Periodontal Bacteria and Novel Systemic Inflammatory Markers in INVEST

Objective: To investigate the relationship between periodontal bacterial colonization and novel inflammatory markers relevant to incident coronary artery disease.

Methods: The Oral Infections and Vascular Disease Epidemiology Study(INVEST) enrolled subjects aged ≥55 years, in northern Manhattan. Participants in the current analysis (n=598) were 60% female, tri-ethnic (58% Hispanic, 22% Black, 18% White, 2% other) with mean age (±SD) 69±9). In the two most posterior teeth/quadrant eleven periodontal microbes were quantified from dental plaques (n=4,866) in 8 sites/mouth (mesio-lingual in the maxilla and mesio-buccal in the mandible) using DNA-DNA checkerboard hybridization. Secretory-phospholipase A2 (s-PLA2) activity and lipoprotein-associated PLA2 (Lp-PLA2) was assessed systemically from stored plasma samples. We examined the cross-sectional relationship between Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia and both s-PLA2 activity and Lp-PLA2 activity. A standardized bacterial burden score was computed by: 1) ln transforming laboratory derived bacterial values; and 2) dividing values for each individual bacteria and person, by the population standard deviation for that bacteria. Etiologic burden (EB) was defined by summing standardized values across the four bacteria and represents the absolute combined level of these species, equating standard deviation units (SDU) across bacteria. In separate analyses, we used ANOVA to assess levels of s-PLA2 or Lp-PLA2 across EB tertiles. Analyses were adjusted for age, gender, race/ethnicity, education, diabetes, smoking, systolic blood pressure, HDL-cholesterol and LDL-cholesterol.

Results: Mean EB was 32±4 SDU and mean s-PLA2 activity and Lp-PLA2 activity values were 0.76±0.56 nmol/min/ml and 30.4±10.9 nmol/min/ml, respectively. s-PLA2 values increased across tertiles of EB, as follows: T1=0.71±0.05, T2=0.74±0.04, T3=0.83±0.05 nmol/min/ml (p for trend=0.12). Lp-PLA2 values were: T1=29.4±0.9, T2=29.1±0.74, T3=32.9 nmol/min/ml (p for trend=0.04).

Conclusion: Bacteria believed to be important contributors to clinical periodontal disease are positively associated with novel inflammatory markers recently shown to have prognostic value for incident coronary artery disease.

Support: NIH-R01DE-13094, InsermR05115DD