Periodontitis Predicts Elevated C-reactive Protein Levels in Chronic Kidney Disease
Identifieur interne : 002419 ( Pmc/Curation ); précédent : 002418; suivant : 002420Periodontitis Predicts Elevated C-reactive Protein Levels in Chronic Kidney Disease
Auteurs : E. Ioannidou ; H. Swede [États-Unis] ; A. Dongari-BagtzoglouSource :
- Journal of Dental Research [ 0022-0345 ] ; 2011.
Abstract
Based on the existing evidence supporting a state of chronic inflammation in chronic kidney disease (CKD), we hypothesized that periodontal infection may affect the systemic inflammatory status of a nationally representative CKD population as measured by serum C-reactive protein (CRP). We examined this hypothesis using the National Health and Nutrition Examination Survey 1988-1994 (NHANES III) dataset including 2303 individuals. We followed the American Academy of Periodontology (AAP)/Centers for Disease Control and Prevention (CDC) case definition for periodontitis. We used a cutoff point of 30% sites with (PD) ≥ 5 mm and (CAL) ≥ 4 mm to define generalized periodontitis cases. We estimated glomerular filtration rate based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio was calculated in milligrams
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DOI: 10.1177/0022034511423394
PubMed: 21940520
PubMed Central: 3215758
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E. Ioannidou<affiliation><nlm:aff id="aff1-0022034511423394">Division of Periodontology, Department of Oral Health and Diagnostic Sciences</nlm:aff>
<wicri:noCountry code="subfield">Department of Oral Health and Diagnostic Sciences</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="aff1-0022034511423394">Division of Periodontology, Department of Oral Health and Diagnostic Sciences</nlm:aff>
<wicri:noCountry code="subfield">Department of Oral Health and Diagnostic Sciences</wicri:noCountry>
</affiliation>
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<front><div type="abstract" xml:lang="en"><p>Based on the existing evidence supporting a state of chronic inflammation in chronic kidney disease (CKD), we hypothesized that periodontal infection may affect the systemic inflammatory status of a nationally representative CKD population as measured by serum C-reactive protein (CRP). We examined this hypothesis using the National Health and Nutrition Examination Survey 1988-1994 (NHANES III) dataset including 2303 individuals. We followed the American Academy of Periodontology (AAP)/Centers for Disease Control and Prevention (CDC) case definition for periodontitis. We used a cutoff point of 30% sites with (PD) ≥ 5 mm and (CAL) ≥ 4 mm to define generalized periodontitis cases. We estimated glomerular filtration rate based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio was calculated in milligrams <italic>per</italic>
gram with a cutoff point of 30 mg/g. CKD was defined based on eGFR < 60 mL/min/1.73m<sup>2</sup>
and albuminuria ≥ 30 mg/g. Periodontitis was found in 427 (12.3%) individuals. Of individuals with periodontitis, 41.8% had serum CRP higher than 0.3 mg/dL compared with 27.1% of non-periodontitis and 53.1% of edentulous individuals (p = 0.001 for all comparisons). When the extent of periodontitis was used as one of the independent variables, the parsimonious model showed a strong independent association between extent of periodontitis and serum CRP levels (OR = 2.0, CI95% = 1.2-3.6).</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Dent Res</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Dent. Res</journal-id>
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<title-group><article-title>Periodontitis Predicts Elevated C-reactive Protein Levels in Chronic Kidney Disease</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Ioannidou</surname>
<given-names>E.</given-names>
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<contrib contrib-type="author"><name><surname>Dongari-Bagtzoglou</surname>
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Division of Periodontology, Department of Oral Health and Diagnostic Sciences</aff>
<aff id="aff2-0022034511423394"><label>2</label>
Division of Epidemiology and Biostatistics, Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06030, USA</aff>
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<email>Ioannidou@uchc.edu</email>
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<pub-date pub-type="epub-ppub"><month>12</month>
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<volume>90</volume>
<issue>12</issue>
<fpage>1411</fpage>
<lpage>1415</lpage>
<history><date date-type="received"><day>2</day>
<month>6</month>
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<date date-type="rev-recd"><day>15</day>
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<permissions><copyright-statement>© 2011 International & American Associations for Dental Research</copyright-statement>
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<abstract><p>Based on the existing evidence supporting a state of chronic inflammation in chronic kidney disease (CKD), we hypothesized that periodontal infection may affect the systemic inflammatory status of a nationally representative CKD population as measured by serum C-reactive protein (CRP). We examined this hypothesis using the National Health and Nutrition Examination Survey 1988-1994 (NHANES III) dataset including 2303 individuals. We followed the American Academy of Periodontology (AAP)/Centers for Disease Control and Prevention (CDC) case definition for periodontitis. We used a cutoff point of 30% sites with (PD) ≥ 5 mm and (CAL) ≥ 4 mm to define generalized periodontitis cases. We estimated glomerular filtration rate based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio was calculated in milligrams <italic>per</italic>
gram with a cutoff point of 30 mg/g. CKD was defined based on eGFR < 60 mL/min/1.73m<sup>2</sup>
and albuminuria ≥ 30 mg/g. Periodontitis was found in 427 (12.3%) individuals. Of individuals with periodontitis, 41.8% had serum CRP higher than 0.3 mg/dL compared with 27.1% of non-periodontitis and 53.1% of edentulous individuals (p = 0.001 for all comparisons). When the extent of periodontitis was used as one of the independent variables, the parsimonious model showed a strong independent association between extent of periodontitis and serum CRP levels (OR = 2.0, CI95% = 1.2-3.6).</p>
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