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Assessment of Vitamin C and Antioxidant Profiles in Saliva and Serum in Patients With Periodontitis and Ischemic Heart Disease


Assessment of Vitamin C and Antioxidant Profiles in Saliva and Serum in Patients With Periodontitis and Ischemic Heart Disease

Gaetano Isola et al. Nutrients.


Vitamin C and antioxidants play a crucial role in endothelial function and may be a link for the known interaction of periodontitis and ischemic heart disease (CAD). This pilot study evaluates the association of gingival health, periodontitis, CAD, or both conditions with salivary and serum vitamin C and antioxidant levels. The clinical and periodontal characteristics, serum, and saliva samples were collected from 36 patients with periodontitis, 35 patients with CAD, 36 patients with periodontitis plus CAD, and 36 healthy controls. Levels of vitamin C, antioxidants, and C-reactive protein (hs-CRP) were assessed with a commercially available kit. The median concentrations of salivary and serum vitamin C and antioxidants (α-tocopherol, β-carotene, lutein, and lycopene) were significantly lower in the CAD group (p < 0.001) and in the periodontitis plus CAD group (p < 0.001) compared to periodontitis patients and controls. In univariate models, periodontitis (p = 0.034), CAD (p < 0.001), and hs-CRP (p < 0.001) were significantly negatively associated with serum vitamin C; whereas, in a multivariate model, only hs-CRP remained a significant predictor of serum vitamin C (p < 0.001). In a multivariate model, the significant predictors of salivary vitamin C levels were triglycerides (p = 0.028) and hs-CRP (p < 0.001). Patients with CAD and periodontitis plus CAD presented lower levels of salivary and serum vitamin C compared to healthy subjects and periodontitis patients. hs-CRP was a significant predictor of decreased salivary and serum vitamin C levels.

Keywords: C-reactive protein; cardiovascular disease; clinical trial; ischemic heart disease; lutein; lycopene; periodontitis; retinol; vitamin C; zeaxanthin; α-carotene; β-carotene; β-cryptoxanthin; γ-tocopherol.

Conflict of interest statement

The authors declare no conflict of interest.


Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Median values (25% and 75% percentiles) of serum and salivary vitamin C levels in each group of subjects. * p < 0.05, ** p < 0.01, and *** p < 0.001 significant differences vs. control subjects (derived by Kruskal–Wallis test). §§ p < 0.01 significant differences vs. periodontitis patients. p < 0.001 (obtained by Jonckheere–Terpstra test).
Figure 3
Figure 3
Correlation analysis of serum and salivary vitamin C levels in all enrolled subjects.
Figure 4
Figure 4
Correlation analysis of serum and salivary vitamin C levels with CRP values in all enrolled subjects.

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