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Systemic Metabolic Signatures of Oral Diseases
TAKE-HOME MESSAGE
- Systemic biomarkers for oral diseases are not well-studied or described. This study examined the systemic metabolic profiles of oral diseases in more than 6000 individuals and uncovered notable associations, such as the number of decayed teeth with the low-density lipoprotein diameter and deepened periodontal pockets with altered concentrations of cholesterol and triglycerides. The analysis, utilizing two distinct cohorts (Health-2000 and Parogene), provides insights into the potential systemic impact of oral health. However, the study's reliance on observational associations raises concerns about confounding variables, limiting the ability to establish causal relationships between oral diseases and systemic metabolic changes.
- Oral diseases, particularly periodontitis, may be linked to changes in metabolic profiles indicative of inflammation, suggesting that addressing oral health could contribute to reducing systemic chronic inflammation.
abstract
This abstract is available on the publisher's site.
Access this abstract nowSystemic metabolic signatures of oral diseases have been rarely 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: the population-based Health-2000 (n = 6,229) and Parogene (n = 452), a cohort of patients with an indication to coronary angiography. Health-2000 participants (n = 4,116) provided follow-up serum samples 11 y after the baseline. Serum concentrations of 157 metabolites were determined with a nuclear magnetic resonance spectroscopy-based method. The 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 (in Health-2000 only). The number of decayed teeth presented positive associations with low-density lipoprotein diameter and the concentrations of pyruvate and citrate. Negative associations were found between caries and the unsaturation degree of fatty acids (FA) and 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 number of particles. Deepened periodontal pockets were positively associated with concentrations of cholesterol, triglycerides, pyruvate, leucine, valine, phenylalanine, and glycoprotein acetyls and negatively associated with high-density lipoprotein (HDL) diameter, FA unsaturation degree, and relative proportions of omega-6 and polyunsaturated FAs. Bleeding on probing (BOP) was associated with increased concentrations of triglycerides and glycoprotein acetyls, as well as decreased proportions of omega-3 and omega-6 FAs. Caries at baseline predicted alterations in apolipoprotein B-containing lipoproteins and HDL-related metabolites in the 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 for inflammation. Oral diseases may represent a modifiable risk factor for systemic chronic inflammation and thus cardiometabolic disorders.
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Systemic Metabolic Signatures of Oral Diseases
J. Dent. Res. 2024 Jan 01;103(1)13-21, A Salminen, AM Määttä, P Mäntylä, J Leskelä, M Pietiäinen, K Buhlin, AL Suominen, S Paju, W Sattler, J Sinisalo, PJ PussinenFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The prevalence of oral diseases is high in most populations, and oral diseases are associated with systemic inflammation. Systemic inflammation and the presence of endotoxins in the blood have been shown to induce metabolic changes in the body. This prospective study was conducted to analyze metabolic biomarkers using nuclear magnetic resonance and evaluate their association with inflammatory oral diseases. The two large populations that were included had a total of 6681 participants. The oral parameters studied included carious lesions, periapical lesions, alveolar bone loss, periodontal probing depths, and bleeding on probing. The results indicated significant associations between oral diseases and an increased saturation degree of fatty acids, lower levels of omega-3 fatty acids, and increased levels of glycolysis-related metabolites, which are inflammatory in nature. Periodontal inflammation was shown to be associated with increased levels of glycoprotein acetyl (GlycA), which is a biomarker of systemic inflammation. Elevated levels of GlycA can reflect chronic inflammation and are associated with IL-6, C-reactive protein, and serum amyloid A levels. The authors concluded that both caries and periodontal disease have similar roles in promoting systemic inflammation by increasing the presence of circulating systemic proinflammatory mediators. The study's strengths included its large sample size and the similarity of the results between the two populations evaluated. This was despite the differences in their risk factors for cardiovascular disease. It was also noted that the metabolites measured can be influenced by factors such as diet, genetics, and medications. Overall, this study offers valuable information regarding the significant impact of inflammatory oral diseases on systemic inflammation.