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Índices de imuno-inflamação sistémica para prever o estadio e grau da periodontite através de marcadores circulatórios
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Abstract(s)
Introdução: Entre 2011 e 2020, estimou-se que cerca de 62% dos adultos dentados apresentaram periodontite, sendo a forma mais severa responsável por 23,6%. A periodontite caracteriza-se por um infiltrado celular inflamatório local e uma multiplicidade pro-inflamatória que se traduz sistemicamente através da corrente
sanguínea. Um novo índice de imuno-inflamação sistémica (SII) tem sido proposto para prever o prognostico de várias doenças. O objetivo deste estudo foi desenvolver e avaliar um índice de imuno-inflamação baseado em marcadores circulatórios sanguíneos para prever a periodontite.
Materiais e Métodos: Foram incluídos participantes com análise periodontal completa do National Health and Nutrition Examination Survey (NHANES) 2009-2010, 2011-2012 e 2013-2014. Os dados periodontais foram obtidos através de um processo calibrado para recessão gengival e profundidade de bolsa periodontal (PPD). De acordo com o protocolo do ciclo NHANES 2011-2014, o método Beckman Coulter, em combinação com um dispositivo de diluição e mistura para processamento de amostras, e um fotómetro para hemoglobinometria, foi utilizado para a contagem de células sanguíneas a partir da amostra de sangue periférico obtida.
Resultados: Num total de 9.709 participantes elegíveis, o SII foi aplicado à amostra, verificando-se que os pacientes com e sem periodontite apresentaram valores pouco diferentes (518,69 vs. 519,86, p<=0,912).
Analisando a distribuição das variáveis PCA, foram encontrados clusters entre as variáveis. Na analise multivariada, 6 variáveis apresentaram valor preditivo significativo para a presença de periodontite (p<0,001): basófilos, eritrócitos, hemoglobina, volume corpuscular medio, volume plaquetário medio e largura da distribuição dos eritrócitos.
Discussão e Conclusões: Foi possível propor um novo índice de imuno-inflamação para a periodontite que, quando comparado com o SII original, apresentou uma elevada significância. A proposta deste índice foi concebida de modo a reconhecer a importância dos fatores e indicadores de risco e comorbilidades associados a doença periodontal, bem como a importância do diagnóstico precoce e tratamento personalizado.
Introduction: It is estimated that between 2011 and 2020, approximately 62% of dentate adults were affected by periodontitis, with severe periodontitis accounting for 23.6% of cases. Periodontitis is characterized by a local inflammatory cellular infiltrate and a pro-inflammatory multiplicity that translates systemically through the bloodstream. A new index of systemic immune-inflammation (SII) has been proposed to predict the prognosis of various diseases. The objective of this study was to develop and evaluate an immune-inflammation index based on blood circulating markers for the prediction of periodontitis. Materials and Methods: Participants with complete periodontal analysis from the National Health and Nutrition Examination Survey (NHANES) 2009-2010, 2011-2012 and 2013–2014 were included. Periodontal data were obtained using a calibrated procedure for gingival recession and periodontal pocket depth (PPD). According to the protocol of the NHANES 2011-2014 cycle, the Beckman Coulter method was used in combination with an automated dilution and mixing device for sample processing, and a photometer for hemoglobinometry for blood cell counts from the obtained peripheral blood sample. Results: In a total of 9.709 eligible participants, the SII was applied to the sample and little difference was found between patients with and without periodontitis (518.69 vs 519.86, p<=0.912). When the distribution of the PCA variables was analyzed, clusters of variables were found. In the multivariate analysis, 6 variables showed significant predictive value for the presence of periodontitis (p<0.001): basophils, erythrocytes, hemoglobin, mean corpuscular volume, mean platelet volume and width of erythrocyte distribution. Discussion and Conclusions: it was possible to propose a new index of immunoinflammation for periodontitis which showed high significance when compared with the original SII. The proposal of this index is designed to recognize the importance of risk factors and indicators and co-morbidities associated with periodontal disease, as well as the importance of early diagnosis and personalized treatment.
Introduction: It is estimated that between 2011 and 2020, approximately 62% of dentate adults were affected by periodontitis, with severe periodontitis accounting for 23.6% of cases. Periodontitis is characterized by a local inflammatory cellular infiltrate and a pro-inflammatory multiplicity that translates systemically through the bloodstream. A new index of systemic immune-inflammation (SII) has been proposed to predict the prognosis of various diseases. The objective of this study was to develop and evaluate an immune-inflammation index based on blood circulating markers for the prediction of periodontitis. Materials and Methods: Participants with complete periodontal analysis from the National Health and Nutrition Examination Survey (NHANES) 2009-2010, 2011-2012 and 2013–2014 were included. Periodontal data were obtained using a calibrated procedure for gingival recession and periodontal pocket depth (PPD). According to the protocol of the NHANES 2011-2014 cycle, the Beckman Coulter method was used in combination with an automated dilution and mixing device for sample processing, and a photometer for hemoglobinometry for blood cell counts from the obtained peripheral blood sample. Results: In a total of 9.709 eligible participants, the SII was applied to the sample and little difference was found between patients with and without periodontitis (518.69 vs 519.86, p<=0.912). When the distribution of the PCA variables was analyzed, clusters of variables were found. In the multivariate analysis, 6 variables showed significant predictive value for the presence of periodontitis (p<0.001): basophils, erythrocytes, hemoglobin, mean corpuscular volume, mean platelet volume and width of erythrocyte distribution. Discussion and Conclusions: it was possible to propose a new index of immunoinflammation for periodontitis which showed high significance when compared with the original SII. The proposal of this index is designed to recognize the importance of risk factors and indicators and co-morbidities associated with periodontal disease, as well as the importance of early diagnosis and personalized treatment.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Índice de imuno-inflamação sistémica Periodontite Previsão Marcadores circulatórios