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Dental and Periodontal Health in Acute Intermittent Porphyria

In the inherited metabolic disorder acute intermittent porphyria (AIP), high sugar intake prevents porphyric attacks due to the glucose effect and the following high insulin levels that may lower AIP disease activity. Insulin resistance is a known risk factor for periodontitis and sugar changes diab...

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Autores principales: Storjord, Elin, Airila-Månsson, Stella, Karlsen, Katarzyna, Madsen, Martin, Dahl, Jim André, Landsem, Anne, Fure, Hilde, Ludviksen, Judith Krey, Fjøse, Johannes Østrem, Dickey, Amy K., Karlsen, Bård Ove, Waage Nielsen, Erik, Mollnes, Tom Eirik, Brekke, Ole-Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410213/
https://www.ncbi.nlm.nih.gov/pubmed/36013449
http://dx.doi.org/10.3390/life12081270
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author Storjord, Elin
Airila-Månsson, Stella
Karlsen, Katarzyna
Madsen, Martin
Dahl, Jim André
Landsem, Anne
Fure, Hilde
Ludviksen, Judith Krey
Fjøse, Johannes Østrem
Dickey, Amy K.
Karlsen, Bård Ove
Waage Nielsen, Erik
Mollnes, Tom Eirik
Brekke, Ole-Lars
author_facet Storjord, Elin
Airila-Månsson, Stella
Karlsen, Katarzyna
Madsen, Martin
Dahl, Jim André
Landsem, Anne
Fure, Hilde
Ludviksen, Judith Krey
Fjøse, Johannes Østrem
Dickey, Amy K.
Karlsen, Bård Ove
Waage Nielsen, Erik
Mollnes, Tom Eirik
Brekke, Ole-Lars
author_sort Storjord, Elin
collection PubMed
description In the inherited metabolic disorder acute intermittent porphyria (AIP), high sugar intake prevents porphyric attacks due to the glucose effect and the following high insulin levels that may lower AIP disease activity. Insulin resistance is a known risk factor for periodontitis and sugar changes diabetogenic hormones and affects dental health. We hypothesized differences in homeostasis model assessment (HOMA) scores for insulin resistance in AIP cases vs. controls and in those with periodontitis. Our aim was to systematically study dental health in AIP as poor dental health was previously only described in case reports. Further, we aimed to examine if poor dental health and kidney failure might worsen AIP as chronic inflammation and kidney failure might increase disease activity. In 47 AIP cases and 47 matched controls, X-rays and physical examination of clinical attachment loss (CAL), probing pocket depth (PPD), and decayed missing filled teeth (DMFT) were performed. Dietary intake was evaluated through a diet logbook. Plasma cytokines and diabetogenic hormones were measured using multiplex technology and urine porphobilinogen and kidney and liver function by routine methods. An excel spreadsheet from the University of Oxford was used to estimate HOMA scores; beta cell function, HOMA%B (%B), insulin sensitivity, HOMA%S (%S), and insulin resistance HOMA-IR (IR), based on glucose and plasma (P) C-peptide. The Wilcoxon matched-pairs signed rank test, the Mann–Whitney U-test, and Spearman’s non-parametric correlation were used. Insulin (p = 0.007) and C-peptide (p = 0.006) were higher in the AIP cases with periodontitis versus those without. In AIP patients, the liver fibrosis index 4 correlated with DMFT (p < 0.001) and CAL ≥4 mm (p = 0.006); the estimated glomerular filtration rate correlated with DMFT (p < 0.001) and CAL ≥4 mm (p = 0.02). CAL ≥4 mm was correlated with chemokine ligand 11 and interleukin (IL)-13 (p = 0.04 for both), and PPD >5 mm was correlated with plasminogen activator inhibitor-1 (p = 0.003) and complement component 3 (p = 0.02). In conclusion, dental health in AIP cases was correlated with insulin resistance, inflammatory markers, and biomarkers of kidney and liver function, demonstrating that organ damage in the kidney and liver are associated with poorer dental health.
