Association between bone turnover markers and periodontitis: A population‐based cross‐sectional study

Reckelkamm, Stefan Lars; Hannemann, Anke; Kocher, Thomas; Nauck, Matthias; Völzke, Henry; Ehmke, Benjamin; Rauner, Martina; Alayash, Zoheir; Baumeister, Sebastian-Edgar; Nolde, Michael; Holtfreter, Birte

Abstract

Aim To examine the associations between bone turnover markers and periodontitis in two cross-sectional population-based studies. Materials and Methods We used data from two independent adult samples (N = 4993), collected within the Study of Health in Pomerania project, to analyse cross-sectional associations of N-procollagen type 1 amino-terminal propeptide (P1NP), C-terminal cross-linking telopeptide, osteocalcin, bone-specific alkaline phosphatase (BAP), fibroblast growth factor 23, wingless-type mouse mammary tumour virus integration site family member 5a (WNT5A), and sclerostin values with periodontitis. Confounder-adjusted gamma and fractional response regression models were applied. Results Positive associations were found for P1NP with mean pocket probing depth (PPD; eβ=1.008 $$ {e}^{\beta }=1.008 $$" role="presentation">𝑒𝛽=1.008; 95% confidence interval [CI]: 1.001–1.015), mean clinical attachment loss (mean CAL; eβ=1.027 $$ {e}^{\beta }=1.027 $$" role="presentation">𝑒𝛽=1.027; 95% CI: 1.011–1.044), and proportion of sites with bleeding on probing (%BOP; eβ=1.055 $$ {e}^{\beta }=1.055 $$" role="presentation">𝑒𝛽=1.055; 95% CI: 1.005–1.109). Similar associations were seen for BAP with %BOP (eβ=1.121 $$ {e}^{\beta }=1.121 $$" role="presentation">𝑒𝛽=1.121; 95% CI: 1.042–1.205), proportion of sites with PPD ≥4 mm (%PPD4) (eβ=1.080 $$ {e}^{\beta }=1.080 $$" role="presentation">𝑒𝛽=1.080; 95% CI: 1.005–1.161), and sclerostin with %BOP (eβ=1.308 $$ {e}^{\beta }=1.308 $$" role="presentation">𝑒𝛽=1.308; 95% CI: 1.005–1.704). WNT5A was inversely associated with mean PPD (eβ=0.956 $$ {e}^{\beta }=0.956 $$" role="presentation">𝑒𝛽=0.956; 95% CI: 0.920–0.993) and %PPD4 (eβ=0.794 $$ {e}^{\beta }=0.794 $$" role="presentation">𝑒𝛽=0.794; 95% CI: 0.642–0.982). Conclusions This study revealed scattered associations of P1NP, BAP, WNT5A, and sclerostin with periodontitis, but the results are contradictory in the overall context. Associations reported in previous studies could not be confirmed.