Antibodies to periodontal organisms are associated with decreased kidney function - The dental atherosclerosis risk in communities study
Antibodies to periodontal organisms are associated with decreased kidney function - The dental atherosclerosis risk in communities study
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DOI：
10.1159/000096411
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发表时间：
2007-01-01
影响因子：
3
通讯作者：
Beck, James D.
中科院分区：
文献类型：
--
作者：
Kshirsagar, Abhijit V.;Offenbacher, Steven;Beck, James D.
背景/目的：越来越多的证据表明牙周病的临床体征与肾损害独立相关。然而，没有研究检查肾脏疾病与口腔病原体血清抗体的可能联系。研究方法：牙周病的状态进行了评估，在老年社区居住的人口（社区的牙科动脉粥样硬化风险），包括：临床测量，口腔生物膜的微生物组成的DNA棋盘，和血清抗体免疫球蛋白-γ（IgG）滴度，以特定的细菌免疫棋盘。在5,032名受试者中，有103名受试者的基线特征用于计算肾小球滤过率估计值，肾小球滤过率估计值eGFR < 60 ml/min/1.73 m（2）定义为肾功能受损。针对特定口腔细菌的血清IgG水平通过四分位数（比较上三个与下三个）分类为高滴度，GFR < 60作为逻辑回归模型中的因变量，调整多重比较（Hotelling T-2）和传统风险因素，包括年龄、种族、吸烟、糖尿病、高血压、体重、腰臀比、血清甘油三酯、HDL和LDL胆固醇。结果如下：高水平的血清IgG对选定的牙周病原体包括牙龈卟啉单胞菌、齿垢密螺旋体和伴放线菌聚集杆菌与GFR < 60 ml/min/1.73 m（2）的比值增加相关，校正比值比范围为1.6 - 1.8，p < 0.05。结论：牙周病原体IgG升高与肾功能受损显著相关，独立于传统的危险因素。前瞻性研究是必要的，以证实这些发现。版权所有（c）2007 S. Karger AG，巴塞尔。
Background/ Aims: Increasing evidence suggests that clinical signs of periodontal disease are independently associated with renal impairment. However, no studies have examined the possible linkage of kidney disease with serum antibody to oral pathogens. Methods: The periodontal disease status was assessed in an older community-dwelling population ( Dental Atherosclerosis Risk in Communities) to include: clinical measurements; oral biofilm microbial composition by DNA checkerboard, and serum antibody immunoglobulin-gamma ( IgG) titers to specific bacteria by immunocheckerboard. Baseline characteristics were used to compute estimated glomerular filtration rate defining eGFR < 60 ml/min/1.73 m(2) as impaired renal function in 103 of 5,032 subjects. Levels of serum IgG to specific oral bacteria were categorized by quartiles ( comparing upper vs. lower three) as high titer and GFR < 60 as the dependent variable in logistic regression models, adjusting for multiple comparisons ( Hotelling T-2) and traditional risk factors including age, race, smoking, diabetes, hypertension, body mass, waist-to-hip ratio, serum triglycerides, HDL, and LDL cholesterol. Results: High levels of serum IgG to selected periodontal pathogens including Porphyromonas gingivalis, Treponema denticola and Aggregobacter actinomycetemcomitans were associated with an increased odds for GFR < 60 ml/min/1.73 m(2), adjusted odds ratio ranging from 1.6 to 1.8 and p < 0.05. Conclusions: Elevated IgG to periodontal pathogens is significantly associated with impaired kidney function, independent of traditional risk factors. Prospective studies are necessary to confirm these findings. Copyright (c) 2007 S. Karger AG, Basel.