title: Candida spp. and gingivitis in children with nephrotic syndrome or type 1 diabetes.
abstract: BACKGROUND
  Diabetes and Nephrotic syndrome (NS) promote plaque-related gingivitis and yeast-like fungal infections. The study assesses the impact of Candida spp. and general disease- or treatment-related factors on plaque-related gingivitis severity in children and adolescents with Nephrotic syndrome /diabetes.
  
  
  METHODS
  Body mass index (BMI), BMI standard deviation score, and oral cavity (Plaque Index--PLI, Gingival Index--GI, mucosa status, presence and Candida enzymatic activity) were assessed in 96 patients (32 with NS: 30- immunosuppressive treatment, 35--type 1 diabetes, and 29 generally healthy), aged; 3-18 years. Laboratory included cholesterol and triglyceride measurements; in diabetic subjects- glycated haemoglobin, in NS: total protein, albumin, creatinine, haemoglobin, haematocrit, white cell count, urinary protein excretion. Medical records supplied information on disease duration and treatment. A statistical analysis was performed; Kendall Tau coefficient, chi-square test, t-test, and multiple regression analysis ( P < 0.05).
  
  
  RESULTS
  Candida spp. often occurred in healthy patients, but oral candidiasis was found only in the NS and diabetes groups (9.37% and 11.43%). Gingivitis occurred more frequently in patients with NS/diabetes. Gingivitis severity was correlated with PLI, age, and yeast enzyme activity in NS--to with immunosuppressive treatment with >1 drug, drug doses, treatment duration, lipid disorders, and BMI; in diabetes, with blood glucose and glycated haemoglobin >8%.
  
  
  CONCLUSIONS
  Poor hygiene control is the main cause of gingivitis. Gingivitis severity is most likely related to age, lipid disorders and increase in body mass. Candida spp., in uncompensated diabetes and in those using immunosuppressive treatment, might intensify plaque-related gingivitis.
authors.affiliation: Department of Paediatric Dentistry, Medical University of Warsaw, 18 Miodowa St, 00-246, Warszawa, Poland. do-k@o2.pl.
authors.forename: Dorota
authors.initials: D
authors.lastname: Olczak-Kowalczyk
authors.affiliation: Department of Paediatric Endocrinology, Medical University of Warsaw, Warszawa, Poland. bpyrzak@wum.edu.pl.
authors.forename: Beata
authors.initials: B
authors.lastname: Pyrżak
authors.affiliation: Department of Dental Medical Microbiology, Medical University of Warsaw, Warszawa, Poland. m.dabkowska@vp.pl.
authors.forename: Maria
authors.initials: M
authors.lastname: Dąbkowska
authors.affiliation: Department of Paediatric Nephrology, Medical University of Warsaw, Warszawa, Poland. m.panczyk@czd.edu.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Pańczyk-Tomaszewska
authors.affiliation: Department of Paediatric Endocrinology, Medical University of Warsaw, Warszawa, Poland. g.miszkurka@czd.edu.pl.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Miszkurka
authors.affiliation: Department of Paediatric Endocrinology, Medical University of Warsaw, Warszawa, Poland. i.rogozinska@wum.edu.pl.
authors.forename: Izabela
authors.initials: I
authors.lastname: Rogozińska
authors.affiliation: Department of Dental Medical Microbiology, Medical University of Warsaw, Warszawa, Poland. ewa.swoboda@gmail.com.
authors.forename: Ewa
authors.initials: E
authors.lastname: Swoboda-Kopeć
authors.affiliation: Department of Experimental Statistics and Bioinformatics, Warsaw University of Life Sciences, Warsaw, Poland. dariusz_gozdowski@sggw.pl.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Gozdowski
authors.affiliation: Department of Paediatric Dentistry, Medical University of Warsaw, 18 Miodowa St, 00-246, Warszawa, Poland. angelikakalinska@gmail.com.
authors.forename: Angelika
authors.initials: A
authors.lastname: Kalińska
authors.affiliation: Department of Paediatric Dentistry, Medical University of Warsaw, 18 Miodowa St, 00-246, Warszawa, Poland. aniapirog@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Piróg
authors.affiliation: Department of Paediatric Nephrology, Medical University of Warsaw, Warszawa, Poland. wasiaczki@wp.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Mizerska-Wasiak
authors.affiliation: Department of Paediatric Nephrology, Medical University of Warsaw, Warszawa, Poland. dblaim@o2.pl.
authors.forename: Maria
authors.initials: M
authors.lastname: Roszkowska-Blaim
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D015992:Body Mass Index; D002180:Candidiasis, Oral / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D003773:Dental Plaque / Q000382:microbiology; D003774:Dental Plaque Index; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D005260:Female; D005891:Gingivitis / Q000209:etiology / Q000382:microbiology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007958:Leukocyte Count; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy; D010512:Periodontal Index; D011507:Proteinuria / Q000652:urine; D012709:Serum Albumin / Q000032:analysis; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D001798:Blood Proteins; D002784:Cholesterol; D003404:Creatinine; D006442:Glycated Hemoglobin; D006454:Hemoglobins; D007166:Immunosuppressive Agents; D012709:Serum Albumin; D014280:Triglycerides