Background: Moderate elevation of C-reactive protein (CRP) is thought to predict type 2 diabetes and cardiovascular disease (CVD), both of which are associated with periodontitis. Recent studies indicate that periodontal disease is associated with moderate elevation of CRP; however, the relationship between alveolar bone loss (ABL) and CRP elevation is unclear.

Methods: A total of 179 Japanese men aged 50 to 54 years old, with at least 10 teeth, were examined as part of a comprehensive health examination before retirement from the Japan Self-Defense Force. ABL was measured at proximal sites of posterior teeth on a panoramic x-ray film. The relationship between the mean ratio of ABL to root length and serum CRP level and other variables was analyzed.

Results: ABL was significantly correlated with serum CRP level (P = 0.008), alkaline phosphatase (P = 0.008), high-density lipoprotein (HDL) cholesterol (P = 0.04, inversely), white blood cell count (P <0.001), erythrocyte sedimentation rate (P = 0.002), age (P = 0.03), and smoking history (P <0.001). In a multiple logistic regression model adjusted for age, smoking history, systolic blood pressure, body-mass index, triglyceride, and HDL cholesterol, subjects in the highest tertile of ABL had an increased risk for CRP elevation ≥1.3 mg/l (odds ratio [OR] = 8.20; 95% confidence interval [CI], 1.6 to 40.7; P = 0.01) when compared to the lowest tertile of ABL.

Conclusion: ABL around posterior teeth was associated with elevated CRP in Japanese men, suggesting an association between periodontal disease and increased risk of type 2 diabetes and CVD. J Periodontol 2003;74:1741-1746.