Serum Inflammatory and Prooxidant Marker Levels in Different Periodontal Disease Stages

Abstract

Background: Periodontitis has been associated to systemic diseases and this association could be due to an increase in circulating inflammatory and oxidative stress biomarkers in the periodontal disease. This study aimed to evaluate the relationship between inflammatory and pro-oxidant markers according to different stages of periodontitis.

Methods: This cross-sectional study included 70 subjects who were divided into three groups according to periodontitis stage: stage II (n = 22), stage III (n = 30), and stage IV (n = 18). We evaluated periodontal parameters and levels of high-sensitivity C-reactive protein (hsCRP), fibrinogen, and malondialdehyde (MDA) in serum, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in urine.

Results: Serum hsCRP and fibrinogen levels were associated with periodontitis severity, which were higher in stage IV than in stages III and II of periodontitis (p = 0.003 and p = 0.025, respectively). We observed a slight yet insignificant increase in MDA levels related to periodontitis severity. Probing depth and clinical attachment loss were associated with serum fibrinogen and hsCRP levels. However, there were no significant associations between periodontal variables and MDA and 8-OHdG levels.

Conclusion: Our data support an association between periodontitis and systemic inflammation, which increases with periodontal disease severity. This indicates the importance of the early diagnosis and treatment of periodontal disease to avoid the development or worsening of systemic inflammatory diseases.

Keywords: 8-hydroxy-2′-deoxyguanosine; inflammation; malondialdehyde; oxidative stress; periodontal diseases; periodontitis.

Figure 1

Study population inflammatory and oxidative stress parameters according to periodontitis stages. Serum high-sensitivity C-reactive protein (A), fibrinogen (B) and malondialdehyde (C), and urine 8-hydroxy-2′-deoxyguanosine (D) levels. Notes: hsCRP, high-sensitive C-reactive protein; MDA, malondialdehyde; and 8-OHdG, 8-hydroxy-2′-deoxyguanosine. Data are presented as mean ± standard error. Values with different superscript letters (a and b) were significantly different (p < 0.05) when the data of patients with different periodontitis stages were compared using a one-way analysis of variance followed by a Student–Newman–Keuls post-hoc test. Hence, means with the same superscript letters are not significantly different (p > 0.05), while means with no superscript letters in common are significantly different (p < 0.05).