Systemic circulating inflammatory burden and periodontitis in adolescents.

Abstract

OBJECTIVES\nTo analyze the association between systemic inflammatory burden of cardiovascular disease (CVD) risk and periodontitis in adolescents, including mediating pathways triggered by their common risk factors.\n\n\nMATERIALS AND METHODS\nUsing a population-based sample study (n = 405) of Brazilian adolescents (17-18 years old), direct and mediation pathways triggered by Socioeconomic Status, Adiposity, Smoking, and Blood Pressure were modelled for the association between the Systemic Circulating Inflammatory Burden of CVD Risk (IL-1β, IL-6, IL-8, TNF-α) and the Initial Periodontitis (bleeding on probing (BoP), probing depth (PD) ≥ 4 mm, clinical attachment loss (CAL) ≥ 4 mm), both as continuous latent variables, using structural equation modeling. Sensitivity analysis was performed for the outcomes Gingivitis (visible plaque; BoP); Moderate Periodontitis (PD ≥ 5 mm and CAL ≥ 5 mm) and periodontitis (CDC-AAP case definition).\n\n\nRESULTS\nHigher Systemic Circulating Inflammatory Burden of CVD Risk was directly associated with higher Initial Periodontitis (standardized coefficient [SC] = 0.178, P value < 0.001). Lower Socioeconomic Status (SC = - 0.022, P value = 0.015) and Smoking (SC = 0.030, P value = 0.021) triggered the Initial Periodontitis , mediated by Systemic Circulating Inflammatory Burden of CVD Risk . Sensitivity analysis showed a dose-response relationship between Systemic Circulating Inflammatory Burden of CVD Risk and Moderate Periodontitis (SC = 0.323, P value = 0.021).\n\n\nCONCLUSIONS\n Systemic Circulating Inflammatory Burden of CVD Risk appeared as an underlying mechanism of early periodontal breakdown in adolescents, also triggered by social vulnerability and smoking.\n\n\nCLINICAL RELEVANCE\nThe association between periodontitis and CVD in adulthood seems to establish much earlier in life than had been previously studied, giving impetus to preventive approaches focused on their common risk factors.