Serum Antibodies to Periodontal Bacteria as Diagnostic Markers of Periodontitis

被引:83
作者
Dye, Bruce A. [2 ]
Herrera-Abreu, Miriam [1 ]
Lerche-Sehm, Julia [1 ]
Vlachojannis, Christian [1 ]
Pikdoken, Levent [1 ,3 ]
Pretzl, Bernadette [1 ,4 ]
Schwartz, Aaron [1 ]
Papapanou, Panos N. [1 ]
机构
[1] Columbia Univ, Coll Dent Med, Div Periodont, Sect Oral & Diagnost Sci, New York, NY 10032 USA
[2] Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA
[3] Haydarpasa Training Hosp, Gulhane Mil Med Acad, Sect Periodont, Dept Dent, Istanbul, Turkey
[4] Univ Heidelberg Hosp, Clin Oral Dent & Maxillofacial Dis, Dept Conservat Dent, Sect Periodontol, Heidelberg, Germany
关键词
Antibody; immunoglobulin G; NHANES; periodontitis; serum; PARTIAL RECORDING PROTOCOLS; CHECKERBOARD ASSESSMENTS; SEROLOGICAL DIAGNOSIS; NATIONAL-HEALTH; DISEASE; RESPONSES; SEVERITY; INDEX; RISK; DEFINITIONS;
D O I
10.1902/jop.2009.080474
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Background: Assessment of periodontal conditions in epidemiologic studies usually requires a clinical examination, which is resource-intensive. We investigated the ability of serum immunoglobulin G (IgG) antibodies to periodontal bacteria to reflect clinical periodontal status. Methods: We used checkerboard immunoblotting to assess serum IgG levels to 19 species, including established/putative periodontal pathogens and non-pathogenic bacteria, in 5,747 dentate adults aged >= 40 years who participated in the third National Health and Nutrition Examination Survey between 1988 and 1994. Three earlier described alternative definitions of periodontitis were used, based on specific combinations of probing depth and attachment level values. Optimized elevated titer thresholds and corresponding sensitivities and specificities were calculated for each definition. Titers significantly associated with periodontitis were identified in univariable and multivariable logistic regression models. Parsimonious models were subsequently developed using age, gender, race/ethnicity, education, smoking, and diagnosed diabetes. Results: In unadjusted models, high titers to Porphyromonas gingivalis were most strongly associated with periodontitis across all definitions (odds ratio, 2.07 to 2.74; P<0.05). In parsimonious models including demographic data, smoking, and diagnosed diabetes, high P. gingivalis titers were consistently associated with periodontitis, whereas high Eubacterium nodatum titers were associated with periodontal health in two of three definitions. Receiver operating characteristic curves for the parsimonious multivariable models showed that the area under the curve ranged between 0.72 and 0.78. Conclusions: Serum IgG titers to selected periodontal species, combined with demographic and behavioral characteristics, resulted in a moderately accurate classification of periodontal status in epidemiologic studies. The external validity of these findings must be examined further. J Periodontol 2009;80:634-647.
引用
收藏
页码:634 / 647
页数:14
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