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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (1): 45-50. doi: 10.19723/j.issn.1671-167X.2024.01.008

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Changes of parameters associated with anemia of inflammation in patients with stage Ⅲ periodontitis before and after periodontal initial therapy

Chang SHU,Ye HAN,Yuzhe SUN,Zaimu YANG,Jianxia HOU*()   

  1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2023-10-11 Online:2024-02-18 Published:2024-02-06
  • Contact: Jianxia HOU E-mail:jxhou@163.com
  • Supported by:
    the National Natural Science Foundation of China(82071117);the Beijing Natural Science Foundation(7212136)

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Abstract:

Objective: To investigate the differences and similarities of parameters associated with anemia of inflammation between patients with stage Ⅲ periodontitis and periodontally healthy volunteers, and to explore the influence of periodontal initial therapy on those indicators. Methods: Patients with stage Ⅲ periodontitis and periodontally healthy volunteers seeking periodontal treatment or prophylaxis at Department of Periodontology, Peking University School and Hospital of Stomatology from February 2020 to February 2023 were enrolled. Their demographic characteristics, periodontal parameters (including probing depth, clinical attachment loss, bleeding index), and fasting blood were gathered before periodontal initial therapy. Three months after periodontal initial therapy, the periodontal parameters of the patients with stage Ⅲ periodontitis were re-evaluated and their fasting blood was collected again. Blood routine examinations (including white blood cells, red blood cells, hemoglobin, packed cell volume, mean corpuscular volume of erythrocytes, and mean corpuscular hemoglobin concentration) were performed. And ferritin, hepcidin, erythropoietin (EPO) were detected with enzyme-linked immunosorbent assay (ELISA). All data analysis was done with SPSS 21.0, independent sample t test, paired t test, and analysis of covariance were used for comparison between the groups. Results: A total of 25 patients with stage Ⅲ periodontitis and 25 periodontally healthy volunteers were included in this study. The patients with stage Ⅲ periodontitis were significantly older than those in periodontally healthy status [(36.72±7.64) years vs. (31.44±7.52) years, P=0.017]. The patients with stage Ⅲ periodontitis showed lower serum hemoglobin [(134.92±12.71) g/L vs. (146.52±12.51) g/L, P=0.002] and higher serum ferritin [(225.08±103.36) μg/L vs. (155.19±115.38) μg/L, P=0.029], EPO [(41.28±12.58) IU/L vs. (28.38±10.52) IU/L, P < 0.001], and hepcidin [(48.03±34.44) μg/L vs. (27.42±15.00) μg/L, P=0.009] compared with periodontally healthy volunteers. After adjusting the age with the covariance analysis, these parameters (hemoglobin, ferritin, EPO, and hepcidin) showed the same trends as independent-sample t test with statistical significance. Three months after periodontal initial therapy, all the periodontal parameters showed statistically significant improvement. The serum hemoglobin raised [(146.05±15.48) g/L vs. (133.77± 13.15) g/L, P < 0.001], while the serum ferritin [(128.52±90.95) μg/L vs. (221.22±102.15) μg/L, P < 0.001], EPO [(27.66±19.67) IU/L vs. (39.63± 12.48) IU/L, P=0.004], and hepcidin [(32.54±18.67) μg/L vs. (48.18±36.74) μg/L, P=0.033] decreased compared with baseline. Conclusion: Tendency of iron metabolism disorder and anemia of inflammation was observed in patients with stage Ⅲ periodontitis, which can be attenuated by periodontal initial therapy.

