Serum C-Reactive Protein values in Diabetics with Periodontal Disease

Objectives: A recent study showed that persons with coronary heart disease also had an increase in periodontal indicators, including alveolar bone loss, gingival bleeding, clinical attachment loss, and C-reactive protein, which are predictors of increased risk of cardiovascular disease. The purpose of this study was to evaluate C-reactive protein values in diabetic persons with periodontal disease.

Methods: We randomly selected 250 patients from the dental outpatient department of BIRDEM, a hospital for persons with diabetes. Each of the 250 patients completed a dental check-up that included a questionnaire survey and clinical examination of periodontal status, including gingival bleeding, and evaluation of gingival inflammation and oral mucosa, to determine the person's periodontal health and treatment needs. A blood sample was collected for C-reactive protein values.

Results: The C-reactive protein values of 61.2% in persons with diabetes are within the reference range (< 6 mg/L), and values of 38.8% in diabetic subjects are above the reference range (> 6 mg/L) for persons with periodontal disease. This relationship was found to be statistically significant (p < 0.016). Among the 250 participants, 82 males and 71 females were within the reference range (< 6 mg/L), and 33 males and 64 females were above the reference range (> 6 mg/L). Thus, females had higher C-reactive protein values, and this was also found to be statistically significant (p < 0.0025).

This study showed that there is a significant relationship between C-reactive protein values and periodontal disease in persons with diabetes, where more females having higher values. Chronic infections and inflammatory responses from diseases such as periodontitis may be the reason behind the initiation and progression of atherosclerosis.

Conclusion: There is an urgent need to identify and treat diabetic patients (because they are the high-risk group) with periodontal disease, to prevent coronary heart disease, but more studies with larger groups of patients are required to confirm this hypothesis.