To address whether periodontal disease indexes are associated with urinary albumin-to-creatinine
ratio (UACR) in conditions of high and low systemic inflammation as reflected by levels
of high-sensitivity C-reactive protein (hs-CRP) in untreated hypertensive patients,
we studied 242 hypertensive patients 51 ± 9 years old (24-hour systolic/diastolic
blood pressure [BP] 132 ± 10/83 ± 8 mm Hg) with varying severity of periodontal disease
evaluated by 3 periodontal disease indexes (PDIs) (i.e., mean clinical loss of attachment,
maximum probe depth, and gingival bleeding index). Patients underwent BP measurements,
echocardiography, and periodontal examination, and from fasting blood samples we assessed
metabolic profile and hs-CRP. From 2 nonconsecutive overnight spot urine samples we
evaluated UACR. With respect to median hs-CRP and UACR levels (1.67 mg/L and 10 mg/g,
respectively), the total population was divided into patients with low-UACR/low–hs-CRP
(n = 65), low-UACR/high–hs-CRP (n = 63), high-UACR/low–hs-CRP (n = 51), and high-UACR/high–hs-CRP
(n = 63). PDIs differed among the 4 groups, and those with high UACR had significantly
higher 24-hour systolic BP compared to those with low UACR. UACR was determined by
all periodontal disease indexes, hs-CRP, and the interaction of each periodontal disease
index with hs-CRP. In addition, mean clinical loss of attachment was the strongest
determinant of the high-UACR/high–hs-CRP pattern among all studied periodontal disease
indexes. In conclusion, in untreated middle-aged hypertensive patients, periodontal
disease indexes and hs-CRP have a synergistic effect on UACR levels independently
of the underlying hemodynamic load.
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Article Info
Publication History
Accepted:
August 21,
2010
Received in revised form:
August 21,
2010
Received:
July 16,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
