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Horina, A.
Nutritional status in patients with peripheral arterial disease (PAD) and concomitant periodontal disease (PD)
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] ; 2015. pp.
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- Authors Med Uni Graz:
- Advisor:
- Gasser Robert
- Seinost Gerald
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- Abstract:
- BACKGROUND: Inadequate nutrition has been associated with an increased risk for both peripheral arterial disease (PAD) and periodontal disease (PD). PD can have profound effects on an individual’s ability to chew and therefore to eat. As the influence of the extent of PD on nutrient intake in PAD patients is unknown, the primary aim of our study was to determine the nutritional status in patients with PAD and concomitant PD depending on the degree of PD. The secondary aim was to assess the effect of non-surgical periodontal treatment on nutrient intake and nutritional status. METHODS: In the first part of the study, the nutritional status of 160 patients suffering from PAD and PD was determined. Patients were divided into 3 groups of PD (gingivitis, moderate periodontitis, and severe periodontitis) according to a standardised basic periodontal examination (PGU). The assessment of the nutritional status included anthropometrical data (lean body and fat mass measured by DEXA; weight, height and waist circumference) and laboratory parameters of nutritional status, as well as dietary intake and quality (determined by 24-h recall and food frequency questionnaire [FFQ]). In the second part of the study, 44 patients with periodontitis were randomised into 3 treatment groups: non-surgical periodontal treatment with (PT1) or without (PT2) antibiotics and a control group (CG), which received no treatment for 3 months. Nutritional status was assessed at baseline (BL), and after 3 (FU1) and 6 months (FU2). Periodontal therapy was administered between baseline and FU1. The Kruskall-Wallis and Friedman tests were used for statistical analysis. Bonferroni correction was applied to correct for multiple testing. RESULTS: Dietary intake of calcium, folic acid, vitamins A, C, D and E, fibre and carbohydrates was considerably below DGE recommendations. Average fat intake in this population was more than 10 per cent above recommendations for daily intake. There were no significant differences in nutrient intake between the PD stages in the 160 screening patients. In the treatment groups, non-surgical periodontal therapy, either with or without antibiotics, did not produce a significant improvement in anthropometrical parameters, laboratory values or nutrient intake throughout the study period. No changes were seen in the control group. Dietary intake of calcium, folic acid, vitamins A, D, E and C, fibre and carbohydrates was below the DGE recommendations at baseline and the follow-up visits. Fat intake continued to exceed recommendations despite periodontal therapy. CONCLUSION: Nutritional status and diet quality in patients with PAD and concomitant PD did not differ depending on the severity of PD. Daily intake of several important nutrients was below current recommendations. The results also indicate that non-surgical treatment of periodontitis with or without adjunctive antibiotics did not significantly alter nutritional status after a study period of 6 months.