Correlation between chronic periodontal disease and malnutrition-inflammation atherosclerosis (MIA) syndrome in maintenance hemodialysis patients

Objective To explore the correlation between chronic periodontal disease and malnutrition-inflammation atherosclerosis syndrome (MICS)in hemodialysis patients. Methods A total of 64 patients with maintenance hemodialysis(MHD)conducting in Blood Purification Center of Department of Nephropathy of Wuhan Municipal Central Hospital from January 2106 to December 2017, who complied with inclusion and exclusion criteria, were divided into no periodontal disease group (No) (16 patients), mild periodontal disease group (mild) (18 patients), moderate periodontal disease group (Moderate) (15 patients), and severe periodontal disease group (Severe) (15 patients). For the patients in each group, the nutrition-related indices including hemoglobin (Hb, serum albumin (Alb), serum iron (Fe), Ferritin and malnutrition-inflammation score (MIS), and the inflammation indices including serum hypersensitive protein C (hs-CRP) and tumor necrosis factor-a (TNF-a) were detected. Multivariate linear regression analysis was adopted to assess and compare the nutrition-related indices and the inflammation-related indices in each group, and partial correlation analysis was used to assess the correlations of MIS, with the inflammation-related indices,and the periodontal disease severity. Results Compared with the severe periodontal disease group, the levels of Hb, Alb, Fe, hs CRP, TNF-α and Ferritin all significantly declined in other groups, with statistically significant difference (P<0.01). The MIS value with the No group was (8.8±1.2); that with the Mild group, (14.0±1.2); that with the Moderate group, (17.7±1.4); that with the Severe group, (22.0±1.1). There was statistically significant difference between the MIS values with the other three groups and that with the Severe group (P<0.05). After controlling age, diabetes and dialysis period partial correlation analysis was used to assess the correlation between periodontal disease index (PDI) and the inflammation -related indices. The results showed significant correlation between PDI and hs-CRP (r=0.258, P<0.05), and significant correlation between MIS values and hs-CRP (r=0.297, P<0.01), between TNF-a levels and PDI (r=0.328, P<0.01). Conclusions Increases in periodontal disease severity and inflammatory factor level both can aggravate MICS. Chronic periodontal disease should be actively prevented and treated in those patients with MHD.