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Catecholamine Metabolites in Urine, as Chronic Stress Biomarkers, Are Associated With Higher Risk of Chronic Periodontitis in Adults
Author(s) -
Mesa Francisco,
MagánFernández Antonio,
Muñoz Ricardo,
PapayRamírez Lara,
Poyatos Rafael,
SánchezFernández Elena,
GalindoMoreno Pablo,
RodríguezBarranco Miguel
Publication year - 2014
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2014.140209
Subject(s) - metanephrine , medicine , periodontitis , metanephrines , saliva , normetanephrine , urine , urinary system , endocrinology , chronic periodontitis , creatinine , gastroenterology , pulpitis , dentistry , pulp (tooth)
Background: The purpose of this case–control study is to investigate the association between stress and periodontitis by determining stress biomarkers in saliva and urine and to determine whether oral hygiene, gingival inflammation, and tooth loss are correlated with stress biomarkers in patients with periodontitis. Methods: A total of 77 patients (41 cases [with periodontitis] and 36 controls) participated in this study. Periodontal examination findings included probing depth, clinical attachment loss, bleeding on probing (BOP), plaque index (PI), and tooth loss. Secretory immunoglobulin (sIg)A and cortisol were determined in saliva. Cortisol, creatinine‐adjusted cortisol, metanephrine, normetanephrine, and total metanephrines were measured in urine. Results: Urinary metanephrine ( P = 0.013) and total metanephrine ( P = 0.023) levels were higher in the case group. In cases, salivary cortisol was correlated with PI ( r = 0.464, P <0.01), BOP ( r = 0.401, P <0.05), and tooth loss ( r = 0.245, P <0.05). Urinary metanephrine levels above the median were associated with a 3.4‐fold higher risk of periodontitis (95% confidence interval [CI] = 1.1 to 10.2; P = 0.029), with an 82% increase in risk for each increment of 0.05 µg/24 hours. Urinary total metanephrine levels above the median were associated with a five‐fold higher risk of periodontitis (95% CI = 1.6 to 15.7; P = 0.006). Conclusions: The present results offer new evidence of the association between urinary concentrations of catecholamine metabolites (metanephrine and total metanephrines) and chronic periodontitis. Salivary IgA level showed no statistical difference between the cases and controls. Salivary cortisol levels in the patients with periodontitis were correlated with worse PI, higher gingival inflammation, and greater tooth loss.