Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.53986/ibjm.2023.0003
Iberoamerican Journal of Medicine
Review

Association of periodontitis with vitamin D and calcium levels: a meta-analysis

Asociación de la periodontitis con los niveles de vitamina D y calcio: un metanálisis

Alberto Rodríguez-Archilla, Nnuar Mohamed-El-Founti

Downloads: 0
Views: 136

Abstract

Introduction: Low levels of vitamin D have been linked to raised periodontal inflammation, a higher concentration of periodontopathogens, greater periodontal destruction, and more severe periodontitis. This study aimed to assess the influence of vitamin D and calcium levels on periodontitis.
Material and methods: A search for studies on vitamin D, calcium, and periodontal disease was conducted in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Scopus. For continuous outcomes, the estimates of effects of an intervention were expressed as mean differences (MD), using the inverse variance (IV) method with 95% confidence intervals. The meta-analysis was conducted using RevMan 5.4 software.
Results: Thirty-one studies with 14,340 participants were included in this meta-analysis. Periodontitis patients had mean vitamin D concentrations significantly lower than controls without the disease (p<0.001). Likewise, these patients showed significantly lower serum vitamin D concentrations (p<0.001) and higher salivary vitamin D concentrations, although without reaching statistical significance (p=0.70). Regarding calcium levels, periodontitis patients had significantly higher salivary levels than controls (p<0.001).
Conclusions: Low vitamin D and high calcium levels are associated with an increased periodontitis risk.

Keywords

Calcium; Periodontitis; Risk; Vitamin D

Resumen

Introducción: Los niveles bajos de vitamina D se han relacionado con una mayor inflamación periodontal, una mayor concentración de periodontopatógenos, una mayor destrucción periodontal y una periodontitis más severa. Este estudio tuvo como objetivo evaluar la influencia de los niveles de vitamina D y calcio en la periodontitis.
Material y métodos: Se realizó una búsqueda de estudios sobre vitamina D, calcio y enfermedad periodontal en las siguientes bases de datos: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS) y Scopus. Para los resultados continuos, las estimaciones de los efectos de una intervención se expresaron como diferencias de medias (DM), mediante el método de la varianza inversa (IV) con intervalos de confianza del 95%. El metanálisis se realizó con el software RevMan 5.4.
Resultados: Treinta y un estudios con 14 340 participantes se incluyeron en este metanálisis. Los pacientes con periodontitis tenían concentraciones medias de vitamina D significativamente más bajas que los controles sin la enfermedad (p<0,001). Asimismo, estos pacientes mostraron concentraciones séricas de vitamina D significativamente más bajas (p<0,001) y concentraciones salivales de vitamina D más altas, aunque sin alcanzar la significación estadística (p=0,70). Con respecto a los niveles de calcio, los pacientes con periodontitis tenían niveles salivales significativamente más altos que los controles (p<0,001).
Conclusiones: Los niveles bajos de vitamina D y altos de calcio se asocian con un mayor riesgo de periodontitis.

