Periodontal Status and Hyperlipidemia: Statin Users vs. Non-Users.
ABSTRACT Background: The association between serum lipids and periodontal disease has been studied predominantly in chronic periodontitis patients with limited data available regarding periodontal status of hyperlipidemic subjects. Meanwhile, the impact of statins on the periodontal health of the population also remains largely under-explored. This study aims to assess the periodontal status among hyperlipidemic subjects and statin users. Methods: In this cross-sectional study, 94 hyperlipidemic subjects (50 on statins and 44 on non-pharmacologic therapy), and 46 normolipidemic controls underwent periodontal examination [plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL)]. Biochemical parameters measured included serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels. Results: PD and GI were significantly higher in non-statin hyperlipidemics compared to normolipidemic [(P <0.001(PD) and P <0.05 (GI)] and statin group [(P=0.001 (PD) and P <0.05 (GI)]. Periodontal parameters between statin and normolipidemic group did not differ significantly. After adjusting for confounders, positive and significant correlations were observed between PD and TG, TC and LDL while CAL shared correlation with TC and LDL. GI was correlated with TG and TC. Regression analyses revealed that while TC was significantly associated with PD (P <0.001), LDL showed significant association with CAL (P=0.013). TG showed significant association with GI (P=0.020). Conclusions: Our findings suggest that relative to the general population, hyperlipidemic subjects are more prone to periodontal disease. Also, within the limits of this study, it may be stated that statins have a positive impact on periodontal health.
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ABSTRACT: Background: Simvastatin is a cholesterol-lowering drug whose pleiotropic effects may have a therapeutic impact on bone. This study evaluated the effect of simvastatin on rats subjected to experimental periodontal disease (EPD). Methods: Periodontitis was induced by ligature placement around the upper second left molar of rats for 11 days. Groups of 6 animals received via oral saline or simvastatin (3, 10 and 30 mg/kg/day) until sacrifice on the 11(th) day. Alveolar bone loss was determined by macroscopic and histologic examination. The serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total alkaline phosphatase (TAP) were evaluated. Gingival myeloperoxidase (MPO) activity and gingival levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), reduced glutathione (GSH), malonylaldehyde (MDA), and nitrate/nitrite (NOX) were analyzed to investigate oxidative stress and inflammation. Expression of inducible nitric oxide synthase (iNOS), matrix metalloproteinase 1 and 8 (MMP-1/8), bone morphogenetic protein-2 (BMP-2), receptor activator of nuclear factor kappa B (RANK), receptor activator of nuclear factor kappa B ligand (RANKL), and osteoprotegerin (OPG) were also investigated by immunohistochemistry to assess bone turnover and metabolism. Immunofluorescence microscopy was used to confirm the expression of RANKL in rats' maxillae. Results: Treatment with simvastatin improved alveolar bone loss within all of the parameters studied, thus demonstrating anti-inflammatory and antioxidant activity. Simvastatin reduced expression of iNOS, MMP-1/8, RANK and RANKL and increased BMP-2 and osteoprotegerin levels in the periodontal tissue. Simvastatin (30 mg/kg) increased TAP activity on the 11(th) day, in comparison to the saline group. No differences were found in the levels of AST and ALT in any of the groups studied. Conclusion: Our data suggest that simvastatin prevents inflammatory bone resorption in experimental periodontitis, which may be mediated by its anti-inflammatory and antioxidant properties.Journal of Periodontology 11/2012; · 2.40 Impact Factor
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ABSTRACT: Objective: To observe the Periodontal Treatment Need (PTN) in adult patients without Diabetes Mellitus type 2 (noDM2) and with Diabetes Mellitus type 2 (DM2) controlled and non-controlled in a chilean population. Materials and Methods: Cross sectional study. A periodontist recorded the PTN according to the Periodontal Treatment Need Community Index (CPITN), from a sample of patients with noDM2, controlled DM2 (Hemoglobin A, Glycosylated HbA1c ≤ a 6.5%) and non-controlled DM2 (HbA1c > 6.5%) from the Army Clinical Center in Valdivia-Chile between april and july 2012. The age, sex and presence of arterial hypertension were recorded. The sociodemographic variables and the statistical association between PTN in patients with noDM2, with controlled and non-controlled DM2 (chi-squared test, p<0.05) were also analyzed. Results: Ninety six patients were analyzed. The average age was 55.2 ± 8.3 years old, 45 of them (48.9%) were diabetics. 96.88% of the samples presented a PTN by the specialists (CPITN codes 3 and 4), there were no significant differences between DM2 and noDM2 patients (p=0.63). No significant differences were observed in PTN between patients with controlled and non-controlled diabetes (p=0.43). Conclusions: Previous reports related the presence and lack of control of DM2 as a risk factor of periodontal disease. Nonetheless, in our study, there was a high index of PTN in all the different types of patients examined. Key words: Periodontitis, diabetes mellitus, periodontal index, hemoglobin A, glycosylated, Chile.Revista clínica de periodoncia, implantología y rehabilitación oral. 08/2013; 6(2):67-70.
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ABSTRACT: Statins are the group of lipid-lowering drugs commonly used to control cardiovascular and cerebrovascular diseases. Statins have potential anti-inflammatory effect by blocking the intermediate metabolites of the mevalonate pathway. The objective of this study was to evaluate the anti-inflammatory effect of statin medication in chronic periodontitis patients. Thirty patients of age group between 40 and 60 years were selected from the outpatient pool of Department of Periodontics, Thaimoogambigai Dental College and Hospital, Chennai. Thirty patients selected were grouped into two groups, Group-I consists of patients with generalized chronic periodontitis and on statin medication and Group-II consists of patients with generalized chronic periodontitis. Clinical parameters were recorded and gingival crevicular fluid (GCF) samples were analyzed for interleukin (IL)-1β using commercially available enzyme-linked immunosorbent assay. The mean GCF IL-1β levels in generalized chronic periodontitis patients who are on statin medication (Group-I) were lower than the generalized chronic periodontitis patients without statin medication (Group-II). Reduction of GCF IL-1β levels in statin users indicate that statins have anti-inflammatory effect on periodontal disease.Indian Journal of Pharmacology 07/2013; 45(4):391-4. · 0.58 Impact Factor