Nylund Karita M, Meurman Jukka H, Heikkinen Anna Maria, Honkanen Eero, Vesterinen Maarit, Furuholm Jussi O, Tervahartiala Taina, Sorsa Timo, Ruokonen Hellevi M
Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Nephrology, University of Helsinki and Helsinki University Hospital.
J Periodontol. 2015 Nov;86(11):1212-20. doi: 10.1902/jop.2015.150285. Epub 2015 Jul 9.
The aim of the present study is to compare periodontal inflammatory burden related to the salivary matrix metalloproteinase (MMP)-8 concentration among patients with chronic kidney disease (CKD) at the predialysis stage.
Salivary samples from 118 predialysis patients were assayed for MMP-8 by immunofluorometric assay. Of the patients, 43 (36%) had diabetic nephropathy, whereas 75 (64%) had other kidney disease. Clinical and radiographic oral health examination was made at Helsinki University Hospital. Oral and general health data including laboratory findings were recorded from hospital records, and the periodontal inflammatory burden index (PIBI) and the total dental index (TDI) were calculated. Results were analyzed with cross tabulation, Pearson χ(2) test, and Mann-Whitney U test.
Results included elevated PIBI, increased TDI, and two or more sites with ≥ 6 mm or deeper periodontal pocket, associated with elevated salivary MMP-8 concentrations (P < 0.05 in all associations). The diabetic nephropathy group and patients with high hemoglobin A1c (HbA1c) values (≥ 6.5%, ≥ 48 mmol/mol) exerted slightly elevated median salivary MMP-8 values compared with the other CKD group or regarding patients with HbA1c values < 6.5%, but these differences were not statistically significant.
Elevated salivary MMP-8 associated significantly with more severe oral/periodontal inflammatory burden among patients with CKD at the predialysis stage. Thus, salivary MMP-8 analysis could give adjunctive information regarding oral health.
本研究旨在比较慢性肾脏病(CKD)透析前阶段患者唾液基质金属蛋白酶(MMP)-8浓度与牙周炎症负担的关系。
采用免疫荧光分析法对118例透析前患者的唾液样本进行MMP-8检测。其中43例(36%)患有糖尿病肾病,75例(64%)患有其他肾脏疾病。在赫尔辛基大学医院进行临床和口腔影像学健康检查。从医院记录中记录口腔和全身健康数据,包括实验室检查结果,并计算牙周炎症负担指数(PIBI)和总牙指数(TDI)。采用交叉表、Pearson χ(2)检验和Mann-Whitney U检验对结果进行分析。
结果显示,PIBI升高、TDI增加以及两个或更多位点出现牙周袋深度≥6 mm,均与唾液MMP-8浓度升高相关(所有关联中P<0.05)。糖尿病肾病组和血红蛋白A1c(HbA1c)值高(≥6.5%,≥48 mmol/mol)的患者,与其他CKD组或HbA1c值<6.5%的患者相比,唾液MMP-8的中位数略高,但这些差异无统计学意义。
透析前阶段CKD患者唾液MMP-8升高与更严重的口腔/牙周炎症负担显著相关。因此,唾液MMP-8分析可为口腔健康提供辅助信息。