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Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: A randomized clinical trial
Author(s) -
Montero Eduardo,
López Mercedes,
Vidal Honorato,
Martínez María,
Virto Leire,
Marrero Jorge,
Herrera David,
Zapatero Antonio,
Sanz Mariano
Publication year - 2020
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14131
Subject(s) - medicine , c reactive protein , periodontitis , randomized controlled trial , body mass index , gastroenterology , placebo , metabolic syndrome , systemic inflammation , scaling and root planing , population , chronic periodontitis , inflammation , obesity , pathology , alternative medicine , environmental health
Aim To determine the impact of periodontal treatment on systemic markers of inflammation in patients with metabolic syndrome (MetS) and periodontitis. Materials and Methods In this parallel‐arm, double‐blind, randomized controlled clinical trial, 63 patients with MetS and severe periodontitis were randomly assigned to receive either intensive periodontal treatment (IPT; scaling and root planing plus azithromycin 500 mg every day for 3 days) or minimal periodontal treatment (MPT; supragingival professional mechanical plaque removal plus a placebo). The primary outcome was the impact of the tested interventions on high‐sensitivity C‐reactive protein (hs‐CRP) serum levels at 6 months. As secondary outcomes, differences in the levels of cytokines, markers of prothrombotic states, carbohydrate and lipid metabolism, as well as blood pressure, were measured at 3 and 6 months after therapy. Results The intention‐to‐treat population consisted of 63 subjects randomly assigned to either the MPT (n = 31) or the IPT (n = 32) group. At baseline, mean hs‐CRP was 3.9 mg/L (standard deviation [SD] = 2.9) and 3.9 mg/L (SD = 3.4), respectively, and no significant differences in cardiometabolic risk profiles were detected between the groups. Adjusting for baseline hs‐CRP, sex, age, smoking status and body mass index, hs‐CRP at 6 months was 1.2 mg/L (95% CI 0.4; 2.0; P = .004) lower in the IPT group than in the MPT group. In the secondary outcomes, significant reductions in IL‐1β, TNF‐α, HbA1c and blood pressure were observed in the IPT group at 3 months compared with the MPT group. Conclusion Effective periodontal treatment significantly reduced hs‐CRP after 6 months in patients with MetS and severe periodontitis. Periodontal therapy might be useful to reduce cardiovascular risk in these patients.