Comparison of serum amyloid A protein and C-reactive protein levels as inflammatory markers in periodontitis
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Purpose: The purpose of this study was to compare serum amyloid A (SAA) protein levelswith high-sensitive C-reactive protein (hs-CRP) levels as markers of systemic inflammationin patients with chronic periodontitis. The association of serum titers of antibodies to periodontalmicrobiota and SAA/hs-CRP levels in periodontitis patients was also studied. Methods: A total of 110 individuals were included in this study. Patients were assessed forlevels of hs-CRP and SAA. Nonfasting blood samples were collected from participants atthe time of clinical examination. The diagnosis of adipose tissue disorders was made accordingto previously defined criteria. To determine SAA levels, a sandwich enzyme-linkedimmunosorbent assay was utilized. Paper points were transferred to a sterile tube to obtaina pool of samples for polymerase chain reaction processing and the identification of Porphyromonasgingivalis, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia. The serum level of IgG1 and IgG2 antibodies to P. gingivalis, A. actinomycetemcomitans,and T. forsythia was also determined. Results: SAA and hs-CRP levels were higher in periodontitis patients than in controls(P<0.05). In bivariate analysis, high levels of hs-CRP (>3 mg/L) and SAA (>10 mg/L) weresignificantly associated with chronic periodontitis (P=0.004). The Spearman correlationanalysis between acute-phase proteins showed that SAA positively correlated with hs-CRP(r=0.218, P=0.02). In the adjusted model, chronic periodontitis was associated with highlevels of SAA (odds ratio [OR], 5.5; 95% confidence interval [CI], 1.6–18.2; P=0.005) andelevated hs-CRP levels (OR, 6.1, 95% CI, 1.6–23.6; P=0.008). Increased levels of serum IgG2antibodies to P. gingivalis were associated with high levels of SAA (OR, 3.6; 95% CI, 1.4–8.5;P=0.005) and high concentrations of hs-CRP (OR, 4.3; 95% CI, 1.9–9.8; P<0.001). Conclusions: SAA and hs-CRP concentrations in patients with chronic periodontitis arecomparably elevated. High serum titers of antibodies to P. gingivalis and the presence ofperiodontal disease are independently related to high SAA and hs-CRP levels.
Abstract
Purpose: The purpose of this study was to compare serum amyloid A (SAA) protein levelswith high-sensitive C-reactive protein (hs-CRP) levels as markers of systemic inflammationin patients with chronic periodontitis. The association of serum titers of antibodies to periodontalmicrobiota and SAA/hs-CRP levels in periodontitis patients was also studied. Methods: A total of 110 individuals were included in this study. Patients were assessed forlevels of hs-CRP and SAA. Nonfasting blood samples were collected from participants atthe time of clinical examination. The diagnosis of adipose tissue disorders was made accordingto previously defined criteria. To determine SAA levels, a sandwich enzyme-linkedimmunosorbent assay was utilized. Paper points were transferred to a sterile tube to obtaina pool of samples for polymerase chain reaction processing and the identification of Porphyromonasgingivalis, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia. The serum level of IgG1 and IgG2 antibodies to P. gingivalis, A. actinomycetemcomitans,and T. forsythia was also determined. Results: SAA and hs-CRP levels were higher in periodontitis patients than in controls(P<0.05). In bivariate analysis, high levels of hs-CRP (>3 mg/L) and SAA (>10 mg/L) weresignificantly associated with chronic periodontitis (P=0.004). The Spearman correlationanalysis between acute-phase proteins showed that SAA positively correlated with hs-CRP(r=0.218, P=0.02). In the adjusted model, chronic periodontitis was associated with highlevels of SAA (odds ratio [OR], 5.5; 95% confidence interval [CI], 1.6–18.2; P=0.005) andelevated hs-CRP levels (OR, 6.1, 95% CI, 1.6–23.6; P=0.008). Increased levels of serum IgG2antibodies to P. gingivalis were associated with high levels of SAA (OR, 3.6; 95% CI, 1.4–8.5;P=0.005) and high concentrations of hs-CRP (OR, 4.3; 95% CI, 1.9–9.8; P<0.001). Conclusions: SAA and hs-CRP concentrations in patients with chronic periodontitis arecomparably elevated. High serum titers of antibodies to P. gingivalis and the presence ofperiodontal disease are independently related to high SAA and hs-CRP levels.
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