Evaluating the clinico-biochemical association between stress and chronic periodontitis by estimation of serum cortisol and serum chromogranin-A levels

Abstract

AIM. Periodontitis is a persistent, long-standing condition of the tissues holding the teeth which manifests itself as loss of attachment. Numerous systemic, environmental as well as psychological factors have the capability to deteriorate the host’s immune response leading to more severe periodontal destruction. Alterations in immune, neural, endocrinal and behavioral systems caused by stressful life events may impair periodontal health. This study was designed to investigate the link between periodontal infection and psychoneuroimmunologic variables by using serum stress markers. MATERIALS AND METHOD. 400 systemically healthy patients in the age group of 20-60 years were employed for this study. These subjects were segregated into 2 groups namely the healthy periodontium group (200 subjects) and the chronic periodontitis group (200 subjects) after recording plaque index, probing depth, gingival index and clinical attachment loss. The analysis of stress levels by using the Social readjustment rating scale and lifestyle evaluation by using the Health Practice Index was done. Serum cortisol and serum chromogranin-A levels were recorded. Descriptive statistics and an Unpaired t-test for comparing the differences in the parameters amongst groups were done. Pearson’s correlation test was performed for establishing a correlation between serum markers with clinical variables and stress levels. MANCOVA analysis to find the linear relation of periodontal and serum parameters (dependent variables) with psychological stress and lifestyle patterns (independent variables) was done. RESULTS. Poorer lifestyle and higher magnitude of stress were more allied to worsened periodontal condition (p ≤0.05) than with healthy periodontium. Significantly higher (p ≤0.05) concentrations of serum cortisol, as well as serum chromogranin-A levels, were observed in the chronic periodontitis group thus suggesting stress to be a risk profile in subjects with chronic periodontitis. CONCLUSION. Stress shall be regarded as a probable risk factor for periodontal infection and henceforth, it should be catered to so as to attain benefits in patients with advanced and inexplicable periodontal disease.