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spelling pubmed-94102132022-08-26 Dental and Periodontal Health in Acute Intermittent Porphyria Storjord, Elin Airila-Månsson, Stella Karlsen, Katarzyna Madsen, Martin Dahl, Jim André Landsem, Anne Fure, Hilde Ludviksen, Judith Krey Fjøse, Johannes Østrem Dickey, Amy K. Karlsen, Bård Ove Waage Nielsen, Erik Mollnes, Tom Eirik Brekke, Ole-Lars Life (Basel) Article In the inherited metabolic disorder acute intermittent porphyria (AIP), high sugar intake prevents porphyric attacks due to the glucose effect and the following high insulin levels that may lower AIP disease activity. Insulin resistance is a known risk factor for periodontitis and sugar changes diabetogenic hormones and affects dental health. We hypothesized differences in homeostasis model assessment (HOMA) scores for insulin resistance in AIP cases vs. controls and in those with periodontitis. Our aim was to systematically study dental health in AIP as poor dental health was previously only described in case reports. Further, we aimed to examine if poor dental health and kidney failure might worsen AIP as chronic inflammation and kidney failure might increase disease activity. In 47 AIP cases and 47 matched controls, X-rays and physical examination of clinical attachment loss (CAL), probing pocket depth (PPD), and decayed missing filled teeth (DMFT) were performed. Dietary intake was evaluated through a diet logbook. Plasma cytokines and diabetogenic hormones were measured using multiplex technology and urine porphobilinogen and kidney and liver function by routine methods. An excel spreadsheet from the University of Oxford was used to estimate HOMA scores; beta cell function, HOMA%B (%B), insulin sensitivity, HOMA%S (%S), and insulin resistance HOMA-IR (IR), based on glucose and plasma (P) C-peptide. The Wilcoxon matched-pairs signed rank test, the Mann–Whitney U-test, and Spearman’s non-parametric correlation were used. Insulin (p = 0.007) and C-peptide (p = 0.006) were higher in the AIP cases with periodontitis versus those without. In AIP patients, the liver fibrosis index 4 correlated with DMFT (p < 0.001) and CAL ≥4 mm (p = 0.006); the estimated glomerular filtration rate correlated with DMFT (p < 0.001) and CAL ≥4 mm (p = 0.02). CAL ≥4 mm was correlated with chemokine ligand 11 and interleukin (IL)-13 (p = 0.04 for both), and PPD >5 mm was correlated with plasminogen activator inhibitor-1 (p = 0.003) and complement component 3 (p = 0.02). In conclusion, dental health in AIP cases was correlated with insulin resistance, inflammatory markers, and biomarkers of kidney and liver function, demonstrating that organ damage in the kidney and liver are associated with poorer dental health. MDPI 2022-08-19 /pmc/articles/PMC9410213/ /pubmed/36013449 http://dx.doi.org/10.3390/life12081270 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Storjord, Elin
Airila-Månsson, Stella
Karlsen, Katarzyna
Madsen, Martin
Dahl, Jim André
Landsem, Anne
Fure, Hilde
Ludviksen, Judith Krey
Fjøse, Johannes Østrem
Dickey, Amy K.
Karlsen, Bård Ove
Waage Nielsen, Erik
Mollnes, Tom Eirik
Brekke, Ole-Lars
Dental and Periodontal Health in Acute Intermittent Porphyria
title Dental and Periodontal Health in Acute Intermittent Porphyria
title_full Dental and Periodontal Health in Acute Intermittent Porphyria
title_fullStr Dental and Periodontal Health in Acute Intermittent Porphyria
title_full_unstemmed Dental and Periodontal Health in Acute Intermittent Porphyria
title_short Dental and Periodontal Health in Acute Intermittent Porphyria
title_sort dental and periodontal health in acute intermittent porphyria
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410213/
https://www.ncbi.nlm.nih.gov/pubmed/36013449
http://dx.doi.org/10.3390/life12081270
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