The association of inflammatory markers and periodontal indexes with the risk of coronary heart disease in Chinese patients with type 2 diabetes mellitus

The present study was designed to investigate the association of four inflammatory markers and five periodontal indexes with the risk of coronary heart disease (CHD) in 131 patients with type 2 diabetes mellitus (T2DM).All subjects were inpatients, including 63 T2DM patients with comorbid CHD ("cases") and 68 T2DM patients without CHD ("controls"). The diagnosis of CHD is based on coronary angiography.Peripheral blood concentrations of high sensitivity C-reactive protein (hs-CRP) (11.51 vs. 10.39 mg/L), leptin (24.60 vs. 21.22 ng/L) and visfatin (65.92 vs. 57.62 ng/L) were significantly higher in cases than in controls (P = .033, 0.041 and 0.041, respectively). The levels of three periodontal indexes - probing pocket depth, attachment loss (AL) and sulcus bleeding index, were significantly higher in cases than in controls, especially for periodontal AL (3.60 mm vs. 3.29 mm, P = .002). A Forward logistic regression was performed for selection, and specifically hs-CRP, leptin, visfatin and periodontal AL were found to be associated with the significant risk of CHD (odds ratio: 1.16, 1.07, 1.03 and 2.04; P = .025, .022, .022 and .010, respectively). Importantly, the benefits of inflammatory markers and periodontal indexes over basic risk factors were significant (likelihood ratio test) and obvious (decision curve analysis). A nomogram was delineated based on significant variables, and it had good accuracy (C-index: 0.801, P < .001).Our findings support the significant contribution of inflammatory markers and periodontal indexes to the pathogenesis of CHD in T2DM. Specifically, hs-CRP, leptin, visfatin and periodontal AL were identified as significant contributors.