Cardioprotective Effect of Periodontal Therapy in Metabolic Syndrome: A Pilot Study in Indian Subjects

Background: Obesity, metabolic syndrome, and atherosclerosis are linked with an increased acute-phase response. Severe periodontal disease is associated with cardiovascular disease as sequelae of a systemic inflammatory response. Objective: The aim of this study was to assess changes in measures of systemic inflammation induced by periodontal therapy in periodontally diseased individuals with metabolic syndrome, compared to those induced in a systemically healthy group. Methods: A total of 31 subjects with chronic generalized periodontitis, including 16 subjects with metabolic syndrome (group A) and 15 systemically healthy subjects (group B), underwent nonsurgical periodontal therapy. Serum high-sensitivity C-reactive protein (hsCRP), total leukocyte count, and measures of lipid metabolism were measured at baseline and at 2 months after periodontal therapy. Baseline data for comparison was also obtained from 15 systemically and periodontally healthy individuals (group C). Results: Baseline periodontal parameters and serum CRP were significantly higher in group A than in group B. In group A, following periodontal therapy, a significant decrease was noted in mean serum CRP (3.28 +/- 1.4 mg/L to 2.6 +/- 1.5 mg/L), total leukocyte counts (8,322 +/- 1,888 cells/mm(3) to 6,361 +/- 1,426 cells/mm(3)), serum triglycerides (153.3 +/- 38 mg/dL to 121.0 +/- 28.57 mg/dL), along with a significant rise in serum high-density lipoprotein (HDL) (41.1 +/- 5.2 mg/dL to 44.37 +/- 6.7 mg/dL). In group B, changes in these parameters were not statistically significant. Mean serum low-density lipoprotein (LDL) and mean cholesterol levels did not change significantly in either group. Conclusions: Periodontal therapy produced significant modulation of serum hsCRP, total leukocytes, serum triglycerides, and HDL, and thus may benefit individuals affected with both metabolic syndrome and advanced periodontal disease.