Association of Carotid Intima-media Thickness and Atherosclerotic Plaque with Periodontal Status.J Dent Res 2014; 93(8):744-51JD
Studies have suggested an association between clinical/subclinical atherosclerosis and periodontal status. The purpose of this study was to investigate the association among maximal carotid intima-media thickness (cIMT), atherosclerotic plaque, and periodontal status in Chinese elderly patients. A cross-sectional study was conducted of 847 participants (age, 70.64 ± 9.03 yr) with ≥10 teeth. A questionnaire survey, routine biochemical tests, a periodontal examination, and maximal cIMT measurement were performed for each. Traditional risk factors for atherogenesis were considered in the statistical analysis. Mean plaque index, which reflects oral hygiene, was correlated with maximal cIMT and atherosclerotic plaque in the study sample overall (β = 0.068, p < .001; OR = 2.051, p < .001) and in euglycemic participants (β = 0.066, p = .008; odds ratio = 2.122, p = .009). In hyperglycemic participants, multiple linear regression analysis (p = .006) and multivariate logistic regression analysis (p = .025) revealed a linear and dose-dependent association between mean clinical attachment loss and maximal cIMT after adjustment for traditional risk factors. Each 1-mm increase in mean clinical attachment loss corresponded to a 0.018-mm increase in maximal cIMT. The risk of atherosclerotic plaque increased by 18.3% with each 1-mm increase in mean clinical attachment loss. Other indicators of periodontal exposure, including percentage of sites with attachment loss ≥ 3 to 5 mm (3%-5%), were also correlated with cIMT and atherosclerotic plaque in hyperglycemic patients. In this elderly population, a linear and dose-dependent association among mean clinical attachment loss, attachment loss 3% to 5%, maximal cIMT, and atherosclerotic plaque was verified in those with hyperglycemia. Poor oral hygiene was correlated with maximal cIMT and atherosclerotic plaque in all participants, including those with normal blood glucose.