Palabras clave

Calcio; Periodontitis; Riesgo; Vitamina D

References

1. Ramseier CA, Anerud A, Dulac M, Lulic M, Cullinan MP, Seymour GJ, ET AL. Natural history of periodontitis: Disease progression and tooth loss over 40 years. J Clin Periodontol. 2017;44(12):1182-91. doi: 10.1111/jcpe.12782.
2. Botelho J, Machado V, Proença L, Delgado AS, Mendes JJ. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients. 2020;12(5):1471. doi: 10.3390/nu12051471.
3. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30. doi: 10.1210/jc.2011-0385.
4. Dragonas P, El-Sioufi I, Bobetsis YA, Madianos PN. Association of Vitamin D With Periodontal Disease: A Narrative Review. Oral Health Prev Dent. 2020;18(1):103-14. doi: 10.3290/j.ohpd.a44323.
5. Olszewska-Czyz I, Firkova E. Vitamin D3 Serum Levels in Periodontitis Patients: A Case-Control Study. Medicina (Kaunas). 2022;58(5):585. doi: 10.3390/medicina58050585.
6. Girgis E, Reyad AA. Vitamin D: Pharmacology and Clinical Challenges in Oral Health Care. J Int Acad Periodontol. 2019;21(3):118-24.
7. Machado V, Lobo S, Proença L, Mendes JJ, Botelho J. Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis. Nutrients. 2020;12(8):2177. doi: 10.3390/nu12082177.
8. Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa (Canada): The Ottawa Hospital. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp [accessed April 2022].
9. Kuraner T, Beksac MS, Kayakirilmaz K, Cağlayan F, Onderoğlu LS, Ozgünes H. Serum and parotid saliva testosterone, calcium, magnesium, and zinc levels in males, with and without periodontitis. Biol Trace Elem Res. 1991;31(1):43-9. doi: 10.1007/BF02990358.
10. Acharya A, Kharadi MD, Dhavale R, Deshmukh VL, Sontakke AN. High salivary calcium level associated with periodontal disease in Indian subjects--a pilot study. Oral Health Prev Dent. 2011;9(2):195-200.
11. Antonoglou G, Knuuttila M, Niemelä O, Hiltunen L, Raunio T, Karttunen R, et al. Serum 1,25(OH)D level increases after elimination of periodontal inflammation in T1DM subjects. J Clin Endocrinol Metab. 2013;98(10):3999-4005. doi: 10.1210/jc.2013-1906.
12. Millen AE, Andrews CA, LaMonte MJ, Hovey KM, Swanson M, Genco RJ, et al. Vitamin D status and 5-year changes in periodontal disease measures among postmenopausal women: the Buffalo OsteoPerio Study. J Periodontol. 2014;85(10):1321-32. doi: 10.1902/jop.2014.130686.
13. Miricescu D, Totan A, Calenic B, Mocanu B, Didilescu A, Mohora M, et al. Salivary biomarkers: relationship between oxidative stress and alveolar bone loss in chronic periodontitis. Acta Odontol Scand. 2014;72(1):42-7. doi: 10.3109/00016357.2013.795659.
14. Antonoglou GN, Knuuttila M, Niemelä O, Raunio T, Karttunen R, Vainio O, et al. Low serum level of 1,25(OH)2 D is associated with chronic periodontitis. J Periodontal Res. 2015;50(2):274-80. doi: 10.1111/jre.12207.
15. Haririan H, Andrukhov O, Pablik E, Neuhofer M, Moritz A, Rausch-Fan X. Comparative Analysis of Calcium-Binding Myeloid-Related Protein-8/14 in Saliva and Serum of Patients With Periodontitis and Healthy Individuals. J Periodontol. 2016;87(2):184-92. doi: 10.1902/jop.2015.150254.
16. Joseph R, Nagrale AV, Joseraj MG, Pradeep Kumar KM, Kaziyarakath JA, Chandini R. Low levels of serum Vitamin D in chronic periodontitis patients with type 2 diabetes mellitus: A hospital-based cross-sectional clinical study. J Indian Soc Periodontol. 2015;19(5):501-6. doi: 10.4103/0972-124X.167162.
