Acute-phase Inflammatory Response to Periodontal Disease in the US Population
Moderate elevation of serum C-reactive protein (CRP) is a risk factor for cardiovascular disease among apparently healthy individuals, although factors that create this inflammatory response in the absence of systemic illness have not been clarified. This study aimed to: (1) evaluate associations am...
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Published in | Journal of dental research Vol. 79; no. 1; pp. 49 - 57 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Los Angeles, CA
SAGE Publications
01.01.2000
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Subjects | |
Online Access | Get full text |
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Abstract | Moderate elevation of serum C-reactive protein (CRP) is a risk factor for cardiovascular disease among apparently healthy individuals, although factors that create this inflammatory response in the absence of systemic illness have not been clarified. This study aimed to: (1) evaluate associations among periodontal disease, established risk factors for elevated CRP, and CRP levels within the US population; and (2) determine whether total tooth loss is associated with reduced CRP. Data were obtained from the third National Health and Nutrition Examination Survey. A random sample of the US population was interviewed in their homes and examined at mobile examination centers. CRP was quantified from peripheral blood samples and analyzed as a continuous variable and as the prevalence of elevated CRP (≥ 10 mg/L). Some 12,949 people aged 18+ years who had periodontal examinations and an additional 1817 edentulous people aged 18+ years were included in the analysis. Dentate people with extensive periodontal disease (> 10% of sites with periodontal pockets 4+ mm) had an increase of approximately one-third in mean CRP and a doubling in prevalence of elevated CRP compared with periodontally healthy people. Raised CRP levels among people with extensive periodontal disease persisted in multivariate analyses (P < 0.01), with established risk factors for elevated CRP (diabetes, arthritis, emphysema, smoking, and anti-inflammatory medications) and sociodemographic factors controlled for. However, CRP levels were similarly raised in edentulous people. Furthermore, the established risk factors for elevated CRP modified relationships between oral status and CRP levels. Periodontal disease and edentulism were associated with systemic inflammatory response in the US population, most notably among people who had no established risk factors for elevated CRP. |
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AbstractList | Moderate elevation of serum C-reactive protein (CRP) is a risk factor for cardiovascular disease among apparently healthy individuals, although factors that create this inflammatory response in the absence of systemic illness have not been clarified. This study aimed to: (1) evaluate associations among periodontal disease, established risk factors for elevated CRP, and CRP levels within the US population; and (2) determine whether total tooth loss is associated with reduced CRP. Data were obtained from the third National Health and Nutrition Examination Survey. A random sample of the US population was interviewed in their homes and examined at mobile examination centers. CRP was quantified from peripheral blood samples and analyzed as a continuous variable and as the prevalence of elevated CRP (≥ 10 mg/L). Some 12,949 people aged 18+ years who had periodontal examinations and an additional 1817 edentulous people aged 18+ years were included in the analysis. Dentate people with extensive periodontal disease (> 10% of sites with periodontal pockets 4+ mm) had an increase of approximately one-third in mean CRP and a doubling in prevalence of elevated CRP compared with periodontally healthy people. Raised CRP levels among people with extensive periodontal disease persisted in multivariate analyses (P < 0.01), with established risk factors for elevated CRP (diabetes, arthritis, emphysema, smoking, and anti-inflammatory medications) and sociodemographic factors controlled for. However, CRP levels were similarly raised in edentulous people. Furthermore, the established risk factors for elevated CRP modified relationships between oral status and CRP levels. Periodontal disease and edentulism were associated