Abstract
In this study, we examined whether the documented increase of plasma triglycerides in patients with generalized aggressive periodontitis (GAgP) is associated with changes in lipoprotein subclass distribution and/or LDL-associated platelet-activating factor acetylhydrolase (PAF-AH) activity. Lipoprotein subclasses were analyzed in whole plasma samples using nuclear magnetic resonance methods. Compared with subjects without periodontitis (NP subjects; n = 12), GAgP subjects (n = 12) had higher plasma levels of large, medium, and small VLDL (35.0 +/- 6.7 vs. 63.1 +/- 9.6 nmol/l; P = 0.025), higher levels of intermediate density lipoprotein (24.8 +/- 11.6 vs. 87.2 +/- 16.6 nmol/l; P = 0.006), lower levels of large LDL (448.3 +/- 48.5 vs. 315.8 +/- 59.4 nmol/l; P = 0.098), and higher levels of small LDL (488.2 +/- 104.2 vs. 946.7 +/- 151.6 nmol/l; P = 0.021). The average size of LDL from NP and GAgP subjects was 21.4 +/- 0.2 and 20.6 +/- 0.3 nm, respectively (P = 0.031). Compared with NP subjects, GAgP subjects had a greater number of circulating LDL particles (961.3 +/- 105.3 vs. 1,349.0 +/- 133.2 nmol/l; P = 0.032). Differences in the plasma levels of large, medium, and small HDL were not statistically significant. NP and GAgP subjects had similar plasma levels of total LDL-associated PAF-AH activity; however, LDL of GAgP subjects contained less PAF-AH activity per microgram of LDL protein (1,458.0 +/- 171.0 and 865.2 +/- 134 pmol/min/microg; P = 0.014). These results indicate that, in general, GAgP subjects have a more atherogenic lipoprotein profile and lower LDL-associated PAF-AH activity than NP subjects. These differences may help explain the increased risk of GAgP subjects for cardiovascular disease.
Highlights
Periodontitis is characterized by chronic inflammation of the supporting structures of the teeth
The most significant difference in triglyceride-rich lipoproteins between NP and generalized aggressive periodontitis (GAgP) subjects is found in the intermediate density lipoprotein (IDL) density class (Fig. 3)
The present study shows that the documented increase of plasma triglycerides in GAgP patients [27,28,29,30,31] (Fig. 1) is the result of modest increases in VLDL (Fig. 2) and a more robust increase in the plasma concentration of IDL (Fig. 3)
Summary
Periodontitis is characterized by chronic inflammation of the supporting structures of the teeth. Infection with oral bacteria, such as Porphyromonas gingivalis, increases markers of systemic inflammation [17, 22,23,24]; high serum antibody levels to P. gingivalis predict myocardial infarction in humans [25]; and oral infection with P. gingivalis accelerates early atherosclerosis in apolipoprotein E-null mice [26]. Together, these studies strongly indicate an association between chronic periodontal inflammation and increased cardiovascular risk. Several studies have indicated that severe periodontitis is associated with a modest decrease in HDL cholesterol, a modest increase in LDL cholesterol, and a more robust increase in plasma triglycerides [27,28,29,30,31]
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