Swoboda Jessica R, Kiyak H Asuman, Darveau Richard, Persson G Rutger
Department of Periodontics, University of Washington, Seattle, WA, USA.
J Periodontol. 2008 Oct;79(10):1920-6. doi: 10.1902/jop.2008.080005.
There is limited information on infectious and host responses distinguishing older people with or without active periodontitis. This study measured bacterial and serum cytokine and high-sensitivity C-reactive protein (hsCRP) levels in older persons.
Elders (mean age: 67 years), whose periodontal status had declined most or least (20% worst or 20% best) over 5 years, were enrolled. Two years later, they were classified as periodontally declining (active periodontitis [AP]), if they had at least five teeth with probing depth (PD) > or =5 mm, or stable (stable periodontally [SP]), if they did not. Groups were compared with respect to demographics, PD, clinical loss of attachment, subgingival bacteria, serum hsCRP, interleukin (IL)-1beta and -6, and chronic diseases.
Ten AP and 24 SP subjects were identified; 13% of women and 44% of men from the original sample were in the AP group (P <0.05). Most Asians were SP; most whites and all African Americans were classified as having AP (P <0.01). More AP elders had osteoporosis (P <0.01), but the AP and SP groups did not differ with respect to IL-1beta and -6 or hsCRP. Bacterial counts were higher in the AP group for Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros) (7.7 x 10(5) cells versus 3.8 x 10(5) cells; P <0.05), Prevotella intermedia (25.7 x 10(5) cells versus 9.8 x 10(5) cells; P <0.01), Tannerella forsythia (previously T. forsythensis) (16.2 x 10(5) cells versus 8.0 x 10(5) cells; P <0.05), and Streptococcus mutans (6.2 x 10(5) cells versus 2.0 x 10(5) cells; P <0.01). Three risk factors were most predictive of periodontal decline: PD, osteoporosis, and being white or African American.
Periodontal decline was associated with osteoporosis, ethnicity, PD, gender, serum hsCRP, and levels of four bacterial species.
关于区分患有或未患有活动性牙周炎的老年人的感染及宿主反应的信息有限。本研究测量了老年人的细菌、血清细胞因子及高敏C反应蛋白（hsCRP）水平。
纳入牙周状况在5年内下降最多或最少（最差的20%或最好的20%）的老年人（平均年龄：67岁）。两年后，如果至少有5颗牙齿的探诊深度（PD）≥5mm，则将他们分类为牙周状况下降（活动性牙周炎[AP]）；如果没有，则分类为稳定（牙周稳定[SP]）。比较两组在人口统计学、PD、临床附着丧失、龈下细菌、血清hsCRP、白细胞介素（IL）-1β和-6以及慢性病方面的情况。
确定了10名AP受试者和24名SP受试者；原始样本中13%的女性和44%的男性在AP组（P<0.05）。大多数亚洲人是SP；大多数白人和所有非裔美国人被分类为患有AP（P<0.01）。更多的AP老年人患有骨质疏松症（P<0.01），但AP组和SP组在IL-1β和-6或hsCRP方面没有差异。AP组微小微单胞菌（以前称为微小消化链球菌或微小微单胞菌）（7.7×10⁵个细胞对3.8×10⁵个细胞；P<0.05）、中间普氏菌（25.7×10⁵个细胞对9.8×10⁵个细胞；P<0.01）、福赛坦纳菌（以前称为福赛斯坦纳菌）（16.2×10⁵个细胞对8.0×10⁵个细胞；P<0.05）和变形链球菌（6.2×10⁵个细胞对2.0×10⁵个细胞；P<0.01）的细菌计数更高。三个风险因素对牙周状况下降的预测性最强：PD、骨质疏松症以及是白人或非裔美国人。
牙周状况下降与骨质疏松症、种族、PD、性别、血清hsCRP以及四种细菌的水平有关。
