OJST  Vol.3 No.8 , November 2013
The relationship among periodontal condition, serum lipid, and electrocardiographic abnormalities in the elderly: A prospective cohort study
Abstract: Periodontal disease is recognized as a risk factor for cardiovascular disease (CVD). Some studies have suggested that serum lipids might play a role in the association between periodontal disease and CVD. However, this hypothesis remains unproven. Present study evaluated the association between periodontal disease and CVD-related parameters including electrocardiographic (ECG) parameters and serum lipid levels in the elderly. This study was a prospective cohort study. A total of 107 subjects (57 males and 50 females) from Niigata City’s community-dwelling elderly (all aged 75 years old) who possessed at least 20 teeth and did not exhibit ECG abnormalities at the baseline underwent annual examinations for 5 years. Logistic regression analysis was used to assess the relationship between periodontal condition and the presence of ECG abnormalities, after adjusting for confounding factors including serum lipid levels. Logistic regression analysis showed that the subjects who exhibited a poor periodontal condition at the baseline had a 2.97 times greater risk of suffering from ECG abnormalities than the subjects who displayed a good periodontal condition at the baseline (p = 0.019). Furthermore, the subjects who displayed a poor periodontal condition and an unfavorable serum lipid profile at the baseline showed a significantly higher frequency of ECG abnormalities (63.6%) than those who exhibited a healthy periodontal condition and a favorable serum lipid profile (21.6%, p = 0.008) as well as those who displayed a healthy periodontal condition and an unfavorable serum lipid profile (21.4%, p = 0.010). As a conclusion, periodontal condition could be a marker of CVD, even in the healthy elderly.
Cite this paper: Hanindriyo, L. , Yoshihara, A. , Hirotomi, T. and Miyazaki, H. (2013) The relationship among periodontal condition, serum lipid, and electrocardiographic abnormalities in the elderly: A prospective cohort study. Open Journal of Stomatology, 3, 457-463. doi: 10.4236/ojst.2013.38076.

[1]   Petersen, P.E., Bourgeois, D., Ogawa, H., Estupinan-Day, S. and Ndiaye, C. (2005) The global burden of oral diseases and risks to oral health. Bulletin of the World Health Organization, 83, 661-669.

[2]   Papapanou, P.N. (1999) Epidemiology of periodontal diseases: An update. Journal of the International Academy of Periodontology, 1, 110-116.

[3]   Petersen, P.E. (2006) Oral health-general health interrelationships: Health policy implications. Inside Dentistry, 2, 1-5.

[4]   DeStefano, F., Anda, R.F., Kahn, H.S., Williamson, D.F. and Russell, C.M. (1993) Dental disease and risk of coronary heart disease and mortality. British Medical Journal, 306, 688-691.

[5]   Corti, M.C., Guralnik, J.M., Salive, M.E., Harris, T., Field, T.S., et al. (1995) HDL cholesterol predicts coronary heart disease mortality in older persons. Journal of American Medical Association, 274, 539-544.

[6]   Izumi, A., Yoshihara, A., Hirotomi, T. and Miyazaki, H. (2009) The relationship between serum lipids and periodontitis in elderly non-smokers. Journal of Periodontology, 80, 740-748.

[7]   Saito, T., Shimazaki, Y. and Sakamoto, M. (1998) Obesity and periodontitis. The New England Journal of Medicine, 339, 482-483.

[8]   Wakai, K., Kawamura, T., Umemura, O., Hara, Y., Machida, J., et al. (1999) Associations of medical status and physical fitness with periodontal disease. Journal of Clinical Periodontology, 26, 664-672.

[9]   Holm-Pedersen, P., Avlund, K., Morse, D.E., Stoltze, K., Katz, R.V., et al. (2005) Dental caries, periodontal disease, and cardiac arrhythmias in community-dwelling older persons aged 80 and older: Is there a link? Journal of American Geriatric Society, 53, 430-437.

[10]   Sridhar, R., Byakod, G., Pudakalkatti, P. and Patil, R. (2009) A study to evaluate the relationship between periodontitis, cardiovascular disease and serum lipid levels. International Journal of Dental Hygiene, 7, 144-150.

[11]   Schulz, K.F. and Grimes, D.A. (2002) Case-control studies: Research in reverse. Lancet, 359, 431-434.

[12]   Saxlin, T., Suominen-Taipale, L., Kattainen, A., Marniemi, J., Knuuttila, M., et al. (2008) Association between serum lipid levels and periodontal infection. Journal of Clinical Periodontology, 35, 1040-1047.

