Mahendra Jaideep, Palathingal Plato, Mahendra Little, Alzahrani Khalid J, Banjer Hamsa Jameel, Alsharif Khalaf F, Halawani Ibrahim Faisal, Muralidharan Janani, Annamalai Pandapulaykal T, Verma Shyam Sankar, Sharma Vivek, Varadarajan Saranya, Bhandi Shilpa, Patil Shankargouda
Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Greater Education and Research, Chennai 600095, India.
Department of Periodontics, PSM College of Dental Science and Research, Thrissur 680519, India.
Biology (Basel). 2022 Mar 16;11(3):451. doi: 10.3390/biology11030451.
Scientific evidence shows a positive association in the etiopathogenesis of periodontitis and chronic kidney disease (CKD). Various confounding factors, such as obesity, diabetes, and inflammation, also play a significant role in the progression of CKD, which remains unexplored. We hypothesise the role of red complex bacteria with various confounding factors associated with chronic kidney disease. The study comprised a total of 120 participants categorised into 4 groups: the control group (C), periodontitis subjects without CKD (P), periodontally healthy chronic kidney disease subjects (CKD), and subjects having both periodontitis and CKD (P + CKD), with 30 subjects in each group. Demographic variables, and periodontal, renal, and diabetic parameters were recorded. Tumour necrosis factor (TNF)-α levels and those of red complex bacteria such as (), (), () were assessed, and the obtained results were statistically analysed. Among the various demographic variables, age showed a level of significance. Mean PI, GI, CAL, and PPD (the proportion of sites with PPD ≥ 5 mm and CAL ≥ 3 mm) were elevated in the P + CKD group. Diabetic parameters such as fasting blood sugar (FBS) and HbA1c levels were also greater in the P + CKD group. Renal parameters such as eGFR and serum creatinine levels were greater in CKD patients. The estimation of red complex periodontal pathogens such as , and levels were significantly greater in the P and P + CKD groups. Pearson correlation analysis revealed significant correlation of red complex bacteria with all variables. Greater levels of , and were found in the P groups, thus indicating their important role in the initiation and progression of inflammation of periodontitis and CKD, with diabetes as one of the confounding factors. The study also confirmed a log-linear relationship between TNF-α levels and red complex bacteria, thereby demonstrating the role of inflammatory biomarkers in periodontal disease progression that could contribute to the development of systemic inflammation such as CKD.
科学证据表明，牙周炎与慢性肾脏病（CKD）的病因发病机制之间存在正相关。各种混杂因素，如肥胖、糖尿病和炎症，在CKD的进展中也起着重要作用，但仍未得到充分研究。我们推测红色复合体细菌与CKD相关的各种混杂因素之间的作用。该研究共纳入120名参与者，分为4组：对照组（C）、无CKD的牙周炎患者（P）、牙周健康的慢性肾脏病患者（CKD）以及同时患有牙周炎和CKD的患者（P + CKD），每组30名受试者。记录人口统计学变量、牙周、肾脏和糖尿病参数。评估肿瘤坏死因子（TNF）-α水平以及红色复合体细菌如（）、（）、（）的水平，并对所得结果进行统计分析。在各种人口统计学变量中，年龄具有显著性。P + CKD组的平均菌斑指数（PI）、牙龈指数（GI）、临床附着丧失（CAL）和探诊深度（PPD，PPD≥5 mm且CAL≥3 mm的部位比例）升高。P + CKD组的糖尿病参数如空腹血糖（FBS）和糖化血红蛋白（HbA1c）水平也更高。CKD患者的肾脏参数如估算肾小球滤过率（eGFR）和血清肌酐水平更高。P组和P + CKD组中红色复合体牙周病原体如（）、（）和（）的水平估计显著更高。Pearson相关分析显示红色复合体细菌与所有变量均存在显著相关性。P组中（）、（）和（）的水平更高，这表明它们在牙周炎和CKD炎症的起始和进展中起着重要作用，糖尿病是混杂因素之一。该研究还证实了TNF-α水平与红色复合体细菌之间的对数线性关系，从而证明了炎症生物标志物在牙周疾病进展中的作用，这可能导致全身性炎症如CKD的发展。
