The Study Of CRP In Chronic Periodontitis Patients With Or Without Atherosclerotic Coronary Artery Disease

Background:A lot of researches and epidemiological survey show chronic periodontitis(CP) and atherosclerotic coronary artery disease (also called coronary artery disease, AS) have a common epidemiological relationship, similar risk factors such as smoking, diabetes, obesity, blood fat, high blood pressure and so on. Researches have shown that periodontitis by periodontal pathogen or their products, or infected periodontal tissue inflammation of release of the induction endothelial cell function obstacle to bring about sclerosis of arterial congee appearance. There may be complex internal relations between periodontitis and atherosclerotic coronary artery disease. Periodontitis and coronary heart disease are the essence of infection and inflammation, inflammation throughout its always, C-reactive protein (C-reactive protein, CRP) as a kind of inflammation markers, play an important role in the development and reaction between periodontitis and coronary heart disease.objective:1. Established Guangdong area people’s survey information base, the clinical information database and biological sample database of three types of population following.(1) chronic periodontitis patients with atherosclerotic coronary artery disease (2) chronic periodontitis patients with no history of any systemic disease (3)healthy individuals with no history of periodontal and systemic disease.2. the relationship between chronic periodontitis and atherosclerotic coronary artery disease by analysing periodontal inflammatory burden, lipid level in serum and hs-CRP among people with or without periodontitis and with or without atherosclerotic coronary artery disease.3. To compare the feasibility of peridontal inflamed surface area with PD as a measure of periodontal tissue local inflammation load index.4. To evaluate the effect of severity of the local periodontal inflammation on systematic inflammatory factors and lipid levels in individuals with periododntitis and atherosclerotic coronary artery disease by cross-sectional study.Materials and MethodsA total of412subjects,279males and133females,123chronic periodontitis patients with atherosclerosis (GroupAS+CP),145chronic periodontitis patients with no history of any systemic disease (GroupCP), and144clinically healthy individuals with no history of periodontal and systemic disease (Group H) were selected for the study. All were collected at five hospitals in Guangzhou City (China) between September2009and January2012.All of participants were asked to complete a questionnaire,full-mouth periodontal assessment and blood sample analysis. The questionnaire gathered their demographic information, treatment and family history. Periodontal examinations, including ulcus bleeding index(SBI), probing depth (PD), gingival recession(GR) and attachment loss (AL), were recorded.Fasting blood sample5ml, left to stand for1～2h, then3500r/min centrifugal15min, and serum was separated and collected in0.5ml sterile EP tube, sealed shading,-70℃low temperature refrigeratoy stand-by.Blood analysis included high-sensitivity C-reaction protein (hsCRP), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG) and fasting glucose (PFG).According to the method reported by Nesse, periodontal inflamed surface area(PISA) was calculated from probing depth(PD), bleeding on probing(BOP), gingival recession(GR) and clinical attachment level(CAL).The results show there were significant difference in PD(P<0.001), PISA(P<0.001), the number of missing teeth(<0.001, hs-CRP(P<0.001), age(P<0.001), BMI(P<0.001) between AS+CPgroup and CP group, and the differences between CP group and H group are hs-CRP, age and BMI, and no significant difference among groups in sex, alcohol consumption and smoke states (P>0.05). Subjects of AS+CP group and CP group have a significant higher level of hsCRP than H group, CP can aggravate of serum hsCRP level. In multiple logistic regression models using with CP or not as the dependant variable, PD(W=34.909, P<0.001, OR=9.776,95%CI:4.589～20.827), PISA(W=16.669, P<0.001, OR=1.024,95%CI:1.012-1.036)and the number of missing teeth(W=4.866, P=0.027, OR=2.210,95%CI:1.092～4.470) are the risk factors for AS, after adjusting for possible confounders such as age.PISA(AUR=0.921, P<0.001,95%CI:0.885～0.957) and PD(AUR=0.879, P <0.001,95%CI:0.836～0.923) both have a high diagnostic value for periodontal inflammatory. PISA can be used as a effective measuring indexes of periodontal index, and its sensitivity is higher than PD. Conclusion1、Atherosclerosis possibly aggravate of periodontal inflammatory reaction. CP can aggravate of serum hsCRP level.2、PISA and PD both have a high diagnostic value for periodontal inflammatory, and the sensitivity of PISA is higher than PD.