Relevance of Dyslipidaemia and its Consequences in Periodontal Patients with Co-Existing Cardiovascular Disease and Diabetes Mellitus: Therapeutic Targets
Affiliation: Periodontology, King's College London Dental Institute, Denmark Hill, London SE5 9RW, UK.
Keywords: Periodontology, inflammation, periodontal pathogens, high density / low density lipoproteins, hyperglycaemia, dyslipidaemia, pathological mechanisms, therapeutic targets
This review addresses the relevance of the consequences of dyslipidaemia amongst patients with diabetes mellitus, cardiovascular and periodontal diseases. Significant presentation of periodontal disease amongst poorly controlled diabetics with cardiovascular complications is an important area for a coordinated therapeutic approach. The pro-inflammatory cycle of events initiated by plaque biofilm generates a similar sequence of events that leads to destruction of the supporting structures of the periodontium. The features of metabolic syndrome and type 2 diabetes mellitus in periodontal patients constitute risk factors for cardiovascular disease with common risk markers such as IL-6, TNF-α, C-reactive protein and low density lipoprotein; the inflammatory burden imposed by periodontal disease contributes to endothelial dysfunction common to both diabetes mellitus and cardiovascular disease. It is relevant that management of periodontal disease leads to significant reduction in pro-inflammatory cytokines and acute phase proteins associated with endothelial dysfunction and cardiovascular pathology. In addition to reducing the inflammatory burden simultaneous control of metabolic factors affecting lipid metabolism appears to be significant for optimal therapeutic benefit. The potential contribution of periodontal disease to mortality and morbidity arising from systemic diseases warrants a stringent approach to its management. This article includes an appraisal of patents and patent applications that explores therapeutic strategy for dyslipidaemia, cardiovascular disease and diabetes mellitus in periodontal patients.
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