Is the relationship between periodontitis and hyperlipidemia mediated by lipoprotein-associated inflammatory mediators?

PURPOSE: The aim of this study was to evaluate the serum levels of oxidized low-density lipoprotein (oxLDL), anti-oxLDL, and myeloperoxidase (MPO) in hyperlipidemic patients with periodontal disease. METHODS: This study included 123 patients with hyperlipidemia categorized based on metabolic control as mild to moderate (H1) (n=66) or poor (H2) (n=57), as well as systemically healthy controls (C) (n=68). Serum levels of lipids, oxLDL, anti-oxLDL, and MPO were evaluated, along with clinical periodontal parameters. RESULTS: The percentage of bleeding on probing (BOP%) and the clinical attachment level were significantly higher in the H2 group than in the C group. Patients with hyperlipidemia had a relatively high risk of developing periodontal disease. The oxLDL and anti-oxLDL levels were higher in H2 patients with periodontitis than in the control or H1 patients with periodontitis. In the H1 and H2 groups, the ratio of total cholesterol to high-density lipoprotein was significantly correlated with gingival index, BOP%, and oxLDL levels. CONCLUSIONS: Our findings indicate that the lipoprotein-associated inflammatory mediators of oxLDL, anti-oxLDL, and MPO may play an important role in the relationship between periodontal disease and hyperlipidemia.

Anti-inflammatory effect of rosuvastatin decreases alveolar bone loss in experimental periodontitis.

The effects of systemically administered rosuvastatin on alveolar bone loss (ABL), cytokine levels and oxidative status were investigated in rats with ligature-induced periodontitis. Rats were divided randomly into four groups: a non-ligated group (C); a non-ligated+rosuvastatin group (R); a ligated group (P); and a ligated+rosuvastatin group (PR). Ligatures were placed at the maxillary second molars, and rosuvastatin was administered for 14 days. After the rats had been euthanatized, histomorphometric and histological analyses were performed, and the serum levels of interleukin (IL)-1ß, IL-10 and oxidant and antioxidant parameters (malondialdehyde [MDA], superoxide dismutase, glutathione, and glutathione peroxidase) were evaluted by enzyme-linked immunosorbent assay. Rosuvastatin significantly decreased the extent of ABL, inflammatory infiltration and osteoclasts in periodontitis, but increased the numbers of osteoblasts. Although rosuvastatin reduced the levels of IL-1ß, they did not differ significantly between the PR and P groups. In the PR group, not only were IL-10 levels significantly higher but also the ratio of IL-1ß to IL-10 was lower than in the P group. Although MDA levels were significantly increased in the P group relative to the C group, they did not differ significantly between the PR and C groups. The present data suggest that rosuvastatin decreases ABL in ligature-induced periodontitis, and that its anti-inflammatory effect is more remarkable than its antioxidant effect.

Serum Lp-PLA2: as a novel viewpoint in periodontal treatment of hyperlipidaemics.

BACKGROUND/AIM: To evaluate the effects of periodontal treatment on serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and C-reactive protein (CRP) levels in hyperlipidaemic patients with periodontitis. MATERIALS AND METHODS: The study included 52 hyperlipidaemics and 28 systemically healthy controls (C) with periodontitis. Of the 52 hyperlipidaemics, 29 received a suggested diet (HD), and 23 of them were prescribed statin (HS). Clinical periodontal parameters, serum lipids, Lp-PLA2, and CRP levels were assessed at the baseline and 2 months after the completion of the nonsurgical periodontal treatment (2MPT). Serum parameters were also evaluated 1 week following the periodontal treatment (1WPT). RESULTS: At the baseline, patients in the HS group had a higher percentage of bleeding on probing than those in the C and HD groups. Hyperlipidaemics had higher serum triglyceride levels than the control group at 2MPT compared to the baseline. At 2MPT, the levels of Lp-PLA2 in the HS group were significantly higher compared to the baseline and 1WPT. There were no statistically significant differences in CRP levels between study periods for all groups. CONCLUSION: The periodontal treatment may affect the inflammatory control of hyperlipidaemic patients with periodontitis via increased Lp-PLA2 levels and severity of the impaired lipid metabolism. These findings may be important regarding the therapeutic strategies for hyperlipidaemics with periodontitis.