Is There a Relationship Between Hyperlipidemia and Periodontitis?

The aim of present study is to investigate any relationship between hyperlipidemia and periodontal disease regarding the periodontal parameters and plasma lipid parameters, along with age, gender, brushing habit, body mass index, dietary habit, physical activity, alcohol consumption.

In this cross sectional study, a total of 160 individuals were divided into two groups based on their metabolic status: hyperlipidemic group (n=97) and normolipidemic group (n=63). Plaque index, gingival index, bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL) clinical parameters and community periodontal index of treatment needs (CPITN) scores were measured. Triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) levels had been determined previously during individuals routine systemic examinations. Daily brushing habits and interdental cleaning together with dietary habits, alcohol consumption and physical activity levels were also recorded.

Study Overview

• Status: Completed
• Conditions: Hyperlipidemia, Periodontal Disease
• Intervention / Treatment: Other: No intervention was applied

• Study Type: Observational
• Enrollment (Actual): 160

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 35 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

A total of 240 subjects were examined among patients who attended to the Department of Periodontology, Marmara University or the Turkish Heart Foundation and had their plasma lipid values determined within the last 3 months. Out of 240, 160 subjects (57 male, 103 female, age range 35-65 years) eligible for this study were selected.

Description

Inclusion Criteria:

• Subjects having no periodontal treatment within previous 6 months,
• number of natural teeth ≥ 10,
• no history of cancer and systemic disease that affects lipid levels or periodontium,
• no history of medical treatment for hyperlipidemia, BMI< 30 kg/m2,
• no pregnancy,
• no history of systemic antibiotic treatment within previous 3 months,
• no smoking.

Exclusion Criteria:

• patients with history of systemic disease that affects lipid metabolism or periodontal disease
• history of medical treatment for hyperlipidemia
• pregnancy, lactation or hormone replacement therapy at the time of study
• use of any other drug known to affect lipid metabolism or periodontal disease
• systemic infection or any history of systemic antibiotic treatment in previous 3 months
• smokers as well as ex-smokers

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
HP+; Subjects with plasma Triglyceride or Total cholesterol levels > 200 mg/dl and low density lipoprotein-cholesterol levels > 130 mg/dl were included in the hyperlipidemic group and having periodontitis which were further evaluated for clinical periodontal parameters as well as to define the effects of the patient's habits on plasma lipid levels.	Other: No intervention was applied; No intervention was applied
HP-; Subjects with plasma Triglyceride or Total cholesterol levels > 200 mg/dl and low density lipoprotein-cholesterol levels > 130 mg/dl were included in the hyperlipidemic group and do not have periodontitis which were further evaluated for clinical periodontal parameters as well as to define the effects of the patient's habits on plasma lipid levels.	Other: No intervention was applied; No intervention was applied
NP+; Subjects with plasma Triglyceride or Total cholesterol levels < 200 mg/dl and low density lipoprotein-cholesterol levels < 130 mg/dl were included in the normolipidemic group and having periodontitis which were further evaluated for clinical periodontal parameters as well as to define the effects of the patient's habits on plasma lipid levels.	Other: No intervention was applied; No intervention was applied
NP-; Subjects with plasma Triglyceride or Total cholesterol levels < 200 mg/dl and low density lipoprotein-cholesterol levels < 130 mg/dl were included in the normolipidemic group and do not have periodontitis which were further evaluated for clinical periodontal parameters as well as to define the effects of the patient's habits on plasma lipid levels.	Other: No intervention was applied; No intervention was applied

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Triglyceride (TG)	Subjects with plasma TG or TC levels > 200 mg/dl and LDL-C levels > 130 mg/dl were included in the hyperlipidemic group, while the normolipidemic group comprised of patients with plasma TG or TC levels below the aforementioned limits	day 0
Total cholesterol (TC)	Subjects with plasma TG or TC levels > 200 mg/dl and LDL-C levels > 130 mg/dl were included in the hyperlipidemic group, while the normolipidemic group comprised of patients with plasma TG or TC levels below the aforementioned limits	day 0
Low density lipoprotein cholesterol (LDL-C)	Subjects with plasma TG or TC levels > 200 mg/dl and LDL-C levels > 130 mg/dl were included in the hyperlipidemic group, while the normolipidemic group comprised of patients with plasma TG or TC levels below the aforementioned limits	day 0

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Plaque index	The measurement of the state of oral hygiene based on recording dental plaque accumulation	day 0
Gingival index	An assessment level of gingival health and inflammation	day 0
Bleeding on probing	A sign of gingival inflammation were assessed on the buccal, lingual, mesial and distal sites of each tooth	day 0
Probing depth	The distance from the gingival margin to bottom of the pocket with using 0.5 mm diameter periodontal probe at mesiobuccal, midbuccal, distobuccal, distolingual, midlingual and mesiolingual sites of each tooth	day 0
Clinical attachment level	The distance between the cemento-enamel junction and bottom of the pocket	day 0
Community Periodontal Index of Treatment Needs score	These scores are used to represent healthy periodontium, bleeding after probing, dental calculus detected by probing, 4-5 mm deep pockets and deep pockets ≥ 6 mm, respectively.	day 0

Collaborators and Investigators

• Sponsor: Marmara University
• Investigators: Principal Investigator: Gülin Tulu Katı, PhD, Periodontist in Private Practice., Istanbul, Turkey. (E-mail: gulintulu@gmail.com); Study Chair: Ülkü Noyan, Prof. Dr., Periodontist in Private Practice., Istanbul, Turkey. (E-mail: noyanulku@yahoo.com); Study Chair: Bahar Kuru, Prof. Dr., Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey. (E-mail: baharkuru@gmail.com); Study Director: Leyla Kuru, Prof. Dr., Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey. (E-mail: lkuru@marmara.edu.tr); Study Chair: Ömer Birkan Ağralı, PhD, Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey. (omer.agrali@marmara.edu.tr); Study Chair: Hatice Selin Yıldırım, PhD, Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey. (Email: yildirimselin@hotmail.com)

Study record dates

Study Major Dates

• Study Start: January 1, 2014
• Primary Completion (Actual): January 1, 2016
• Study Completion (Actual): March 1, 2016

Study Registration Dates

• First Submitted: June 29, 2016
• First Submitted That Met QC Criteria: July 5, 2016
• First Posted (Estimate): July 11, 2016

Study Record Updates

• Last Update Posted (Estimate): July 11, 2016
• Last Update Submitted That Met QC Criteria: July 5, 2016
• Last Verified: July 1, 2016

More Information

Terms related to this study

• Keywords: Hyperlipidemia; HDL cholesterol; LDL cholesterol; Triglyceride; Periodontal disease
• Additional Relevant MeSH Terms: Metabolic Diseases; Stomatognathic Diseases; Mouth Diseases; Lipid Metabolism Disorders; Dyslipidemias; Periodontitis; Hyperlipidemias; Periodontal Diseases; Hyperlipoproteinemias
• Other Study ID Numbers: MIHS-25