title: Gingival health status in renal transplant recipients: relationship between systemic inflammation and atherosclerosis.
abstract: 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.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Genctoy
authors.forename: M
authors.initials: M
authors.lastname: Ozbek
authors.forename: N
authors.initials: N
authors.lastname: Avcu
authors.forename: S
authors.initials: S
authors.lastname: Kahraman
authors.forename: A
authors.initials: A
authors.lastname: Kirkpantur
authors.forename: R
authors.initials: R
authors.lastname: Yilmaz
authors.forename: O
authors.initials: O
authors.lastname: Kansu
authors.forename: M
authors.initials: M
authors.lastname: Arici
authors.forename: B
authors.initials: B
authors.lastname: Altun
authors.forename: Y
authors.initials: Y
authors.lastname: Erdem
authors.forename: M
authors.initials: M
authors.lastname: Bakkaloğlu
authors.forename: U
authors.initials: U
authors.lastname: Yasavul
authors.forename: C
authors.initials: C
authors.lastname: Turgan
authors.forename: H
authors.initials: H
authors.lastname: Kansu
mesh_terms: 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