Gingival health status in renal transplant recipients: relationship between systemic inflammation and atherosclerosis.
Cardiovascular disease (CVD) is the leading cause of mortality in renal transplant recipients (RTR). Systemic and periodontal inflammation has been suggested to have a possible role in the development of atherosclerosis. In the present study, we aimed to investigate the relationship between gingival health status, inflammation and atherosclerosis in RTRs. Eighty-three RTR (50 male, 33 female) were enrolled in the study. Routine biochemical analyses, serum lipoproteins, C-reactive protein, fibrinogen, homocystein, parathyroid hormone (PTH) and cyclosporin A (CsA) trough levels were studied. All patients had 24-h ambulatory blood pressure monitoring and B-mode ultrasound of the common carotid arteries. Gingival status was evaluated by the Löe and Silness gingival index (GI). Mean GI value was 2.3 +/- 0.5. Fifty patients (60.3%) had GI value >or= 2.1 (severe gingivitis; group A). Thirty-three patients (39.7%) had GI value < 2.1 (no or moderate gingivitis; group B). Age, carotid intima-media thickness (CIMT) and mean time on dialysis before transplantation were significantly higher in group A than in B. Systemic inflammation markers were not different between group A and group B. Mean CIMT was positively correlated with GI (r = 0.425; p = 0.001) and negatively correlated with high-density lipoprotein cholesterol (r = -0.256; p = 0.023). After the correction for confounding variables, mean CIMT was still significantly correlated with GI (r = 0.376, p = 0.02). In RTR, gingival inflammation seems to be associated with CIMT in the absence of systemic inflammation. Thus, gingivitis may, in part, play a role in the development of systemic atherosclerosis without causing any aggravation in systemic inflammatory response.
Genctoy
G
G
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Ozbek
M
M
Avcu
N
N
Kahraman
S
S
Kirkpantur
A
A
Yilmaz
R
R
Kansu
O
O
Arici
M
M
Altun
B
B
Erdem
Y
Y
Bakkaloğlu
M
M
Yasavul
U
U
Turgan
C
C
Kansu
H
H
D000328:Adult; D050197:Atherosclerosis / Q000209:etiology*; D017536:Carotid Artery, Common / Q000473:pathology; D005260:Female; D005891:Gingivitis / Q000150:complications*; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012720:Severity of Illness Index; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology