Cengiz M Inanç, Bal Seda, Gökçay Sibel, Cengiz Kuddusi
Department of Periodontology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey.
J Periodontol. 2007 Oct;78(10):1926-34. doi: 10.1902/jop.2007.060499.
Chronic infection and inflammation, including periodontitis, are linked to an increased risk for atherosclerosis. To investigate the possible adverse effects of periodontitis in continuous ambulatory peritoneal dialysis (CAPD) patients, we compared periodontal severity with inflammation and malnutrition, which are associated with poor atherosclerotic outcome in CAPD patients.
A total of 110 CAPD patients were included in this study to evaluate their clinical periodontal status by using the plaque index, gingival index, and periodontal disease index. Values for nutritional and inflammatory markers and atherosclerotic risk factors were included for analysis with the periodontal index. Analysis of variance, post hoc Tukey's honestly significant difference, univariate and multivariate linear regression analysis, Pearson correlation analysis, and chi2 analysis were used in the evaluation of the data.
Poor oral health status was exhibited by 85.5% of our CAPD patients with periodontal disease. We found that age and longer dialysis duration were associated with the severity of periodontitis. Parameters of malnutrition and inflammation and atherosclerotic risk factors also were associated with poor periodontal status. We carried out multiple regression analysis and found that age, albumin level, and duration of dialysis were associated independently with the severity of periodontitis in CAPD patients. A higher percentage of patients in the severe periodontitis group had malnutrition (chi2 = 59.4; P < 0.001), inflammation (chi2 = 60; P < 0.001), and atherosclerosis (chi2 = 65.6; P < 0.001).
Periodontal health is poor in CAPD patients and correlates with markers of malnutrition, inflammation, and atherosclerosis. The diagnosis and treatment of periodontal diseases require better awareness.
包括牙周炎在内的慢性感染和炎症与动脉粥样硬化风险增加有关。为了研究牙周炎对持续性非卧床腹膜透析（CAPD）患者可能产生的不良影响，我们比较了牙周严重程度与炎症和营养不良的关系，而炎症和营养不良与CAPD患者不良的动脉粥样硬化结局相关。
本研究共纳入110例CAPD患者，通过菌斑指数、牙龈指数和牙周疾病指数评估其临床牙周状况。纳入营养和炎症标志物以及动脉粥样硬化危险因素的值，与牙周指数进行分析。采用方差分析、事后Tukey真实显著性差异检验、单变量和多变量线性回归分析、Pearson相关分析和卡方分析对数据进行评估。
85.5%的CAPD牙周疾病患者口腔健康状况较差。我们发现年龄和较长的透析时间与牙周炎的严重程度相关。营养不良、炎症和动脉粥样硬化危险因素的参数也与牙周状况较差相关。我们进行了多元回归分析，发现年龄、白蛋白水平和透析时间独立与CAPD患者牙周炎的严重程度相关。重度牙周炎组中，更高比例的患者存在营养不良（卡方=59.4；P<0.001）、炎症（卡方=60；P<0.001）和动脉粥样硬化（卡方=65.6；P<0.001）。
CAPD患者的牙周健康状况较差，且与营养不良、炎症和动脉粥样硬化标志物相关。需要提高对牙周疾病诊断和治疗的认识。
