30

How to Cite

Javaid, R., Mukhtar, S., Nawaz, A., Errum, A., Arslan, B., & Fatima, A. (2024). The Association Between High Cholesterol Levels and Severity of Periodontitis: High Cholesterol Levels and Severity of Periodontitis. Pakistan Journal of Health Sciences, 5(11), 79–84. https://doi.org/10.54393/pjhs.v5i11.2201

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Original Article

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