Gingival crevicular fluid oxidative stress level in patients with periodontal disease and hyperlipidemia

Elif Eser Sakallioğlu,Ahmet Aydoğdu,Müge Lutfioğlu,Vadim Ekrem Atabay,Bahattin Avci

doi:10.1590/1807-3107bor-2017.vol31.0110

Abstract

This study aimed to assess the impact of hyperlipidemia on healthy and diseased periodontal tissue by evaluating oxidative stress biomarkers in gingival crevicular fluid (GCF). Clinical periodontal parameters and blood serum lipid, GCF malondialdehyde (MDA), protein carbonyl (PC), and total antioxidant capacity (TAOC) levels were evaluated in six age and sex-matched groups (n = 15 each) of normolipidemic and hyperlipidemic individuals as follows: normolipidemic + periodontally healthy (H), normolipidemic + gingivitis (G), normolipidemic + chronic periodontitis (CP), hyperlipidemic + periodontally healthy (HH), hyperlipidemic + gingivitis (HG), and hyperlipidemic + CP (HCP). GCF MDA, and PC levels varied among groups, with patients with periodontitis having the highest MDA and PC levels [CP > G > H (p < 0.01) and HCP > HG > HH (p < 0.01)] and the lowest TAOC levels [CP < G < H (p < 0.01) and HCP < HG < HH (p < 0.01)]. Furthermore, paired comparisons showed MDA and PC levels to be higher and TAOC levels to be lower in HCP compared with NCP (p < 0.01). In patients with hyperlipidemia, GCF, MDA, and PC levels positively correlated with clinical assessments and serum triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) levels and negatively correlated with serum high-density lipoprotein cholesterol (HDL) levels, whereas GCF TAOC levels negatively correlated with clinical assessments and serum TG, TC, and LDL levels, but positively correlated with serum HDL levels (p < 0.01). In normolipidemic patients, GCF, MDA, and PC levels positively correlated with clinical assessments and serum TG levels and negatively correlated with serum HDL levels, whereas GCF TAOC levels negatively correlated with clinical assessments and serum TG levels and positively correlated with serum HDL levels (p < 0.01). In conclusion, abnormal serum lipid subfractions could be considered a risk factor for enhancing oxidative stress in GCF in the presence of periodontal disease.

Highlights

Periodontal disease is associated with reduced antioxidant capacity and increased oxidative damage in the oral cavity
The paired comparisons showed no significant differences in plaque index (PI), gingival index (GI), or bleeding on probing (BOP) scores between hyperlipidemic and normolipidemic groups, regardless of periodontal status, indicating that these clinical manifestations of periodontal disease were not affected by serum lipid levels (p > 0.05)
This study evaluated gingival crevicular fluid (GCF) protein carbonyl (PC), MDA, and total antioxidant capacity (TAOC) levels relating to periodontal pathology and hyperlipidemia

Summary

Introduction

Periodontal disease is associated with reduced antioxidant capacity and increased oxidative damage in the oral cavity. Oxidative damage is suggested to be a common risk factor for several inflammatory disorders. Gingival crevicular f luid oxidative stress level in patients with periodontal disease and hyperlipidemia by inducing inflammatory reactions.[1] Oxidative stress (OS) promotes the pathophysiological progression of periodontal disease by triggering local and systemic inflammatory responses.[2,3,4,5]. Hyperlipidemia, i.e., elevated serum lipid levels, is thought to cause imbalance in the production of highly reactive molecular species and antioxidant defenses, leading to increased OS and creating a proinflammatory state that predisposes subjects to infections.[1,6] Hyperlipidemia is a risk factor for atherosclerotic diseases by causing hyperactivity of white blood cells,[7] and this hyperactivity leads to an increase in production of reactive oxygen species (ROS) and lipid peroxidation.[8]

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Conclusion