title: Periodontitis predicts elevated C-reactive protein levels in chronic kidney disease.
abstract: Based on the existing evidence supporting a state of chronic inflammation in chronic kidney disease (CKD), we hypothesized that periodontal infection may affect the systemic inflammatory status of a nationally representative CKD population as measured by serum C-reactive protein (CRP). We examined this hypothesis using the National Health and Nutrition Examination Survey 1988-1994 (NHANES III) dataset including 2303 individuals. We followed the American Academy of Periodontology (AAP)/Centers for Disease Control and Prevention (CDC) case definition for periodontitis. We used a cutoff point of 30% sites with (PD) ≥ 5 mm and (CAL) ≥ 4 mm to define generalized periodontitis cases. We estimated glomerular filtration rate based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio was calculated in milligrams per gram with a cutoff point of 30 mg/g. CKD was defined based on eGFR < 60 mL/min/1.73 m(2) and albuminuria ≥ 30 mg/g. Periodontitis was found in 427 (12.3%) individuals. Of individuals with periodontitis, 41.8% had serum CRP higher than 0.3 mg/dL compared with 27.1% of non-periodontitis and 53.1% of edentulous individuals (p = 0.001 for all comparisons). When the extent of periodontitis was used as one of the independent variables, the parsimonious model showed a strong independent association between extent of periodontitis and serum CRP levels (OR = 2.0, CI95% = 1.2-3.6).
authors.affiliation: Division of Periodontology, Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA. Ioannidou@uchc.edu
authors.forename: E
authors.initials: E
authors.lastname: Ioannidou
authors.forename: H
authors.initials: H
authors.lastname: Swede
authors.forename: A
authors.initials: A
authors.lastname: Dongari-Bagtzoglou
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000175:diagnosis; D002097:C-Reactive Protein / Q000032:analysis*; D016009:Chi-Square Distribution; D055113:Chronic Periodontitis / Q000097:blood* / Q000150:complications; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein