The Role of Systemic Health Indicators, Including C-Reactive Protein and eGFR, in Predicting Periodontal Disease: A Longitudinal Study

Abstract

C-reactive protein (CRP) and estimated glomerular filtration rate (eGFR) are key biomarkers reflecting systemic inflammation and metabolic dysfunction. This study explored systemic and oral health indicators, including CRP and eGFR, as potential factors associated with periodontitis, using a longitudinal clinical dataset comprising 23,742 records from patients identified by ICD-10 codes between 2015 and 2022. Univariate Cox analysis and Gompertz models, selected based on AIC and BIC after evaluating alternative models, were employed to assess the predictive roles of CRP and eGFR in periodontitis incidence, adjusting for oral and systemic health factors. Elevated CRP (>15 mg/L) and reduced eGFR (<60 mL/min/1.73 m2) were significant predictors of periodontitis, with hazard ratios (HR) of 1.36 [1.05–1.77] and 1.39 [1.08–1.78], respectively. Atherosclerosis (HR: 2.12 [1.11–4.06]), diseases of the hard tissues of the teeth (HR: 7.30 [5.45–9.78]), and disorders of the teeth and supporting structures (HR: 3.02 [2.05–4.43]) also demonstrated strong predictive associations. CRP and eGFR emerged as potential biomarkers for predicting periodontitis, enabling early interventions to prevent tooth loss and systemic complications. Patients with chronic kidney disease, atherosclerotic heart disease, and lipid metabolism disorders are at higher risk, emphasizing the need for integrated care addressing both systemic and oral health factors.