Periodontal Pathogens, Serum Lipids, and Lipid Peroxidation in a Population-Based Sample
Epidemiological studies have demonstrated a significant link between periodontal disease (PD) and increased risk of cardiovascular disease (CVD). This study was conducted to evaluate if lipid metabolism and peroxidation may represent potential pathways linking PD to CVD. The study sample included 747 randomly selected residents of Erie and Niagara counties of New York who had 6 or more teeth and no history of heart attack. Periodontal assessments included pocket depth (POD) and attachment loss (ATL). Periodontitis was defined by 2+ teeth with ATL≥6mm and 1+ teeth with POD≥5mm. Subgingival plaque was sampled and tested using immunofluorescence microscopic technique for the presence of four putative periodontal pathogens: Bacteriodes forsythus (BF), Porphyromouas gingivilis (PG), Prevotella intermedia (PI), and Campyglobacter recta (CR). Fasting blood sample was obtained and determinations of total and LDL cholesterol, triglycerides, and plasma thiobarbituric acid reacting substance (TBARS) were performed. In the sample as a whole, prevalence of specific bacteria in the subgingival plaque were 29.6% for BF, 8.3% for PG, 31.6% for PI, and 4.4% for CR. As expected, prevalence was much higher in participants with periodontitis. Presence of BF and CR (but not PI and PG) was associated significantly with higher levels of LDL cholesterol (Mean LDL cholesterol (mg/dl), 151.3 for BF + and 142.8 for BF -, p<0.05; and 158.4 for CR + and 144.7 for CR -, p<0.05). Presence of PG and CR (but not BF and PI) was significantly associated with higher TBARS (Mean TBARS (nmol/ml), 1.51 for PG + and 1.38 for PG -, p<0.05; and 1.57 for CR + and 1.38 for CR -, p<0.05). These associations remained statistically significant after adjustment by sex, age, education, body mass index, diabetes status, smoking and alcohol use. No significant association with bacteria was found for total cholesterol and triglycerides. In conclusion, subgingival presence of specific periodontal bacteria (bf, pg, and cr) was associated with higher serum LDL cholesterol and/or plasma TBARS. This suggests that lipid alteration and peroxidation may represent potential pathways in the link between PD and CVD.