[13]   Rich, M.W. (2009) Epidemiology of atrial fibrillation. Journal of Interventional Cardiac Electrophysiology, 25, 3-8.

[14]   Albandar, J.M., Brunelle, J.A. and Kingman, A. (1999) Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994. Journal of Periodontology, 70, 13-29.

[15]   Shimazaki. Y., Saito, T., Kiyohara, Y., Kato, I., Kubo, M., et al. (2004) Relationship between electrocardigraphic abnormalities and periodontal disease: The Hisayama study. Journal of Periodontology, 75, 791-797.

[16]   Rautuharju, P.M., Park, L., Rautuharju, F.S. and Crow, R. (1998) A standardized procedure for locating and documenting ECG chest electrode positions, consideration of the effect of breast tissue on ECG amplitudes in women. Journal of Electrocardiology, 31, 17-29.

[17]   Takata, Y., Ansai, T., Matsumura, K., Awano, S., Hamasaki, T., et al. (2001) Relationship between tooth loss and electrocardiographic abnormalities in octogenarians. Journal of Dental Research, 80, 1648-1652.

[18]   Ichihara, Y., Sugino, M., Hattori, R., Anno, T., Mizuno, Y., et al. (1997) Relation of electrocardiographic left ventricular hypertrophy with and without T-wave changes to systemic blood pressure, body mass, and serum lipid and blood glucose level in Japanese men. The American Journal of Cardiology, 80, 730-735.

[19]   Teramoto, T., Sasaki, J., Ueshima, H., Egusa, G., Kinoshita, M., et al. (2007) Executive summary of Japanese Atherosclerosis Society (JAS) guideline for diagnosis and prevention of atherosclerotic cardiovascular diseases for Japanese. Journal of Atherosclerosis and Thrombosis, 14, 45-50.

[20]   Mattila, K.J., Nieminen, M.S., Valtonen, V.V., Rasi, V.P., Kesaniemi, A., et al. (1989) Association between dental health and acute myocardial infarction. British Medical Journal, 298, 779-781.

[21]   Kaneko M, Yoshihara A and Miyazaki H. (2011) Relationship between root caries and cardiac dysrhythmia. Gerodontology, 28, 289-295.

[22]   Saito, T., Murakami, M., Shimazaki, Y. Oobayashi, K., Matsumoto, S., et al. (2003) Association between alveolar bone loss and elevated serum C-Reactive Protein in Japanese men. Journal of Periodontology, 74, 1741-1746.

[23]   Loos, B.G., Craandijk, J., Hoek, F.J., Wertheim van Dillen, P.M.E. and van der Velden, U. (2000) Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. Journal of Periodontology, 71, 1528-1534.

[24]   Nakano, K., Nemoto, H., Nomura, R., Homma, H., Yoshioka, H., et al. (2006) Serotype distribution of Streptococcus mutans a pathogen of dental caries in cardiovascular specimens from Japanese patients. Journal of Medical Microbiology, 56, 551-556.

[25]   Beg, A.M., Jones, M.N., Miller-Torbert, T. and Holt R.G. (2002) Binding of Streptococcus mutans to extracellular matrix molecules and fibrinogen. Biochemical and Biophysical Research Communications, 298, 75-79.

[26]   Pucar, A., Milasin, J., Lekovic, V., Vulkadinovic, M., Ristic, M., et al. (2007) Correlation between atherosclerosis and periodontal putative pathogenic bacterial infections in coronary and internal mammary arteries. Journal of Periodontology, 78, 677-682.

[27]   Brescianini, S., Maggi, S., Farchi, G., Mariotti, S., Carlo, A.D., et al. (2003) Low total cholesterol and increased risk of dying: are low levels clinical warning signs in the elderly? Results from the Italian Longitudinal Study on Aging. Journal of American Geriatric Society, 51, 991-996.

[28]   Weverling-Rijnsburger, A.W., Blauw, G.J., Lagaay, A.M., Knook, D.L., Meinders, A.E., et al. (1997) Total cholesterol and risk of mortality in the oldest old. Lancet, 350, 1119-1123.

[29]   Schatz, I.J., Masaki, K., Yano, K., Chen, R., Rodrigues, B.L. et al. (2001) Cholesterol and all-cause mortality in elderly people from the Honolulu heart program: A cohort study. Lancet, 358, 351-355.