with systemic inflammatory response in the US population, most notably among people who had no established risk factors for elevated CRP. Moderate elevation of serum C-reactive protein (CRP) is a risk factor for cardiovascular disease among apparently healthy individuals, although factors that create this inflammatory response in the absence of systemic illness have not been clarified. This study aimed to: (1) evaluate associations among periodontal disease, established risk factors for elevated CRP, and CRP levels within the US population; and (2) determine whether total tooth loss is associated with reduced CRP. Data were obtained from the third National Health and Nutrition Examination Survey. A random sample of the US population was interviewed in their homes and examined at mobile examination centers. CRP was quantified from peripheral blood samples and analyzed as a continuous variable and as the prevalence of elevated CRP (> or = 10 mg/L). Some 12,949 people aged 18+ years who had periodontal examinations and an additional 1,817 edentulous people aged 18+ years were included in the analysis. Dentate people with extensive periodontal disease (> 10% of sites with periodontal pockets 4+ mm) had an increase of approximately one-third in mean CRP and a doubling in prevalence of elevated CRP compared with periodontally healthy people. Raised CRP levels among people with extensive periodontal disease persisted in multivariate analyses (P < 0.01), with established risk factors for elevated CRP (diabetes, arthritis, emphysema, smoking, and anti-inflammatory medications) and sociodemographic factors controlled for. However, CRP levels were similarly raised in edentulous people. Furthermore, the established risk factors for elevated CRP modified relationships between oral status and CRP levels. Periodontal disease and edentulism were associated with systemic inflammatory response in the US population, most notably among people who had no established risk factors for elevated CRP. Moderate elevation of serum C-reactive protein (CRP) is a risk factor for cardiovascular disease among apparently healthy individuals, although factors that create this inflammatory response in the absence of systemic illness have not been clarified. This study aimed to: (1) evaluate associations among periodontal disease, established risk factors for elevated CRP, and CRP levels within the US population; and (2) determine whether total tooth loss is associated with reduced CRP. Data were obtained from the third National Health and Nutrition Examination Survey. A random sample of the US population was interviewed in their homes and examined at mobile examination centers. CRP was quantified from peripheral blood samples and analyzed as a continuous variable and as the prevalence of elevated CRP (> or = 10 mg/L). Some 12,949 people aged 18+ years who had periodontal examinations and an additional 1,817 edentulous people aged 18+ years were included in the analysis. Dentate people with extensive periodontal disease (> 10% of sites with periodontal pockets 4+ mm) had an increase of approximately one-third in mean CRP and a doubling in prevalence of elevated CRP compared with periodontally healthy people. Raised CRP levels among people with extensive periodontal disease persisted in multivariate analyses (P < 0.01), with established risk factors for elevated CRP (diabetes, arthritis, emphysema, smoking, and anti-inflammatory medications) and sociodemographic factors controlled for. However, CRP levels were similarly raised in edentulous people. Furthermore, the established risk factors for elevated CRP modified relationships between oral status and CRP levels. Periodontal disease and edentulism were associated with systemic inflammatory response in the US population, most notably among people who had no established risk factors for elevated CRP. |
Author | Beck, J.D. Slade, G.D. Heiss, G. Offenbacher, S. Pankow, J.S. |
Author_xml | – sequence: 1 givenname: G.D. surname: Slade fullname: Slade, G.D. organization: Department of Dental Ecology – sequence: 2 givenname: S. surname: Offenbacher fullname: Offenbacher, S. organization: Department of Periodontology – sequence: 3 givenname: J.D. surname: Beck fullname: Beck, J.D. organization: Department of Dental Ecology – sequence: 4 givenname: G. surname: Heiss fullname: Heiss, G. organization: Department of Epidemiology, University of North Carolina at Chapel Hill, CB7450, Chapel Hill, NC 27599-7450, USA – sequence: 5 givenname: J.S. surname: Pankow fullname: Pankow, J.S. organization: Department of Epidemiology, University of North Carolina at Chapel Hill, CB7450, Chapel Hill, NC 27599-7450, USA |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/10690660$$D View this record in MEDLINE/PubMed |
