Association of simvastatin and hyperlipidemia with periodontal status and bone metabolism markers

J Periodontol. 2014 Oct;85(10):1408-15. doi: 10.1902/jop.2014.130652. Epub 2014 Feb 21.

Abstract

Background: The objective of this study is to determine whether simvastatin consumption and hyperlipidemia are associated with a worse periodontal condition and specific bone activity biomarkers.

Methods: This cross-sectional and analytic study includes 73 patients divided into three groups: 1) simvastatin-treated patients with hyperlipidemia (n = 29); 2) patients with hyperlipidemia treated by diet alone (n = 28); and 3) normolipidemic patients (controls, n = 16). The periodontal clinical variables of all participants were gathered, a blood sample was drawn from each to determine the lipid profile (total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein), serum levels of acute-phase reactants (C-reactive protein), erythrocyte sedimentation rate, and bone metabolism markers (osteoprotegerin [OPG], osteocalcin, procollagen type I N-terminal propeptide, and C-terminal telopeptide of type I collagen).

Results: The mean ESR was higher in the diet-treated patients with hyperlipidemia than in the normolipidemic controls (P = 0.04). Serum OPG concentrations were significantly higher in the simvastatin-treated patients with hyperlipidemia than in the diet-treated patients with hyperlipidemia (P = 0.05). Multivariable linear regression analysis adjusted for age, sex, tobacco, and alcohol revealed that, compared with the normolipidemic patients, the simvastatin-treated patients with hyperlipidemia showed a mean reduction of 0.8 mm (95% confidence interval = -1.5 to 0.0, P = 0.05) in clinical attachment loss.

Conclusions: Within the limits of this study, the findings suggest that the intake of simvastatin is associated with increasing serum OPG concentrations, and this could have a protective effect against bone breakdown and periodontal attachment loss. The baseline systemic inflammatory state of patients with hyperlipidemia is indicated by their increased erythrocyte sedimentation rate.

Keywords: Lipid metabolism disorders; osteoprotegerin; periodontitis; simvastatin.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking
  • Biomarkers / analysis
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Collagen Type I / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hyperlipidemias / diet therapy
  • Hyperlipidemias / drug therapy*
  • Hypolipidemic Agents / therapeutic use*
  • Male
  • Middle Aged
  • Osteocalcin / blood
  • Osteoprotegerin / blood
  • Peptide Fragments / blood
  • Peptides / blood
  • Periodontal Attachment Loss / classification
  • Periodontal Index*
  • Procollagen / blood
  • Simvastatin / therapeutic use*
  • Smoking
  • Triglycerides / blood

Substances

  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Collagen Type I
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents
  • Osteoprotegerin
  • Peptide Fragments
  • Peptides
  • Procollagen
  • Triglycerides
  • collagen type I trimeric cross-linked peptide
  • procollagen Type I N-terminal peptide
  • Osteocalcin
  • C-Reactive Protein
  • Cholesterol
  • Simvastatin