Periodontitis and mechanisms of cardiometabolic risk: Novel insights and future perspectives.
Mesa F, Magan-Fernandez A, Castellino G, Chianetta R, Nibali L, Rizzo M
Biochim Biophys Acta Mol Basis Dis. Feb 2019
COMMENT: The authors in this review article summarize the current knowledge of the influence of the periodontitis in the development of the cardiovascular disease. They review recent epidemiological studies that support the association of the periodontitis and the development of CVD. They also highlight the importance of the periodontal microbiome in atherosclerosis by means of dysregulation of immune system and of changes in the lipid profile.
The aim of this review is to provide new and recent insights on the relationship between periodontitis and cardiometabolic risk, focusing on recent evidence. Comments on shared potential therapeutic targets, such as the role of glucagon-like peptide 1, are also highlighted.
The PAROKRANK study, one of the biggest epidemiologic studies performed to date, followed a case-control design in more than 1,600 Swedish patients. The results showed a significant increased risk for first acute myocardial infarction (AMI) among those diagnosed with periodontitis (OR 1.28, 95% CI 1.03-1.60) after adjusting for confounding variables (smoking habits, diabetes mellitus, years of education, and marital status).
The link between periodontitis and atherosclerosis has been described by two mechanisms, directly by the periodontal pathogens or indirectly by bacterial components or inflammatory mediators. A third mechanism that would also support this link, is the relationship between periodontitis and the lipid profile.