Antioxidants and periodontitis in 60–70-year-old men Linden GJ, McClean KM, Woodside JV, Patterson CC, Evans A, Young IS, Kee F. Antioxidants and periodontitis in 60–70-year-old men. J Clin Periodontol 2009; 36: 843–849. doi: 10.1111/j.1600-051X.2009.01468.x. Abstract Objective: The aim was to investigate the association between periodontal health and the serum levels of various antioxidants including carotenoids, retinol and vitamin E in a homogenous group of Western European men. Materials and Methods: A representative sample of 1258 men aged 60–70 years, drawn from the population of Northern Ireland, was examined between 2001 and 2003. Each participant had six or more teeth, completed a questionnaire and underwent a clinical periodontal examination. Serum lipid-soluble antioxidant levels were measured by high-performance liquid chromatography with diode array detection. Multivariable analysis was carried out using logistic regression with adjustment for possible confounders. Models were constructed using two measures of periodontal status (low- and high-threshold periodontitis) as dependent variables and the fifths of each antioxidant as a predictor variable. Results: The levels of a- and b-carotene, b-cryptoxanthin and zeaxanthin were highly significantly lower in the men with low-threshold periodontitis (po0.001). These carotenoids were also significantly lower in high-threshold periodontitis. There were no significant differences in the levels of lutein, lycopene, a- and g-tocopherol or retinol in relation to periodontitis. In fully adjusted models, there was an inverse relationship between a number of carotenoids (a- and b-carotene and b-cryptoxanthin) and low-threshold periodontitis. b-Carotene and b-cryptoxanthin were the only antioxidants that were associated with an increased risk of high-threshold severe periodontitis. The adjusted odds ratio for high-threshold periodontitis in the lowest fifth relative to the highest fifth of b-cryptoxanthin was 4.02 (p 5 0.003). Conclusion: It is concluded that low serum levels of a number of carotenoids, in particular b-cryptoxanthin and b-carotene, were associated with an increased prevalence of periodontitis in this homogenous group of 60–70-year-old Western European men. Key words: antioxidants; carotenoids; periodontitis Accepted for publication 1 July 2009 Periodontitis is an inflammatory condi- tion representing the response of the periodontal tissues to lipopolysacchar- ide derived from Gram-negative anae- robic bacteria. Inflammation is known to be a protective response that focuses on the removal of the stimuli responsible for damage to the tissues, thereby lead- ing to the restoration of health (Medz- hitov 2008). The persistence of the bacterial stimulus results in the inflam- matory process becoming chronic in nature. However, this is not associated with progressive damage to the perio- dontal tissues in all those affected. Some factors associated with progression have been identified. For example smoking is known to be a major environmental risk factor (Tomar & Asma 2000). There may also be regulatory factors, not well characterized as yet, which are protective and limit the progression of periodontal tissue destruction. In this context, antioxidant micronutrients may have an important protective role. A recent comprehensive review con- cluded that oxidative stress is at the heart of the periodontal tissue damage that results from host–microbial interac- tions (Chapple & Matthews 2007). Tis- sue damage results from dysregulation of chronic inflammation as a conse- quence of the excessive recruitment Gerard J. Linden 1 , Kathy M. McClean 1 , Jayne V. Woodside 1 , Chris C. Patterson 1 , Alun Evans 1,2 , Ian S. Young 1,2 and Frank Kee 1,2 1 Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, Northern Ireland, UK; 2 UKCRC Centre of Excellence for Public Health, Belfast, Northern Ireland, UK Conflict of interest and source of funding statement The authors have no conflict of interests in relation to this research study. This research was supported by a grant from the Northern Ireland NHS Research and Development Fund. J Clin Periodontol 2009; 36: 843–849 doi: 10.1111/j.1600-051X.2009.01468.x 843 r 2009 John Wiley & Sons A/S