Association between periodontitis, leukoaraiosis and sTWEAK. A case-control study

Background In recent years, periodontitis has been associated with various systemic diseases, including neurological pathology, and systemic inflammation has been proposed as a potential link. The aim of this study was to investigate the relationship between periodontitis and the presence of leukoaraiosis (LA). The contribution of periodontitis to serum levels of soluble fragment of tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) in LA was also explored. Methods We performed a nested case-control study including patients with LA ( n = 70) and control subjects without known neurological diseases ( n = 140). A full-mouth periodontal examination was carried out in all participants. Socio-demographic and oral care related data, self-reported vascular risk factors and body mass index (BMI) were also recorded. Neuroimaging and ultrasonographic assessments were performed in LA patients. Blood samples were collected from all participants to determine serum sTWEAK levels by enzyme-linked immunosorbent assay technique. Results Both the prevalence of periodontitis and mean serum sTWEAK concentrations were significantly higher in LA patients than controls (74.3% vs. 32.1%, p < 0.001 and 247.5 ± 90.2 vs. 27.5 ± 17.6 pg/mL, p < 0.001). With multiple logistic regression analysis, a positive relationship was shown between periodontitis and presence of LA independent of well-known LA risk factors such as age, gender, hypertension, diabetes, dyslipidemia and BMI (OR = 6.3; 95% CI: 2.5–15.6, p < 0.001). In LA cases, periodontitis was associated with increased sTWEAK levels (B coefficient = 198.3; 95%CI: 95.5–301.2, p < 0.001). Conclusions Periodontitis may be associated with the presence of LA and when present it could contribute to elevated serum levels of sTWEAK.