UKY DENTAL COBRE: ORAL INFECTIONS: IMPACT ON GESTATIONAL DIABETES

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 我们的一般假设是，患有妊娠期糖尿病的妇女比非妊娠期糖尿病的妇女患更严重的牙周病的风险更高，而且妊娠期糖尿病和牙周病的结合将与对母婴健康的负面影响增加相关。这些前瞻性临床数据将与基础科学实验室对微生物区系和宿主反应的评估相关联，以深入了解与炎症性牙周病和妊娠期糖尿病相关的不良母婴结局的致病机制。 该项目包括三个特定的目标，旨在研究妊娠期糖尿病(GDM)对牙周病的临床、微生物学和免疫学特征的影响，以及这些潜在危险因素与母婴健康的关系。在注册时，调查员进行临床牙周检查，以证明牙周炎的存在和严重程度(具体目标1)。在怀孕早期(31周)登记的患者只能看一次诊。在没有妊娠期糖尿病的对照组上进行类似的检查，这些对照组在年龄、种族/民族和孕周方面与测试对象相匹配。根据糖尿病状态和牙周炎的存在与否，将受试者分为4组：GDM合并牙周炎(GDM+PD)组；GDM无牙周炎(GDM PD)组；正常对照组(NC+PD)；正常对照组(NC PD)。除了进行临床检查外，作为基线和34周检查的一部分，我们还收集了牙菌斑和血清样本，使我们能够确定每个组和每个时间点的龈下生物膜微生物区系特征(特定目标2)和全身炎症生物标志物水平(特定目标3)。研究人群由一群16-45岁的流动妇女组成，她们的怀孕通过肯塔基大学诊所、肯塔基州里士满的Gordon and Salter，Inc.和肯塔基州乔治敦的乔治敦妇产科诊所进行管理。我们目前已将271名受试者分为以下类别：GDM+PD 56；GDM PD 83；NC+PD 42；NC PD 90。民族/种族概况是100名白人，120名西班牙裔/拉丁裔，29名黑人/非裔美国人和22名亚洲人。所有的数据，包括孕妇和胎儿的结局，都是在230名受试者身上收集的。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Our GENERAL HYPOTHESIS is that women with GDM are at higher risk for developing more severe periodontal disease than women without GDM and that the combination of GDM and periodontal disease will be associated with an increased negative impact on maternal and fetal health. These prospective clinical data will be correlated with basic science laboratory evaluations of the microflora and host response to provide insight into the pathogenic mechanisms contributing to negative maternal and fetal outcomes associated with inflammatory periodontal disease and GDM. This project consists of three specific aims that are designed to study the effects of Gestational Diabetes Mellitus (GDM) on the clinical, microbiologic and immunologic characteristics of periodontal disease and the associations between these potential risk factors and maternal and fetal health. At enrollment, the investigator performs a clinical periodontal examination to document the presence and severity of periodontitis (Specific Aim 1). Patients who are enrolled early in their pregnancy (31 weeks), may only be seen for one visit. Comparable examinations are performed on the controls without GDM, who have been matched with the test subjects for age, race/ethnicity and gestational week. The subjects are stratified into four groups based on diabetic status and the presence or absence of periodontitis  Group 1: GDM with periodontitis (GDM + PD); Group 2: GDM without periodontitis (GDM  PD); Group 3: normal controls with periodontitis (NC + PD); and Group 4: normal controls without periodontitis (NC  PD). In addition to performing the clinical examinations, dental plaque and serum samples are collected as part of the baseline and 34 week examinations, allowing us to characterize the subgingival biofilm microbiota (Specific Aim 2) and quantify levels of systemic inflammatory biomarkers (Specific Aim 3) in each group and at each time point. The study population consists of a group of ambulatory women, aged 16-45, whose pregnancies are being managed through the University of Kentucky Clinics, the Gordon and Salter, Inc. practice in Richmond, KY and the Georgetown Obstetrics and Gynecology practice in Georgetown, KY. We have currently enrolled 271 subjects into the following categories: GDM + PD 56; GDM  PD 83; NC + PD 42; NC  PD 90. The ethnic/racial profiles are 100 White, 120 Hispanic/Latino, 29 Black/African American and 22 Asian. All of the data, including maternal and fetal outcomes, have been collected on 230 of these subjects.