Framingham cardiovascular risk in patients with obesity and periodontitis

Abstract

Background:Obesity is a chronic inflammatory condition that has been associated to a risk factor for the development of periodontitis and cardiovascular disease; however, the relationship still needs to be clarified. The objective of this study was to evaluate the cardiovascular risk in obese patients with chronic periodontitis.Materials and Methods:A total of 87 obese patients were evaluated for anthropometric data (body mass index [BMI], waist circumference, body fat), systolic blood pressure (SBP) and diastolic blood pressure (DBP), cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL), triglycerides, glycemia and periodontal parameters (visible plaque index (VPI), gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment level (CAL)).Results:Patients were divided into two groups according to the periodontal characteristics found: Group O-PD: Obese patients with chronic periodontitis (n = 45), 22 men and 23 women; and Group O-sPD: Obese patients without chronic periodontitis (n = 42), 17 men and 25 women. Patients had a BMI mean of 35.2 (±5.1) kg/m2 . Group O-PD showed a similarity between the genders regarding age, SBP, DBP, cholesterol, HDL, GBI, VPI, PPD ≥4 mm and CAL ≥4 mm. O-PD women showed greater glycemia level and smoking occurrence, but O-PD men presented a 13% - risk over of developing coronary artery disease in 10 years than O-PD women, 9% - risk over than O-sPD men and 15% - risk over than O-sPD women, by the Framingham Score.Conclusions:It was concluded that obesity and periodontal disease are cardiovascular risk factors and that the two associated inflammatory conditions potentially increases the risk for heart diseases.

Relationship between periodontal disease and cardiovascular risk factors among young and middle-aged Brazilians. Cross-sectional study

“…was reported for the relationship between obesity and periodontitis. 34 Although several studies have reported the relationship between obesity and periodontal disease, 11,[13][14][15][17][18][19][20][21] there is no consensus about which pathophysiological mechanism could explain this relationship. Most findings have come from studies with different methodologies for classifying periodontal disease, or with cross-sectional designs or selected or small samples.…”

“…Most findings have come from studies with different methodologies for classifying periodontal disease, or with cross-sectional designs or selected or small samples. 11,13,14,[17][18][19][20] Some studies were conducted on large and more representative cohorts but still with diverse methodology, particularly relating to the diagnosis of PD, and were restricted to certain sex or age strata. 5,12,15,21 Very few studies other than ours have considered oral health or hygiene status in their analyses.…”

“…9 However, it is not totally clear what the causal pathway between PD and CVD risk is. 10 Many observational studies have evaluated the association between different levels of periodontal disease and traditional CVRFs, such as obesity or correlated measurements, [11][12][13][14][15][16][17][18][19][20][21] while others have reported some association with diabetes 22 or metabolic disorders. 23,24 Among these studies, most reported an increased odds ratio (OR) for the relationship between obesity and periodontal disease.…”

Lipid profile and high-sensitivity C-reactive protein levels in obese and non-obese subjects undergoing non-surgical periodontal therapy

“…Periodontitis may influence the levels of hs-CRP, and their serum elevation is associated with increased risk of cardiovascular diseases (36) as well as obesity and hyperlipidemia (37)(38)(39). CRP levels >3 mg/L can be classified as high risk of cardiovascular diseases, CRP = 1 to 3 mg/L as medium risk, and CRP <1 mg/L (40) as low risk.…”

The association of periodontal disease and cardiovascular disease risk: Results from the Hispanic Community Health Study/Study of Latinos

“…37, 38 However, there appear to be no previous studies that have directly examined the PD-FGRS association. One study of obese patients by Pires et al 39 reported higher Framingham scores for the prediction of coronary artery disease, for obese patients with PD compared to obese patients without PD. Their results were analogous to ours despite different operational definitions for PD and CVD risk than used in the present study.…”