17. Kambalyal P, Kambalyal P, Hungund S. Comparison of salivary calcium level in smokers and non-smokers with chronic periodontitis, aggressive periodontitis, and healthy controls. J Int Soc Prev Community Dent. 2015;5(Suppl 2):S68-73. doi: 10.4103/2231-0762.171595.
18. Rajesh KS, Zareena, Hegde S, Arun Kumar MS. Assessment of salivary calcium, phosphate, magnesium, pH, and flow rate in healthy subjects, periodontitis, and dental caries. Contemp Clin Dent. 2015;6(4):461-5. doi: 10.4103/0976-237X.169846.
19. Abreu OJ, Tatakis DN, Elias-Boneta AR, López Del Valle L, Hernandez R, Pousa MS, et al. Low vitamin D status strongly associated with periodontitis in Puerto Rican adults. BMC Oral Health. 2016;16(1):89. doi: 10.1186/s12903-016-0288-7.
20. Eshghi R, Rashidi Maybodi F, Khabazian A, Shahhosseini S. Association between serum levels of vitamin D and chronic periodontitis in premenopausal women in Yazd. Caspian J Dent Res. 2016;5(1):47-51. doi: 10.22088/cjdr.5.1.47.
21. Gümüş P, Öztürk VÖ, Bozkurt E, Emingil G. Evaluation of the gingival inflammation in pregnancy and postpartum via 25-hydroxy-vitamin D3,
prostaglandin E2 and TNF-α levels in saliva. Arch Oral Biol. 2016;63:1-6. doi: 10.1016/j.archoralbio.2015.11.018.
22. Moghadam SA, Zakeri Z, Fakour SR, Moghaddam AA. Does Salivary Calcium and Phosphate Concentrations Adequately Reflect Bone Mineral Density in Patients with Chronic Periodontitis? Glob J Health Sci. 2016;8(10):56723. doi: 10.5539/gjhs.v8n10p282.
23. Balci Yuce H, Gokturk O, Aydemir Turkal H, Inanir A, Benli I, Demir O. Assessment of local and systemic 25-hydroxy-vitamin D, RANKL, OPG, and TNF levels in patients with rheumatoid arthritis and periodontitis. J Oral Sci. 2017;59(3):397-404. doi: 10.2334/josnusd.16-0677.
24. Chandak LG, Lohe VK, Bhowate RR, Gandhi KP, Vyas NV. Correlation of periodontitis with mandibular radiomorphometric indices, serum calcium and serum estradiol in postmenopausal women: A case-control study. Indian J Dent Res. 2017;28(4):388-94. doi: 10.4103/ijdr.IJDR_532_16.
25. Laky M, Bertl K, Haririan H, Andrukhov O, Seemann R, Volf I, et al. Serum levels of 25-hydroxyvitamin D are associated with periodontal disease. Clin Oral Investig. 2017;21(5):1553-8. doi: 10.1007/s00784-016-1965-2.
26. Rane MV, Suragimath G, Varma S, Zope SA, Ashwinirani SR. Estimation and comparison of salivary calcium levels in healthy controls and patients with generalized gingivitis and chronic periodontitis. J Oral Res Rev. 2017;9(1):12-5.
27. Cholewa M, Madziarska K, Radwan-Oczko M. The association between periodontal conditions, inflammation, nutritional status and calcium-phosphate metabolism disorders in hemodialysis patients. J Appl Oral Sci. 2018;26:e20170495. doi: 10.1590/1678-7757-2017-0495.
28. Ebersole JL, Lambert J, Bush H, Huja PE, Basu A. Serum Nutrient Levels and Aging Effects on Periodontitis. Nutrients. 2018;10(12):1986. doi: 10.3390/nu10121986.
29. Patel RM, Varma S, Suragimath G, Zope S. Estimation and Comparison of Salivary Calcium, Phosphorous, Alkaline Phosphatase and pH Levels in Periodontal Health and Disease: A Cross-sectional Biochemical Study. J Clin Diagn Res. 2016;10(7):ZC58-61. doi: 10.7860/JCDR/2016/20973.8182.
30. Agrawal AA, Kolte AP, Kolte RA, Chari S, Gupta M, Pakhmode R. Evaluation and comparison of serum vitamin D and calcium levels in periodontally healthy, chronic gingivitis and chronic periodontitis in patients with and without diabetes mellitus - a cross-sectional study. Acta Odontol Scand. 2019;77(8):592-9. doi: 10.1080/00016357.2019.1623910.
31. Anbarcioglu E, Kirtiloglu T, Öztürk A, Kolbakir F, Acıkgöz G, Colak R. Vitamin D deficiency in patients with aggressive periodontitis. Oral Dis. 2019;25(1):242-9. doi: 10.1111/odi.12968.
