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Multiple risk factor clustering syndrome (diabetes, dyslipidemia, hypertension, and obesity) is characterized by an increased risk of ischemic heart events, such as myocardial infarction. In this case report, we describe the clinical course of a patient suffering from severe periodontitis with the multiple risk factor clustering syndrome, whose blood glucose control was improved following periodontal treatment, but who developed myocardial infarction and stroke, and then heart failure, during supportive periodontal treatment (SPT). The purpose of the present case report is to discuss the influence of periodontal disease on the systemic health in such subjects based on our clinical observations. The patient was a 62-year old woman. Who had been suffering from type 2 diabetes, dyslipidemia, hypertension and presented to us with severe periodontitis. At her first visit to us, her glycemic control was very poor. The serum IgG antibody titer to Porphyromonas gingivalis (Pg) was higher than the mean titer in healthy subjects plus two standard deviations. Her body mass index was 21.3 kg/m2. There was no evidence of diabetic complications at this time. Based on our examinations, we diagnosed her as having severe periodontitis associated with insulin resistance (diabetes). Our treatment goal was thorough removal of infection from the periodontal pockets. Following treatment, the antibody titer to Pg, and the glycosylated hemoglobin value decreased, as other clinical parameters improved. However, the subject developed acute myocardial infarction during the SPT period, which was followed by relapse of the periodontitis 連絡先:高柴正悟 〒 700-8525 岡山市鹿田町 2-5-1 岡山大学大学院医歯薬学総合研究科病態制御科学専攻病態機構学講座歯周病態学分野 Shogo Takashiba Department of Pathophysiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences 2-5-1 Shikata-cho, Okayama 700-8525, Japan E-mail stakashi@cc.okayama-u.ac.jp 61

A Clinical Case of Chronic Periodontitis with the Multiple Risk Factor Syndrome