Abstract：
Tissue concentrations of advanced glycation end product (AGE) and peripheral soluble receptor of AGE (sRAGE) levels may be associated with periodontitis severity. Both parameters and periodontitis might serve as outcome predictors for patients undergoing coronary artery bypass grafting (CABG). This study aimed to investigate possible associations between periodontitis and AGE/sRAGE. Ultimately, we wanted to examine whether AGE, sRAGE, and severe periodontitis are associated with the incidence of new cardiovascular events within 3 years of follow-up after CABG. Ninety-five patients with coronary vascular disease (CVD) (age 69 years, 88.3% males) needing CABG surgery were included. Periodontal diagnosis was made according to the guidelines of the \"Centers for Disease Control and Prevention (CDC)\" (2007) and staged according to the new classification of periodontal diseases (2018). AGE tissue concentrations were assessed as skin autofluorescence (sAF). sRAGE levels were determined by using a commercially available enzyme-linked immunoabsorbance assay (ELISA) kit. Univariate and multivariate baseline and survival analyses were carried out with Mann-Whitney U test, Chi² test, Kaplan-Meier curves with Log-Rank test, and logistic and Cox regression. sAF was identified as an independent risk indicator for severe periodontitis with respect to the cofactors age, gender, plaque index, and diabetes (adjusted odds ratio [OR] = 2.9, p = 0.028). The degree of subgingival inflammation assessed as a percentage of sites with bleeding on probing (BOP) was inversely correlated with sRAGE concentration (r = -0.189, p = 0.034). Both sAF (Hazard Ratio [HR] = 2.4, p = 0.004) and sRAGE (HR = 1.9, p = 0.031) increased the crude risk for new adverse events after CABG. The occurrence of severe periodontitis trends towards a higher risk for new cardiovascular events (HR = 1.8, p = 0.115). Applying multivariate Cox regression, only peripheral arterial disease (adjusted HR = 2.7, p = 0.006) and history of myocardial infarction (adjusted HR = 2.8, p = 0.010) proved to be independent risk factors for cardiovascular outcome. We conclude that sAF may represent a new, independent risk indicator for severe periodontitis. In contrast, sAF, sRAGE, and severe periodontitis were not independent prognostic factors for postoperative outcome in patients undergoing CABG.
摘要：
晚期糖基化终产物（AGE）的组织浓度和AGE的外周可溶性受体（sRAGE）水平可能与牙周炎的严重程度有关。参数和牙周炎均可作为冠状动脉旁路移植术（CABG）患者的预后预测因子。本研究旨在探讨牙周炎与AGE/sRAGE之间可能的关联。最终,我们想检查年龄，SRAGE,严重牙周炎与CABG术后3年内新的心血管事件发生率相关。95例冠状动脉血管疾病（CVD）患者（年龄69岁，88.3%的男性）需要CABG手术。根据“疾病控制与预防中心（CDC）”（2007年）的指南进行牙周诊断，并根据牙周疾病的新分类（2018年）进行分期。将AGE组织浓度评估为皮肤自发荧光(sAF)。通过使用市售的酶联免疫吸附测定(ELISA)试剂盒测定sRAGE水平。单变量和多变量基线和生存分析采用Mann-WhitneyU检验，Chi²test,采用对数秩检验的卡普兰-迈耶曲线，Logistic和Cox回归。sAF被确定为重度牙周炎的独立风险指标，性别,菌斑指数,和糖尿病（校正比值比[OR]=2.9，p=0.028）。以探查出血部位（BOP）的百分比评估的牙龈下炎症程度与sRAGE浓度呈负相关（r=-0.189，p=0.034）。sAF（危险比[HR]=2.4，p=0.004）和sRAGE（HR=1.9，p=0.031）均增加了CABG后新不良事件的粗风险。严重牙周炎的发生倾向于新心血管事件的风险更高（HR=1.8，p=0.115）。应用多元Cox回归，只有外周动脉疾病(校正HR=2.7,p=0.006)和心肌梗死史(校正HR=2.8,p=0.010)被证明是心血管结局的独立危险因素.我们得出结论，sAF可能代表了一种新的，重度牙周炎的独立风险指标。相比之下,sAF,SRAGE,严重牙周炎不是CABG患者术后结局的独立预后因素。
