Examination of the relation between periodontal health status and cardiovascular risk factors: Serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen

Using data from the Third National Health and Nutrition Examination Survey (1988-1994), the authors examined the relation between periodontal health a nd cardiovascular risk factors: serum total and high density lipoprotein ch olesterol, C-reactive protein, and plasma fibrinogen. A total of 10,146 par ticipants were included in the analyses of cholesterol and C-reactive prote in and 4,461 in the analyses of fibrinogen. Periodontal health indicators i ncluded the gingival bleeding index, calculus index, and periodontal diseas e status (defined by pocket depth and attachment loss). While cholesterol a nd fibrinogen were analyzed as continuous variables, C-reactive protein was dichotomized into two levels. The results show a significant relation betw een indicators of poor periodontal status and increased C-reactive protein and fibrinogen. The association between periodontal status and total choles terol level is much weaker. No consistent association between periodontal s tatus and high density lipoprotein cholesterol was detectable. Similar patt erns of association were observed for participants aged 17-54 years and tho se 55 years and older. In conclusion, this study suggests that total choles terol, C-reactive protein, and fibrinogen are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.