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J Clin Periodontol. 2008 Oct;35(10):853-61. doi: 10.1111/j.1600-051X.2008.01309.x. Epub 2008 Aug 24.

Association of cortisol and dehydroepiandrosterone sulphate levels in serum with periodontal status in older Japanese adults.

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Department of Health Promotion, Division of Community Oral Health Science, Kyushu Dental College, Kitakyushu, Japan.



The associations between periodontitis and stress-related steroid hormone levels released by the hypothalamic-pituitary-adrenal axis are poorly understood. In this study, we examined the association between levels of the stress-related steroid hormones cortisol and dehydroepiandrosterone-sulphate (DHEAS) and periodontitis in elderly subjects.


A total of 467 subjects participated in this study. Serum cortisol and DHEAS levels were determined, and a medical questionnaire regarding medical conditions and lifestyle was administered. In addition, clinical examinations including probing depth (PD), bleeding on probing (BOP), and clinical attachment loss (CAL) were conducted.


The subjects were divided into tertiles on the basis of periodontitis severity. When the analysis was stratified by smoking status, we found that cortisol levels were significantly higher in those with severe CAL among subjects who had never smoked. Furthermore, multiple regression analysis showed that a higher level of cortisol was significantly associated with greater numbers of sites with severe CAL only in those who had never smoked, while a somewhat weaker association was also observed regarding cortisol/DHEAS ratio. In contrast, the level of DHEAS in serum was not associated with periodontitis.


There were significant associations between serum cortisol level, including cortisol/DHEAS ratio, and periodontitis severity in elderly subjects who had never smoked.

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