Abstract
The association between clinically diagnosed periodontitis, a common chronic oral infection, and metabolic syndrome has been previously reported. The aim of this study was to investigate the association of plasma IgG levels against Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia, C-reactive protein, and periodontal status with metabolic syndrome. Plasma IgG levels and C-reactive protein were measured by enzyme-linked immunosorbent assay, and salivary levels of A. actinomycetemcomitans and P. gingivalis were determined by quantitative real-time polymerase chain reaction. Among 127 individuals aged 35–76 years, 57 participants had metabolic syndrome and severe periodontitis, 25 had metabolic syndrome and an absence of severe periodontitis, 17 healthy individuals had severe periodontitis, and 28 healthy individuals were without severe periodontitis. Patients with metabolic syndrome had reduced humoral immune response to A. actinomycetemcomitans (p = 0.008), regardless of their salivary levels or periodontitis status compared with healthy participants. The IgG antibody response to P. gingivalis, regardless of their salivary levels or participants’ health condition, was significantly higher in severe periodontitis patients (p<0.001). Plasma IgG titers for P. intermedia were inconsistent among metabolic syndrome or periodontal participants. Our results indicate that the presence of lower levels of IgG antibodies to A. actinomycetemcomitans (OR = 0.1; 95%CI 0.0–0.7), but not P. gingivalis, a severe periodontitis status (OR = 7.8; 95%CI 1.1–57.0), high C-reactive protein levels (OR = 9.4; 95%CI 1.0–88.2) and body mass index (OR = 3.0; 95%CI 1.7–5.2), are associated with the presence of metabolic syndrome. The role of the decreased IgG antibody response to A. actinomycetemcomitans, increased C-reactive protein levels on the association between periodontal disease and metabolic syndrome in a group of Thai patients is suggested.
Highlights
Evidence for an association between periodontitis; one of the most common oral infections, and metabolic syndrome (MS); the predisposing condition to coronary heart disease (CHD), has been recently reported in the literature [1]
We examined whether C-reactive protein (CRP) or plasma Immunoglobulin G (IgG) antibody levels to these periodontal pathogens were associated with MS
We discovered that systemic exposure to major periodontal pathogens, A. actinomycetemcomitans, and signs of oral infection, severe periodontitis, as well as elevated CRP and body mass index (BMI) are associated with the presence of MS
Summary
Evidence for an association between periodontitis; one of the most common oral infections, and metabolic syndrome (MS); the predisposing condition to coronary heart disease (CHD), has been recently reported in the literature [1]. Periodontopathic bacteria Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Prevotella intermedia (P. intermedia) can trigger host immunological inflammatory responses, both locally and systemically, and generate secretion of many inflammatory cytokines. The systemic immunological response to periodontitis can be measured as increased plasma antibody levels against these periodontopathic bacteria. Ueno et al reported that high plasma antibody levels to A. actinomycetemcomitans, P. gingivalis and P. intermedia were associated with an increased risk of CHD [5]. High levels of Immunoglobulin G (IgG) antibody titers to P. gingivalis are observed in periodontitis patients [6]. With this association with the chronic inflammatory response, it is postulated that periodontitis may enhance atherosclerosis in patients with MS, leading to early CHD
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