title: Increased infection with key periodontal pathogens during gestational diabetes mellitus.
abstract: OBJECTIVE
  Gestational diabetes mellitus (GDM), gingivitis, infection with specific periodontal pathogens and systemic inflammation each increase the risk for poor pregnancy outcome. We set out to monitor the interactions of gingivitis and GDM with respect to oral infection and the systemic inflammatory burden.
  
  
  METHODS
  Four case-control groups (n = 117) were recruited, (1) No gingivitis, No GDM (n = 27); (2) Gingivitis, No GDM (n = 31); (3) No gingivitis, GDM (n = 21); and (4) Gingivitis, GDM (n = 38). Oral infection with three key periodontal pathogens was determined by PCR. Systemic inflammation was determined by quantification of CRP by EIA.
  
  
  RESULTS
  Gingivitis during pregnancy was associated with oral infection with Porphyromonas gingivalis, Filifactor alocis and Treponema denticola and combinations thereof (all p < 0.01). GDM was also associated with increased infection with individual and multiple oral pathogens (all p < 0.05). Gingivitis during pregnancy led to a 325% increase in systemic CRP (mean, 2495 versus 8116 ng/ml, p < 0.01).
  
  
  CONCLUSIONS
  Diabetes and gingivitis act in concert to increase risk biomarkers for poor pregnancy outcome.
authors.affiliation: Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA.
authors.forename: Himabindu
authors.initials: H
authors.lastname: Gogeneni
authors.affiliation: Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
authors.forename: Nurcan
authors.initials: N
authors.lastname: Buduneli
authors.affiliation: Department of Endocrine and Metabolic Diseases, Aydın State Hospital, Aydın, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Ceyhan-Öztürk
authors.affiliation: Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Gümüş
authors.affiliation: Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
authors.forename: Aliye
authors.initials: A
authors.lastname: Akcali
authors.affiliation: Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA.
authors.forename: Iris
authors.initials: I
authors.lastname: Zeller
authors.affiliation: Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Renaud
authors.affiliation: Oral Immunology & Infectious Diseases, University of Louisville, Louisville, KY, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Scott
authors.affiliation: Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
authors.forename: Özgün
authors.initials: Ö
authors.lastname: Özçaka
mesh_terms: D000328:Adult; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D003367:Cotinine / Q000032:analysis; D003774:Dental Plaque Index; D016640:Diabetes, Gestational / Q000097:blood / Q000382:microbiology*; D005260:Female; D005891:Gingivitis / Q000097:blood / Q000382:microbiology*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000382:microbiology*; D011256:Pregnancy Outcome; D012463:Saliva / Q000737:chemistry / Q000382:microbiology; D048373:Treponema denticola / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D003367:Cotinine
keywords: CRP; gestational diabetes; gingivitis; periodontopathogens; pregnancy