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Observational Study
. 2020 Feb 13;22(1):27.
doi: 10.1186/s13075-020-2121-6.

Association between periodontitis and anti-citrullinated protein antibodies in rheumatoid arthritis patients: a cross-sectional study

Jerián González-Febles  1   2 , Beatriz Rodríguez-Lozano  3 , Carlos Sánchez-Piedra  4 , Jorge Garnier-Rodríguez  5 , Sagrario Bustabad  3 , Martina Hernández-González  5 , Enrique González-Dávila  6 , Mariano Sanz  2 , Federico Díaz-González  7   8
Affiliations
Observational Study

Association between periodontitis and anti-citrullinated protein antibodies in rheumatoid arthritis patients: a cross-sectional study

Jerián González-Febles et al. Arthritis Res Ther. .

Abstract

Aim: The aim of this study was to evaluate the association between periodontal parameters related with the periodontal disease severity and the presence and levels of anti-citrullinated protein antibodies (ACPAs) in rheumatoid arthritis (RA) patients.

Materials and methods: This cross-sectional study included 164 RA patients. Socio-demographics and RA disease characteristics, including ELISA-detected ACPA (anti-CCP-2), were recorded. Exposure was assessed by periodontal parameters: plaque index (PI), bleeding on probing (BoP), probing pocket depth, and clinical attachment levels (CAL). Presence and levels of ACPAs (outcome) and exposure variables were compared by both parametric and non-parametric tests and associations were evaluated by adjusted odds ratio (OR).

Results: A significant association was observed between the presence of anti-CCP antibodies and severity of periodontal outcomes such as the mean CAL (OR 1.483, p = 0.036), mean PI (OR 1.029, p = 0.012), and the number of pockets ≥ 5 mm (OR 1.021, p = 0.08). High anti-CCP antibodies levels were associated with mean CAL, mean PI, and number of pockets ≥ 5 mm with an OR of 1.593 (p = 0.043), 1.060 (p < 0.001), and 1.031 (p = 0.031), respectively. Furthermore, a significant increase of 4.45 U/mL in anti-CCP antibodies levels (p = 0.002) in RA patients was found for each pocket ≥ 5 mm after adjusting for age, gender, smoking, time of disease evolution, and RA activity.

Conclusions: In RA patients, the severity of periodontal conditions such as mean CAL, mean PI, and the number of pockets ≥ 5 mm were linearly associated with both the presence and levels of anti-CCP antibodies.

Keywords: ACPA; Rheumatoid arthritis; Rheumatoid factor; Severe periodontitis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Number of pockets > 5 mm in RA patients negative or positive (categorized in low, moderate, or high titers) for anti-CCP antibodies. Data represent mean and SE of each group
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