Wynimko Marta, Walicka Magdalena, Sanchak Yaroslav, Gozdowski Dariusz, Błach Anna, Więcek Andrzej, Śliwczyński Andrzej, Franek Edward, Kolonko Aureliusz
Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Wołoska 137, 02-507 Warsaw, Poland.
Department of Biometry, Warsaw University of Life Sciences, Nowoursynowska 166, 02-787 Warsaw, Poland.
J Clin Med. 2020 Jun 23;9(6):1968. doi: 10.3390/jcm9061968.
Chronic periodontitis (CP) is associated with cardiovascular disease and mortality in different populations. The aim of this study was to examine an association of CP with hard endpoints in patients after kidney transplantation during a 15-year follow-up period. Study group consist of 117 patients (77M/40F, median age 44 years) divided into two subgroups: those with initially advanced CP (CPITN 3-4) and those with no or moderate CP (CPITN 0-2). All cardiovascular events, graft losses, and re-transplantations were recorded. All deaths were noted and verified, including those occurred after the return to dialysis therapy, the causes of death were identified. Cox regression with Firth's penalized maximum likelihood models were used for data analysis. During the observation period, 49 deaths occurred. Advanced CP ( = 35) was not associated with overall mortality but was associated with increased risk of death with functioning graft (DWFG) [HR 3.54 (1.20-10.45); < 0.05]. Risk of graft loss was not associated with CP status. In conclusion, an advanced CP was independently associated with increased risk of DWFG, but not all-cause or cardiovascular mortality after renal transplantation.
慢性牙周炎（CP）与不同人群的心血管疾病及死亡率相关。本研究旨在探讨在15年随访期内，CP与肾移植患者硬终点事件之间的关联。研究组由117例患者（77例男性/40例女性，中位年龄44岁）组成，分为两个亚组：初始患有重度CP（社区牙周指数[CPITN]为3 - 4）的患者和无CP或患有中度CP（CPITN为0 - 2）的患者。记录所有心血管事件、移植物丢失及再次移植情况。记录并核实所有死亡病例，包括恢复透析治疗后发生的死亡病例，确定死亡原因。采用带有Firth惩罚最大似然模型的Cox回归进行数据分析。在观察期内，发生了49例死亡。重度CP（n = 35）与总体死亡率无关，但与移植肾功能正常时的死亡风险增加相关[风险比（HR）为3.54（范围1.20 - 10.45）；P < 0.05]。移植物丢失风险与CP状态无关。总之，重度CP与移植肾功能正常时死亡风险增加独立相关，但与肾移植后的全因死亡率或心血管死亡率无关。
