Aterosclerosis en sujetos con periodontitis

Néstor J López,Adriana Chamorro,Marcelo Llancaqueo

doi:10.4067/s0034-98872011000600004

Abstract

Chronic inflammation and infections are involved in the development and progression of atherosclerotic vascular disease.To evaluate the association between periodontitis and early atherosclerosis.Fifty-three subjects who received periodontal treatment and regular maintenance for at least 10 years, and 55 subjects with periodontitis but without a history of periodontal treatment were studied. Carotid artery intima-media wall thickness (CIMT) was measured with high-resolution B-mode ultrasonography. A blood sample was obtained to measure high sensitivity C-reactive protein, fibrinogen, lipoprotein cholesterol, leukocyte count and erythrocyte sedimentation rate. Covariates included age, gender, smoking, level of education, body mass index and physical activity. The benzoyl-DL-arginine-naphthylamide (BANA) test was used to determine the number of periodontal sites with periodontal pathogens.CIMT value was significantly higher in subjects with periodontitis than those without it (0.775 ± 0.268 and 0.683 ± 0.131 mm respectively, p = 0.027). C-reactive protein, leukocyte count and percentage of sites with periodontal pathogens were also significantly higher in subjects with periodontitis. Regression analysis identified age, periodontitis, and smoking as independent predictors of CIMT.These results suggest that untreated periodontitis is associated with early atherosclerotic carotid lesions and higher levels of inflammatory markers.

Highlights

Chronic inflammation and infections are involved in the development and progression of atherosclerotic vascular disease
Los casos tenían pobre estado periodontal y había diferencias altamente significativas entre casos y controles en todas las variables periodontales (Tabla 2)
Examination of the relation between periodontal health status and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen

Summary

Background

Chronic inflammation and infections are involved in the development and progression of atherosclerotic vascular disease. Conclusions: These results suggest that untreated periodontitis is associated with early atherosclerotic carotid lesions and higher levels of inflammatory markers. Los factores de riesgo clásicos de ECV explican sólo el 50% de las muertes por enfermedad coronaria[6]. Se ha demostrado asociación entre periodontitis y aterosclerosis temprana en sujetos sin signos de ECV23,24, y entre carga de patógenos periodontales y GIMC25, que disminuye significativamente después del tratamiento periodontal en sujetos sin ECV26. Este último estudio es el único que ha demostrado el efecto del tratamiento de la periodontitis sobre la aterosclerosis temprana. La periodontitis es una enfermedad prevenible y de fácil tratamiento por lo que es importante determinar si su eliminación como factor contribuyente de aterosclerosis reduce el riesgo cardiovascular

Material y Métodos

Detección de patógenos periodontales con Test BANA

Medición del grosor de la íntima y media de arterias carótidas

Findings

Valor de t Valor de p