Periodontitis and placental growth factor in oral fluids are early pregnancy predictors of gestational diabetes mellitus
Periodontitis and placental growth factor in oral fluids are early pregnancy predictors of gestational diabetes mellitus
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DOI：
10.1002/jper.17-0497
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发表时间：
2018-09-01
影响因子：
4.3
通讯作者：
Illanes, Sebastian E.
中科院分区：
文献类型：
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作者：
Chaparro, Alejandra;Zuniga, Edgardo;Illanes, Sebastian E.
背景：妊娠糖尿病（GDM）影响约7%至10%的所有妊娠。早期检测GDM易感性是开发有效预防治疗的第一步。本研究的目的是建立实用的胎盘蛋白存在于口腔液（龈沟液[GCF]和唾液），牙周疾病的状态作为早期妊娠GDM.Methods预测：嵌套病例对照组内的前瞻性队列进行。纳入妊娠11 - 14周时年龄在18 - 40岁之间的妊娠全身健康女性。收集口腔液样本，并获得完整的孕产妇/产科和牙周病史。胎盘生长因子（PlGF）和可溶性Fms样酪氨酸激酶1（sFlt-1）的浓度测定酶联免疫吸附试验在巢式病例对照样本的前瞻性队列。多元logistic回归模型评估了这种关联。通过计算曲线下面积（AUC），通过受试者工作特征（ROC）曲线进行生物标志物诊断准确性的评估。6.6%）发生GDM，并显示探诊出血（BOP）[P=0.0003]、牙周探诊深度（PD）[P=0.0028]、临床附着水平（AL）[P=0.0008]和牙周炎表面积（比萨）[P=0.0001]显著更大。类似地，GDM女性的初始PGF和GCF-PlGF浓度显著更高[分别为P=0.0012和P=0.0019]。当对数据进行ROC曲线分析时，初始浓度和GCF-PlGF浓度的组合提供0.897的ROC曲线下面积。多元逻辑回归分析表明，（OR 1.21，95%置信区间[CI] 1.06至1.38; P=0.005）和GCF-PlGF浓度（OR 1.68，CI 1.05 ~ 2.68 P=0.03）。在本研究的局限性内，结果支持孕早期母体妊娠率与GCF-PlGF浓度的组合可以是症状前女性中GDM未来发展的替代生物标志物。
Background: Gestational diabetes mellitus (GDM) affects around 7% to 10% of all pregnancies. Early detection of predisposition to GDM is the first step in developing efficacious preventive treatment. The objective of the present study was to establish the utility of placental proteins presents in oral fluids (gingival crevicular fluid [GCF] and saliva), and periodontal disease status as early pregnancy predictors of GDM.Methods: A nested case control within a prospective cohort was conducted. Pregnant systemically healthy women, aged between 18 and 40 years at 11 to 14 weeks gestation were included. Samples of oral fluids were collected and a complete maternal/obstetric and periodontal history was obtained. The concentration of placental growth factor (PlGF) and soluble Fms-like tyrosine kinase 1 (sFlt-1) were measured by enzyme-linked immunosorbent assay in a nested case control sample of the prospective cohort. Multiple logistic regression models assessed the association. The evaluation of the diagnostic accuracy of the biomarkers was performed through receiver operating characteristic (ROC) curves by calculating the area under the curve (AUC).Results: There were recruited 212 pregnant women at 11 to 14 weeks of pregnancy, of these, 14 women (i.e., 6.6%) developed GDM, and displayed significant greater bleeding on probing (BOP) [P=0.0003]; periodontal probing depth (PD) [P=0.0028]; clinical attachment level (AL) [P=0.0008] and periodontal inflamed surface area (PISA) [P=0.0001]. Similarly, initial glycemia and GCF-PlGF concentrations were significantly greater in women with GDM [P=0.0012, and P=0.0019, respectively]. When data were subjected to ROC curve analysis, the combination of initial glycemia and GCF-PlGF concentration delivered an area under the ROC curve of 0.897. Multiple logistic regression analyses demonstrate an association between glycemia (OR 1.21, 95% confidence interval [CI] 1.06 to 1.38; P=0.005) and GCF-PlGF concentrations in women who developed GDM (OR 1.68, CI 1.05 to 2.68 P=0.03).Conclusions: Within the limitations of the present study, the results support that first trimester maternal glycemia combined with GCF-PlGF concentrations could be a surrogate biomarker for the future development of GDM in pre-symptomatic women.