Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan.
J Periodontal Res. 2018 Aug;53(4):487-494. doi: 10.1111/jre.12537. Epub 2018 Feb 15.
Salivary lactate dehydrogenase (LDH) was reported to be a useful parameter for the screening of periodontal disease. We performed a cross-sectional study to verify the usefulness of salivary LDH as a biomarker of periodontitis and to investigate the association of severity of periodontitis with systemic inflammation by measuring salivary LDH and serum high sensitive C-reactive protein (hs-CRP) levels in a community-based middle-aged and elderly population in Japan.
We recruited 644 men and 1171 women, aged 30-79 years, who participated in the Toon Health Study during 2011-15. Periodontal condition was assessed by full-mouth examination including mean value of probing depth, percentage of probing depth of ≥4 mm and ≥6 mm, and bleeding on probing. Saliva and blood serum samples were collected for measurement of salivary LDH level and hs-CRP, respectively. A linear trend across quartiles of salivary LDH was calculated using linear regression. Interaction of salivary LDH and overweight status (body mass index of ≥25 kg/m ) was tested using the cross-product term of log-transformed continuous salivary LDH and overweight status.
Analysis of covariance adjusted for potential confounders revealed strong associations between salivary LDH level and the indicators of periodontal condition (P < .01) in both men and women. Sex- and age-adjusted mean values of hs-CRP according to salivary LDH quartiles were 0.40, 0.45, 0.45 and 0.50 mg/L (P for trend <.01). Although the association was attenuated after further adjustment for body mass index, hypertension, diabetes mellitus, dyslipidemia, alcohol intake, smoking status and physical activity. When stratified by overweight status, the association remained significant in overweight individuals (P = .03). The multivariable adjusted odds ratio of hs-CRP level of ≥1 mg/L for the highest vs lowest quartile of salivary LDH was 1.93 (95% CI, 1.01-3.69) in overweight individuals, but not significant in non-overweight individuals.
Salivary LDH appears to be a promising biomarker for the mass screening of periodontitis in local community health settings. High salivary LDH levels, particularly in overweight individuals might contribute to prevention of cardiovascular disease, through measuring systemic inflammatory burdens as well as traditional cardiovascular risk factors.
唾液乳酸脱氢酶（LDH）被报道为牙周病筛查的有用参数。我们进行了一项横断面研究，以验证唾液 LDH 作为牙周炎生物标志物的有用性，并通过测量日本社区中年和老年人的唾液 LDH 和血清高敏 C 反应蛋白（hs-CRP）水平来研究牙周炎严重程度与全身炎症的关系。
我们招募了 644 名男性和 1171 名女性，年龄在 30-79 岁之间，他们在 2011-15 年期间参加了 Toon 健康研究。通过全口检查评估牙周状况，包括平均探诊深度、≥4mm 和≥6mm 的探诊深度百分比以及探诊出血。收集唾液和血清样本，用于测量唾液 LDH 水平和 hs-CRP。使用线性回归计算唾液 LDH 四分位间距的线性趋势。使用对数转换的连续唾液 LDH 和超重状态的交叉乘积项测试唾液 LDH 和超重状态之间的交互作用。
调整了潜在混杂因素的协方差分析显示，唾液 LDH 水平与男性和女性的牙周状况指标之间存在很强的关联（P<0.01）。根据唾液 LDH 四分位数，hs-CRP 的年龄和性别调整后的平均值分别为 0.40、0.45、0.45 和 0.50mg/L（P 趋势<.01）。尽管进一步调整体重指数、高血压、糖尿病、血脂异常、饮酒、吸烟状况和体力活动后，相关性减弱。当按超重状态分层时，超重个体的相关性仍然显著（P=0.03）。最高与最低唾液 LDH 四分位数相比，hs-CRP 水平≥1mg/L 的多变量调整比值比为 1.93（95%CI，1.01-3.69）在超重个体中，但在非超重个体中不显著。
唾液 LDH 似乎是局部社区卫生环境中牙周炎大规模筛查的有前途的生物标志物。高唾液 LDH 水平，特别是在超重个体中，可能通过测量系统性炎症负担以及传统心血管危险因素，有助于预防心血管疾病。
