Faculty of Dentistry, Department of Periodontology, University of Dicle, Diyarbakir, Turkey.
J Periodontal Res. 2010 Aug;45(4):445-50. doi: 10.1111/j.1600-0765.2009.01252.x. Epub 2010 Mar 9.
The prevalence of chronic renal disease in industrialized countries is increasing, and chronic renal disease and periodontitis can have significant, reciprocal effects. The aim of this study was to evaluate the associations between specific clinical parameters and the levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) in the gingival crevicular fluid of hemodialysis (HD) patients with periodontal disease.
Forty-three HD patients and 43 systemically healthy subjects were enrolled in this study. Plaque index (PI), gingival index (GI) and pocket depth were used to determine periodontal status. Venous blood samples were obtained from each patient in the morning before the dialysis session and analyzed to determine the levels of inflammatory, biochemical and hematological parameters. Gingival crevicular fluid was collected from all subjects, and the levels of TNF-alpha and IL-8 were determined in the gingival crevicular fluid samples.
The following results were obtained from HD patients and controls: TNF-alpha (pg/mL), 31.40 +/- 1.46 and 3.06 +/- 0.15 (p < 0.001); IL-8 (pg/mL), 90.98 +/- 94.03 and 35.05 +/- 16.86 (p < 0.001); PI, 1.69 +/- 1.02 and 0.04 +/- 0.02 (p < 0.001); GI, 0.82 +/- 0.06 and 0.04 +/- 0.02 (p < 0.001); and pocket depth, 2.23 +/- 0.63 and 1.51 +/- 0.05 (p < 0.001), respectively. In addition, there were positive correlations between TNF-alpha and PI (r = 0.642, p < 0.001), between TNF-alpha and GI (r = 0.565, p < 0.001), between TNF-alpha and pocket depth (r = 0.522, p < 0.001), between IL-8 and PI (r = 0.402, p = 0.002), between IL-8 and GI (r = 0.396, p = 0.002), and between IL-8 and pocket depth (r = 0.326, p = 0.012). There were negative correlations between albumin and PI (r = -0.491, p < 0.001), albumin and GI (r = -0.406, p < 0.001), albumin and pocket depth (r = -0.464, p < 0.001) and albumin and CRP (r = -0.467, p = 0.002) and between the gingival crevicular fluid levels of TNF-alpha and IL-8, TNF-alpha and hemoglobin (r = -0.745, p < 0.001; r = -0.285, p < 0.05) (respectively).
The levels of TNF-alpha and IL-8 in gingival crevicular fluid were significantly higher in HD patients than in controls. There were strong, positive correlations between clinical periodontal parameters and the levels of inflammatory cytokines in gingival crevicular fluid from the HD patients.
在工业化国家，慢性肾病的发病率正在上升，慢性肾病和牙周炎之间可能存在显著的相互影响。本研究旨在评估特定临床参数与血液透析（HD）伴牙周病患者龈沟液中肿瘤坏死因子-α（TNF-α）和白细胞介素-8（IL-8）水平之间的相关性。
纳入 43 例 HD 患者和 43 例系统健康受试者。使用菌斑指数（PI）、牙龈指数（GI）和牙周袋深度来确定牙周状况。每位患者在透析前的早晨采集静脉血样，并进行分析以确定炎症、生化和血液学参数水平。从所有受试者中采集龈沟液，并测定龈沟液中 TNF-α和 IL-8的水平。
HD 患者和对照组的结果如下：TNF-α（pg/mL），31.40±1.46 和 3.06±0.15（p<0.001）；IL-8（pg/mL），90.98±94.03 和 35.05±16.86（p<0.001）；PI，1.69±1.02 和 0.04±0.02（p<0.001）；GI，0.82±0.06 和 0.04±0.02（p<0.001）；牙周袋深度，2.23±0.63 和 1.51±0.05（p<0.001）。此外，TNF-α与 PI 之间呈正相关（r=0.642，p<0.001），TNF-α与 GI 之间呈正相关（r=0.565，p<0.001），TNF-α与牙周袋深度之间呈正相关（r=0.522，p<0.001），IL-8 与 PI 之间呈正相关（r=0.402，p=0.002），IL-8 与 GI 之间呈正相关（r=0.396，p=0.002），IL-8 与牙周袋深度之间呈正相关（r=0.326，p=0.012）。白蛋白与 PI 之间呈负相关（r=-0.491，p<0.001），白蛋白与 GI 之间呈负相关（r=-0.406，p<0.001），白蛋白与牙周袋深度之间呈负相关（r=-0.464，p<0.001），白蛋白与 CRP 之间呈负相关（r=-0.467，p=0.002），TNF-α 和 IL-8 龈沟液水平之间呈负相关（r=-0.745，p<0.001；r=-0.285，p<0.05）。
HD 患者龈沟液中 TNF-α和 IL-8 的水平明显高于对照组。HD 患者的临床牙周参数与龈沟液中炎症细胞因子水平之间存在强烈的正相关。
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