Key words: Periodontitis, Anemia of inflammation, Iron metabolism, Periodontal diseases

CLC Number: 

  • R781.4

Table 1

Demographics of participants"

Items Control Stage Ⅲ periodontitis P
Age/years, ${\bar x}$±s 31.44±7.52 36.72±7.64 0.017
Gender, n
  Male 13 14 0.777
  Female 12 11
PD/mm, ${\bar x}$±s 1.56±0.68 4.71±0.95 < 0.001
BI, ${\bar x}$±s 1.12±0.52 3.44±0.57 < 0.001
CAL/mm, ${\bar x}$±s 0 4.27±0.98 < 0.001

Table 2

Fasting blood examinations of patients with stage Ⅲ periodontitis and periodontally healthy volunteers"

Items Control, ${\bar x}$±s Stage Ⅲ periodontitis, ${\bar x}$±s P
WBC/(×109/L) 5.90±1.13 6.48±1.74 0.169
RBC/(×1012/L) 4.85±0.45 4.86±0.56 0.962
HGB/(g/L) 146.52±12.51 134.92±12.71 0.002**
HCT 0.43±0.04 0.42±0.04 0.382
MCV/fL 89.24±3.75 87.62±5.81 0.246
MCH/(pg/cell) 29.86±1.56 29.68±2.67 0.763
MCHC/(g/dL) 334.52±10.35 338.2±13.56 0.286
Transferrin/(mg/dL) 268.81±37.86 254.92±47.25 0.254
Ferritin/(μg/L) 155.19±115.38 225.08±103.36 0.029*
Hepcidin/(μg/L) 27.42±15.00 48.03±34.44 0.009**
EPO/(IU/L) 28.38±10.52 41.28±12.58 < 0.001***

Table 3

Analysis of covariance of fasting blood examinations of patients with stage Ⅲ periodontitis and periodontally healthy volunteers"

Items Control, ${\bar x}$±s Stage Ⅲ periodontitis, ${\bar x}$±s P
WBC/(×109/L) 5.79±0.30 6.59±0.30 0.070
RBC/(×1012/L) 4.84±0.11 4.87±0.11 0.811
HGB/(g/L) 146.51±2.63 134.93±2.63 0.004**
HCT 0.43±0.01 0.43±0.01 0.627
MCV/fL 89.08±1.02 87.79±1.02 0.386
MCH/(pg/cell) 29.86±0.46 29.68±0.46 0.784
MCHC/(g/dL) 335.18±2.48 337.54±2.48 0.518
Transferrin/(mg/dL) 269.48±8.92 254.36±8.92 0.250
Ferritin/(μg/L) 152.01±22.75 228.26±22.75 0.026*
Hepcidin/(μg/L) 27.33±5.54 48.13±5.54 0.013*
EPO/(IU/L) 28.64±2.41 41.02±2.41 0.001**

Table 4

Periodontal clinical parameters pre- and post-treatment"

Items Baseline, ${\bar x}$±s After therapy, ${\bar x}$±s P
PD/mm 4.66±0.88 2.92±0.45 < 0.001
BI 3.46±0.57 1.66±0.74 < 0.001
CAL/mm 4.23±0.89 3.03±0.75 < 0.001

Table 5

Fasting blood parameters pre- and post-treatment of stage Ⅲ periodontitis"

Items Baseline, ${\bar x}$±s After therapy, ${\bar x}$±s P
WBC/(×109/L) 6.43±1.83 6.28±1.88 0.401
RBC/(×1012/L) 4.85±0.60 4.79±0.56 0.272
HGB/(g/L) 133.77±13.15 146.05±15.48 < 0.001***
HCT 0.42±0.04 0.42±0.04 0.244
MCV/fL 87.40±6.14 87.27±6.19 0.655
MCH/(pg/cell) 29.64±2.83 29.31±2.60 0.051
MCHC/(g/dL) 338.55±14.33 335.18±12.12 0.102
Transferrin/(mg/dL) 257.45±49.62 258.06±34.06 0.957
Ferritin/(μg/L) 221.22±102.15 128.52±90.95 < 0.001***
Hepcidin/(μg/L) 48.18±36.74 32.54±18.67 0.033*
EPO/(IU/L) 39.63±12.48 27.66±19.67 0.004**
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