Systemic metabolic signatures of oral diseases Summary Systemic metabolic signatures of oral diseases have rarely been investigated and prospective studies do not exist. We analyzed whether signs of current or past infectious/inflammatory oral diseases are associated with circulating metabolites . Two study populations were included: Health-2000 (n = 6,229) and Parogene (n = 452), a cohort of patients with an indication for coronary angiography. Health-2000 participants (n = 4116) provided follow-up serum samples 11 years after baseline. Serum concentrations of 157 metabolites were determined with a method based on nuclear magnetic resonance spectroscopy. Associations between oral parameters and metabolite concentrations were analyzed using linear regression models adjusted for age, sex, number of teeth, smoking, presence of diabetes, and education (Health-2000 only). The number of carious teeth presented positive associations with the diameter of low-density lipoproteins and pyruvate and citrate concentrations. Negative associations were found between caries and the degree of fatty acid (FA) unsaturation and the relative proportions of docosahexaenoic and omega-3 FAs. The number of root canal fillings was positively associated with very low density lipoprotein parameters, such as diameter, cholesterol, triglycerides, and particle number. The deeper periodontal pockets were positively associated with concentrations of cholesterol, triglycerides, pyruvate, leucine, valine, phenylalanine and acetylated glycoproteins and negatively with the diameter of high-density lipoproteins (HDL), the degree of unsaturation of FAs and the proportions relative omega-6 and polyunsaturated. FA. Bleeding on probing (BOP) was associated with higher concentrations of triglycerides and acetyl glycoproteins, as well as lower proportions of omega-3 and omega-6 fatty acids. Caries at baseline predicted alterations in apolipoprotein B-containing lipoproteins and HDL-related metabolites at follow-up, and both caries and BOP were associated with changes in HDL-related metabolites and omega-3 FAs. in the follow-up. Signs of current or past infectious/inflammatory oral diseases , especially periodontitis , were associated with metabolic profiles typical of inflammation. Oral diseases may represent a modifiable risk factor for chronic systemic inflammation and, therefore, cardiometabolic disorders. |
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Common oral infections, periodontal diseases and caries are associated with inflammatory metabolic profiles linked to an increased risk of cardiometabolic diseases, suggests a new study by an international team of researchers. Oral infections also predicted future adverse changes in metabolic profiles.
The association between oral infections and adverse metabolic profiles was observed in the Finland Health 2000/2011 and Parogene study cohorts.
"The observation is novel, as there are few studies relating extensive metabolic measures to oral infections, and no previous prospective studies exist," says Professor Pirkko Pussinen from the University of Eastern Finland.
Published in the Journal of Dental Research , the study also involved researchers from the University of Helsinki, the Karolinska Institute and the Medical University of Graz.
Progressive oral infections and inflammations (endodontic lesions and periodontitis) are known to be associated with an increased risk of cardiometabolic diseases. Although the mechanisms behind these associations are partially unclear, poor oral health is likely underpinning systemic inflammation.
The present study included 452 middle-aged and elderly Parogene patients and 6,229 participants from the Health-2000 population-based survey. In 2011, 4,116 Health-2000 participants provided a follow-up serum sample.
Serum concentrations of 157 metabolites reflecting the risk of chronic diseases, such as lipid and glucose metabolites, ketone bodies, and amino acids, were determined by an NMR spectroscopy method.
Parameters describing oral health status were collected at baseline in clinical and radiographic examinations. They included those that described periodontal status, such as bleeding on probing, periodontal probing depth, and alveolar bone loss. Caries-related parameters included root canal fillings, apical rarefactions, and caries lesions.
The study consists of a cross-sectional part that analyzes the association between metabolic measures with prevalent oral health, and a prospective part that examines whether oral infections predict the levels of metabolic measures at follow-up.
Periodontitis was especially linked to the prevalent inflammatory metabolic profile, and caries to future adverse metabolites .
Among 157 metabolic measures, increased periodontal probing depth was associated with 93, bleeding on probing with 88, and periodontal inflammation burden with 77 measures.
Among caries-related parameters, root canal fillings were associated with 47, inadequate root canal fillings with 27, and caries lesions with 8 metabolic measures. In prospective analyses, caries was associated with 30 metabolites and bleeding on probing with 8.
These metabolic measures were typical of inflammation, thus showing positive associations with the degree of fatty acid saturation and very low-density lipoprotein (VLDL) parameters, and negative associations with high-density lipoprotein (HDL) parameters.
"Oral infections may partly explain unhealthy lipid profiles," says Associate Professor Aino Salminen from the University of Helsinki.
Associate Professor Kåre Buhlin from Karolinska Institutet concludes: "Oral infections represent an important risk factor for systemic health. Importantly, they can be modified through early prevention and treatment."
Final message We conclude that oral disease signs related to caries and periodontitis are associated with non-beneficial metabolic profiles of an inflammatory nature. Due to the high prevalence of oral diseases in most populations, their role in the total inflammatory burden is important and they can lead to a deterioration in public health. Oral infectious/inflammatory diseases may represent a modifiable risk factor for chronic systemic inflammation and, therefore, cardiometabolic disorders. |
