Beneficial Effects of Hormone Replacement Therapy on Periodontitis are Vitamin D Associated.
Forskningsoutput: Tidskriftsbidrag › Artikel i vetenskaplig tidskrift
Background: Possible synergism between female sex hormones and vitamin D on periodontitis pathology has not been assessed. Here, we investigate effects of estrogen, progesterone and vitamin D on periodontitis in a population-based sample and use cell studies to explore mechanistic explanations of the population-based findings. Methods: The epidemiological analysis utilizes cross-sectional data from the continuous NHANES 2001-2004. The cross-sections include n=1,230 women aged 40-85 who received a periodontal examination, responded to questions regarding hormone replacement therapy (HRT) and provided a blood sample for serum vitamin D assessments. For mechanistic cell culture studies, human monocytes were cultured with or without LPS, estradiol, progesterone and/or 1,25-dihydroxyvitamin D3 and transcriptional activity of IL-6, IL-1β, BLC and RANTES was assessed. Results: HRT use (vs. none) was associated with higher attachment levels and more teeth only among vitamin D sufficient (>20 ng/ml) participants. The odds ratio for having moderate/severe periodontitis among HRT vs. non-HRT users was 0.69 among vitamin D sufficient participants and 1.19 in vitamin D deficient subjects. LPS-induced IL-6, IL-1β and BLC expression was attenuated in human monocytes treated with estrogen and progesterone. Down-regulation of IL-6 expression by estrogen and progesterone was potentiated when vitamin D was included. LPS-induced IL-6 and RANTES expression was decreased, and BLC expression was totally reversed, by vitamin D treatment. Conclusion: Maximal beneficial effects of HRT on periodontitis are associated with high vitamin D levels. This effect is plausibly mediated via an anti-inflammatory transcriptional mechanism.