Association between periodontal parameters and thyroid markers in autoimmune hypothyroidism: A cross‐sectional study

BACKGROUND: Inflammatory cytokines play a significant role in the pathogenesis of both autoimmune hypothyroidism and periodontal disease. The cumulative effect of these inflammatory markers may lead to extensive periodontal breakdown. This study was undertaken to assess the prevalence and severity of periodontitis, to correlate clinical attachment loss (CAL), and periodontal inflamed surface area (PISA) with anti-thyroid peroxidase (anti-TPO) antibody, triiodothyronine (T3), thyroxine (T4), thyroid- stimulating hormone (TSH), and C-reactive protein (CRP) in autoimmune hypothyroid patients and systemically healthy subjects. METHODS: This cross-sectional study comprised of 65 autoimmune hypothyroid patients under treatment and 75 systemically healthy subjects. All participants were evaluated for periodontal parameters (bleeding on probing (BoP), probing pocket depth (PPD), CAL, oral hygiene index-simplified (OHI-S Index), Plaque Index (PI) and PISA) and systemic parameters (T3, T4, TSH, anti-TPO antibody, and CRP). Analysis of quantitative and qualitative data was done by unpaired t-test and Chi-Square test, respectively. RESULTS: Prevalence and severity of periodontitis in the autoimmune hypothyroid group were significantly higher compared with the systemically healthy group (p < 0.001). CAL, PISA, T3, TSH, and anti-TPO antibody were significantly higher in the autoimmune hypothyroid group as compared with the systemically healthy group. Mean CAL and PISA were positively correlated with anti-TPO antibody, T3, T4, TSH, and CRP. The multivariate linear regression model with dependent variable mean CAL showed that anti-TPO antibody was significantly associated with mean CAL (β = 0.001, p = 0.02). CONCLUSIONS: Autoimmune hypothyroid subjects exhibited a higher prevalence and severity of periodontitis compared with the systemically healthy group. BoP, PPD, CAL and PISA were also higher in autoimmune hypothyroid group as compared with the systemically healthy group. A statistically significant positive correlation of CAL, and PISA with anti-TPO antibody, T3, TSH, and CRP was observed. PLAIN LANGUAGE SUMMARY: This study assessed the link between autoimmune hypothyroidism (a condition characterized by decreased thyroid function) and periodontitis by comparing 65 individuals with autoimmune hypothyroidism undergoing treatment to 75 healthy subjects. This research measured periodontal health indicators, thyroid hormone levels, and inflammatory markers. Results indicated that those with autoimmune hypothyroidism experienced more severe periodontal disease and increased periodontal tissue loss. They also showed elevated levels of specific thyroid antibodies and thyroid hormonal imbalances. Importantly, a significant positive association was found between the extent of periodontal tissue loss and these thyroid-related markers, especially the anti-TPO antibody. In conclusion, individuals with autoimmune hypothyroidism are at a higher risk for severe periodontal disease, suggesting a relationship between thyroid dysfunction and periodontal health. Therefore, it is crucial for both periodontists and endocrinologists to recognize this association when planning appropriate treatments.