title: Antibodies to periodontal organisms are associated with decreased kidney function. The Dental Atherosclerosis Risk In Communities study.
abstract: OBJECTIVE
  Increasing evidence suggests that clinical signs of periodontal disease are independently associated with renal impairment. However, no studies have examined the possible linkage of kidney disease with serum antibody to oral pathogens.
  
  
  METHODS
  The periodontal disease status was assessed in an older community-dwelling population (Dental Atherosclerosis Risk in Communities) to include: clinical measurements; oral biofilm microbial composition by DNA checkerboard, and serum antibody immunoglobulin-gamma (IgG) titers to specific bacteria by immunocheckerboard. Baseline characteristics were used to compute estimated glomerular filtration rate defining eGFR <60 ml/min/1.73 m(2) as impaired renal function in 103 of 5,032 subjects. Levels of serum IgG to specific oral bacteria were categorized by quartiles (comparing upper vs. lower three) as high titer and GFR <60 as the dependent variable in logistic regression models, adjusting for multiple comparisons (Hotelling T(2)) and traditional risk factors including age, race, smoking, diabetes, hypertension, body mass, waist-to-hip ratio, serum triglycerides, HDL, and LDL cholesterol.
  
  
  RESULTS
  High levels of serum IgG to selected periodontal pathogens including Porphyromonas gingivalis, Treponema denticola and Aggregobacter actinomycetemcomitans were associated with an increased odds for GFR <60 ml/min/1.73 m(2), adjusted odds ratio ranging from 1.6 to 1.8 and p < 0.05.
  
  
  CONCLUSIONS
  Elevated IgG to periodontal pathogens is significantly associated with impaired kidney function, independent of traditional risk factors. Prospective studies are necessary to confirm these findings.
authors.affiliation: Division of Nephrology and Hypertension, UNC Kidney Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors.forename: Abhijit V
authors.initials: AV
authors.lastname: Kshirsagar
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Moss
authors.forename: Silvana P
authors.initials: SP
authors.lastname: Barros
authors.forename: James D
authors.initials: JD
authors.lastname: Beck
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000276:immunology* / Q000502:physiology; D050197:Atherosclerosis / Q000503:physiopathology; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010510:Periodontal Diseases / Q000150:complications / Q000276:immunology* / Q000382:microbiology*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D007074:Immunoglobulin G