Pejcic Ana, Kesic Ljiljana, Brkic Zlata, Pesic Zoran, Mirkovic Dimitrije
Department of Periodontology and Oral Medicine, Dental Clinic, Medical Faculty, University of Nis, Nis, Serbia.
South Med J. 2011 Aug;104(8):547-52. doi: 10.1097/SMJ.0b013e3182242eaa.
Recent epidemiological studies have shown that individuals with periodontitis have a significantly increased risk of developing coronary heart disease. In addition to conventional risk factors, dyslipidemia may be associated with this increased risk.
We measured concentration of lipids in patients with moderate to severe periodontitis before and 3, 6 and 12 months after local periodontal treatment. A total of 50 participants with periodontitis and 25 participants without periodontitis were included in the analyses. Lipoproteins were measured by using serological analyses of the Central Biochemical Laboratory in Clinical Center in Nis. Periodontal health indicators included the plaque index, gingival bleeding index, and periodontal disease status (defined by pocket depth and attachment loss). Patients were non-surgically treated with mechanical debridement of calculus once a week for 1 month.
The results show a significant relation between indicators of poor periodontal status and serum level lipoproteins. Periodontal therapy resulted in a significant reduction of local inflammation and tissue destruction as reflected in reduced pocket depth and reduced bleeding indices. The levels of lipoproteins after therapy seemed to be lower than those reported before treatment in patients with periodontitis compared with healthy ones. Lipoproteins were significantly decreased after treatment (P < 0.005) except high-density lipoprotein cholesterol which was not significantly reduced (P > 0.05).
This pilot study shows that periodontal disease significantly affects the serum levels of lipoproteins and suggests that following successful periodontal treatment decreases serum lipid concentration. This study suggests also that lipoproteins are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.
近期的流行病学研究表明，患有牙周炎的个体患冠心病的风险显著增加。除了传统的风险因素外，血脂异常可能与这种风险增加有关。
我们测量了中重度牙周炎患者在局部牙周治疗前以及治疗后3个月、6个月和12个月时的血脂浓度。共有50名牙周炎患者和25名无牙周炎患者纳入分析。血脂蛋白通过塞尔维亚尼斯临床中心中央生化实验室的血清学分析进行测量。牙周健康指标包括菌斑指数、牙龈出血指数和牙周疾病状况（由牙周袋深度和附着丧失定义）。患者每周接受一次非手术机械清除牙结石治疗，为期1个月。
结果显示牙周状况不佳的指标与血清脂蛋白水平之间存在显著关联。牙周治疗导致局部炎症和组织破坏显著减轻，这体现在牙周袋深度减小和出血指数降低。与健康患者相比，牙周炎患者治疗后的脂蛋白水平似乎低于治疗前报告的水平。除高密度脂蛋白胆固醇未显著降低（P>0.05）外，治疗后脂蛋白水平显著降低（P<0.005）。
这项初步研究表明，牙周疾病显著影响血清脂蛋白水平，并表明成功的牙周治疗后血清脂质浓度降低。这项研究还表明，脂蛋白可能是将牙周疾病与心血管风险升高联系起来的潜在中间因素。