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Structural biology, gene expression, and host defense function publication-title: Immunol Res contributor: fullname: Volanakis JE – volume: 24 start-page: 8 year: 1997 end-page: 16 article-title: Monocytic TNF alpha secretion patterns in IDDM patients with periodontal diseases publication-title: J Clin Periodontol contributor: fullname: Offenbacher S. – volume: 65 start-page: 139 year: 1994 end-page: 146 article-title: The secretion of PGE2, IL-1 beta, IL-6, and TNF alpha by adherent mononuclear cells from early onset periodontitis patients publication-title: J Periodontol contributor: fullname: Barak V. – volume: 42 start-page: 987 year: 1997 end-page: 995 article-title: Reprioritization of liver protein synthesis resulting from recombinant human growth hormone supplementation in parenterally fed trauma patients: the effect of growth hormone on the acute-phase response publication-title: J Trauma-Injury Infect Crit Care contributor: fullname: Holaday NJ – volume: 312 start-page: 1061 year: 1996 end-page: 1065 article-title: C-reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study publication-title: BMJ contributor: fullname: Northfield TC – volume: 74 start-page: 1118 year: 1995 end-page: 1128 article-title: Critical issues in periodontal research publication-title: J Dent Res contributor: fullname: Page RC – volume: 34 start-page: 141 year: 1983 end-page: 212 article-title: Acute phase proteins with special reference to C-reactive and related proteins (Pentaxins) and serum amyloid A protein publication-title: Adv Immunol contributor: fullname: Baltz ML – volume-title: National Center for Health Statistics year: 1996 ident: atypb30 contributor: fullname: US Department of Health and Human Services (DHHS) – ident: atypb15 doi: 10.1902/annals.1996.1.1.821 – ident: atypb23 doi: 10.7326/0003-4819-116-4-273 – ident: atypb24 doi: 10.1111/j.1600-051X.1997.tb01178.x – ident: atypb6 doi: 10.1016/S0140-6736(96)07591-5 – volume-title: Laboratory procedures used for the third national health and nutrition examination survey (NHANES III) 1988-1994 year: 1996 ident: atypb5 contributor: fullname: Gunter EW – ident: atypb22 doi: 10.1056/NEJM199704033361401 – ident: atypb4 doi: 10.1111/j.1365-2249.1997.270-ce1162.x – ident: atypb16 doi: 10.1177/00220345950740041301 – ident: atypb1 doi: 10.1177/10454411970080040501 – volume-title: Epidemiologic research year: 1982 ident: atypb8 contributor: fullname: Kleinbaum DG – ident: atypb20 doi: 10.1097/00005373-199706000-00001 – volume: 44 start-page: 585 year: 1994 ident: atypb13 publication-title: Int Dent J contributor: fullname: Nasi JH – volume: 16 start-page: 127 issue: 2 year: 1997 ident: atypb27 publication-title: Immunol Res doi: 10.1007/BF02786357 contributor: fullname: Szalai AJ – ident: atypb2 doi: 10.1902/jop.1996.67.10s.1123 – ident: atypb3 doi: 10.1111/j.1600-051X.1986.tb01497.x – ident: atypb21 doi: 10.1111/j.1752-7325.1995.tb02377.x – ident: atypb28 doi: 10.1161/01.ATV.17.10.2167 – volume: 77 start-page: 115 year: 1998 ident: atypb7 publication-title: J Dent Res doi: 10.1177/00220345980770030501 contributor: fullname: Kingman A. – ident: atypb26 doi: 10.1111/j.1752-7325.1999.tb03237.x – ident: atypb9 doi: 10.1177/002203459607502S01 – ident: atypb19 doi: 10.1016/S0065-2776(08)60379-X – ident: atypb29 doi: 10.1111/j.1600-0714.1993.tb01051.x – volume-title: Oral health of United States adults. 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SubjectTerms | Acute-Phase Reaction - blood Acute-Phase Reaction - epidemiology Adolescent Adult Aged C-Reactive Protein - analysis Cross-Sectional Studies Dentistry Female Humans Male Middle Aged Mouth, Edentulous - blood Mouth, Edentulous - epidemiology Periodontal Diseases - blood Periodontal Diseases - epidemiology Prevalence Risk Factors Tooth Loss - blood Tooth Loss - epidemiology United States - epidemiology |
Title | Acute-phase Inflammatory Response to Periodontal Disease in the US Population |
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