Systemic circulating inflammatory burden and periodontitis in adolescents

Objectives To analyze the association between systemic inflammatory burden of cardiovascular disease (CVD) risk and periodontitis in adolescents, including mediating pathways triggered by their common risk factors. Materials and methods Using a population-based sample study (n = 405) of Brazilian adolescents (17-18 years old), direct and mediation pathways triggered by Socioeconomic Status, Adiposity, Smoking, and Blood Pressure were modelled for the association between the Systemic Circulating Inflammatory Burden of CVD Risk (IL-1 beta, IL-6, IL-8, TNF-alpha) and the Initial Periodontitis (bleeding on probing (BoP), probing depth (PD) >= 4 mm, clinical attachment loss (CAL) >= 4 mm), both as continuous latent variables, using structural equation modeling. Sensitivity analysis was performed for the outcomes Gingivitis (visible plaque; BoP); Moderate Periodontitis (PD >= 5 mm and CAL >= 5 mm) and periodontitis (CDC-AAP case definition). Results Higher Systemic Circulating Inflammatory Burden of CVD Risk was directly associated with higher Initial Periodontitis (standardized coefficient [SC] = 0.178, P value < 0.001). Lower Socioeconomic Status (SC = - 0.022, P value = 0.015) and Smoking (SC = 0.030, P value = 0.021) triggered the Initial Periodontitis, mediated by Systemic Circulating Inflammatory Burden of CVD Risk. Sensitivity analysis showed a dose-response relationship between Systemic Circulating Inflammatory Burden of CVD Risk and Moderate Periodontitis (SC = 0.323, P value = 0.021). Conclusions Systemic Circulating Inflammatory Burden of CVD Risk appeared as an underlying mechanism of early periodontal breakdown in adolescents, also triggered by social vulnerability and smoking.

Automated summary

This study examined the association between systemic inflammatory burden of cardiovascular disease (CVD) risk and periodontitis in adolescents. The results showed that lower socioeconomic status and smoking triggered initial periodontitis, while systemic inflammatory burden of CVD risk played a mediating role. Sensitivity analysis revealed a dose-response relationship between systemic inflammatory burden of CVD risk and moderate periodontitis.