Sincronicidade entre periodontite inicial e alterações vasculares incipientes ao final da segunda década de vida

Abstract

Periodontal disease (PD) and cardiovascular disease (CVD) have been associated in a bidirectional way in adulthood. However, both diseases are chronic and have a long period of latency, presenting a chain of progressive events until target organ failure, known as the periodontal continuum and the cardiovascular continuum. We hypothesized that the early events of the PD and CVD continuum would already be ongoing and synchronously in adolescents linked by the fractal pattern of vascular changes, and a relationship between early periodontal changes and incipient vascular changes is observable. Thus, we aimed to analyze the association between Initial Periodontitis and Vascular Risk Phenotype at the end of the second decade of life, using structural equation modeling. This is a population-based study, using data from the RPS birth cohort in the city of São Luis, Maranhao, and with cross-sectional analysis of follow-up at 18-19 years (n=2515). The theoretical model explored Initial Periodontitis and Vascular Risk Phenotype as outcomes, as well as the explanatory variables: socioeconomic status, smoking, risk of alcohol dependence, and obesity in model 1; and, adding adjustment for sex in model 2. The Vascular Risk Phenotype was a latent variable representing the shared variance between carotid-femoral pulse wave velocity, systolic blood pressure, and diastolic blood pressure. Initial Periodontitis a latent variable deduced from the shared variance between visible plaque index, bleeding on probing, clinical probing depth ≥4 millimeters (mm), and clinical attachment level ≥4mm. The Vascular Risk Phenotype and Initial Periodontitis were associated in the crude models (Standardized Coefficient - SC: 0.115; p-value<0.001) and in model 1 (SC=0.067; p=0.026); however, the association was lost when the model was adjusted for sex (SC=0.006; p=0.796). Higher socioeconomic status reduced the values of Initial Periodontitis (SC=-0.155; p<0.001) and Vascular Risk Phenotype (SC=-0.057; p=0.006); obesity increased the values of Initial Periodontitis (SC=0.112; p<0.001) and Vascular Risk Phenotype (SC=0.310; p<0.001); and smoking increased the values of Initial Periodontitis (SC=0.207; p=0.026). Initial periodontal collapse and incipient vascular abnormalities are explained by common causes and seem to occur as synchronous events in young people, affected by sexual dimorphisms. Thus, efforts to reduce the burden of chronic diseases, as Periodontal Disease and Cardiovascular Disease, should begin at early stages and be directed at controlling common risk factors.