32. Bhargava A, Rastogi P, Lal N, Singhal R, Khatoon S, Ali Mahdi A. Relationship between VITAMIN D and chronic periodontitis. J Oral Biol Craniofac Res. 2019;9(2):177-9. doi: 10.1016/j.jobcr.2018.07.001.
33. Ketharanathan V, Torgersen GR, Petrovski BÉ, Preus HR. Radiographic alveolar bone level and levels of serum 25-OH-Vitamin D3 in ethnic Norwegian and Tamil periodontitis patients and their periodontally healthy controls. BMC Oral Health. 2019;19(1):83. doi: 10.1186/s12903-019-0769-6.
34. Rafique S, Hingorjo MR, Mumtaz M, Qureshi MA. The relationship of 1,25-dihydroxyvitamin D and Vitamin D binding protein in periodontitis. Pak J Med Sci. 2019;35(3):847-51. doi: 10.12669/pjms.35.3.482.
35. Bayirli BA, Öztürk A, Avci B. Serum vitamin D concentration is associated with antimicrobial peptide level in periodontal diseases. Arch Oral Biol. 2020;117:104827. doi: 10.1016/j.archoralbio.2020.104827.
36. Costantini E, Sinjari B, Piscopo F, Porreca A, Reale M, Caputi S, et al. Evaluation of Salivary Cytokines and Vitamin D Levels in Periodontopathic Patients. Int J Mol Sci. 2020;21(8):2669. doi: 10.3390/ijms21082669.
37. Isola G, Alibrandi A, Rapisarda E, Matarese G, Williams RC, Leonardi R. Association of vitamin D in patients with periodontitis: A cross-sectional study. J Periodontal Res. 2020;55(5):602-12. doi: 10.1111/jre.12746.
38. Pradhan S, Agrawal S. Serum Vitamin D in Patients with Chronic Periodontitis and Healthy Periodontium. J Nepal Health Res Counc. 2021;18(4):610-4. doi: 10.33314/jnhrc.v18i4.2904.
39. Botelho J, Leira Y, Viana J, Machado V, Lyra P, Aldrey JM, et al. The Role of Inflammatory Diet and Vitamin D on the Link between Periodontitis and Cognitive Function: A Mediation Analysis in Older Adults. Nutrients. 2021;13(3):924. doi: 10.3390/nu13030924.
40. Jagelavičienė E, Vaitkevičienė I, Šilingaitė D, Šinkūnaitė E, Daugėlaitė G. The Relationship between Vitamin D and Periodontal Pathology. Medicina (Kaunas). 2018;54(3):45. doi: 10.3390/medicina54030045.
41. Perić M, Cavalier E, Toma S, Lasserre JF. Serum vitamin D levels and chronic periodontitis in adult, Caucasian population-a systematic review. J Periodontal Res. 2018;53(5):645-56. doi: 10.1111/jre.12560.
42. Niu L, Chen S, Yang X, Ma C, Pan C, Wang H, et al. Vitamin D decreases Porphyromonas gingivalis internalized into macrophages by promoting autophagy. Oral Dis. 2021;27(7):1775-88. doi: 10.1111/odi.13696.
43. Lee MR, Han SJ, Kim HE, Choi JS. Relationship between Vitamin D Deficiency and Periodontitis in Korean Adults Aged ≥60 Years: Analysis of
Data from the Korea National Health and Nutrition Examination Survey (2013-2014). Int J Environ Res Public Health. 2021;18(8):4181. doi: 10.3390/ijerph18084181.
44. Meghil MM, Hutchens L, Raed A, Multani NA, Rajendran M, Zhu H, et al. The influence of vitamin D supplementation on local and systemic inflammatory markers in periodontitis patients: A pilot study. Oral Dis. 2019;25(5):1403-13. doi: 10.1111/odi.13097.
45. Baumeister SE, Reckelkamm SL, Baurecht H, Nolde M, Kocher T, Holtfreter B, et al. A Mendelian randomization study on the effect of 25-hydroxyvitamin D levels on periodontitis. J Periodontol. 2022;93(8):1243-9. doi: 10.1002/JPER.21-0463.


Submitted date:
07/11/2022

Reviewed date:
10/10/2022

Accepted date:
10/28/2022

Publication date:
11/02/2022

6362b122a95395696b35e423 iberoamericanjm Articles
Links & Downloads

Iberoam J Med

Share this page
Page Sections