Vitamin D receptor alleles, periodontal disease progression, and tooth loss in the VA dental longitudinal study

Background: The relationship between the vitamin D receptor (VDR) genotype and periodontal disease is not known. This study compared periodontal disease progression among poly-morphisms of 2 VDR genes in men in the VA Dental Longitudinal Study. Methods: Subjects were 125 medically healthy, middle-aged men who had serial oral examinations over a mean 23-year period. Probing depth, gingival bleeding on probing, clinical attachment loss (CAL), and alveolar bone loss (ABL) from radiographs were measured at each examination. Progression of periodontal disease was defined as the percentage of teeth per decade that increased ABL by greater than or equal to40%, and the percentage of teeth per decade that developed CAL greater than or equal to5 mm. Apal and Taql polymorphisms were determined from buffy coat cells following polymerase chain reaction (PCR) amplification. Mean changes in oral status were adjusted for baseline values of smoking status, number of teeth present, and periodontal status by analysis of covariance. Results: Genotype distributions were 41 AA, 58 Aa, 26 aa; and 53 TT, 46 Tt, 26 tt. The AA genotype showed the highest rates of progression of ABL (5 +/- 1% versus 1 +/- 1% and 2 +/- 1% teeth in Aa and aa, respectively; P = 0.03), CAL (37 +/- 4% versus 17 +/- 4% and 27 +/- 6% teeth; P = 0.004), and tooth loss (2 +/- 0.3 versus 1 +/- 0.3 and 1 +/- 0.4 teeth; P= 0.04). When genotype combinations were examined, progression of ABL, CAL, and tooth loss was highest in the AATT and AATt genotypes. Conclusions: The Apal polymorphism of the VDR gene is associated with oral bone loss, clinical attachment loss, and tooth loss in older men. Analysis of the VDR alleles may prove useful for predicting periodontal disease.