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Epidemiologic evaluation of Nhanes for environmental Factors and periodontal disease.

ABSTRACT: Periodontitis is a chronic inflammation that destroys periodontal tissues caused by the accumulation of bacterial biofilms that can be affected by environmental factors. This report describes an association study to evaluate the relationship of environmental factors to the expression of periodontitis using the National Health and Nutrition Examination Study (NHANES) from 1999-2004. A wide range of environmental variables (156) were assessed in patients categorized for periodontitis (n?=?8884). Multiple statistical approaches were used to explore this dataset and identify environmental variable patterns that enhanced or lowered the prevalence of periodontitis. Our findings indicate an array of environmental variables were different in periodontitis in smokers, former smokers, or non-smokers, with a subset of specific environmental variables identified in each population subset. Discriminating environmental factors included blood levels of lead, phthalates, selected nutrients, and PCBs. Importantly, these factors were found to be coupled with more classical risk factors (i.e. age, gender, race/ethnicity) to create a model that indicated an increased disease prevalence of 2-4 fold across the sample population. Targeted environmental factors are statistically associated with the prevalence of periodontitis. Existing evidence suggests that these may contribute to altered gene expression and biologic processes that enhance inflammatory tissue destruction.

SUBMITTER: Emecen-Huja P

PROVIDER: S-EPMC6547714 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Epidemiologic evaluation of Nhanes for environmental Factors and periodontal disease.

Emecen-Huja P P Li H-F HF Ebersole J L JL Lambert J J Bush H H

Scientific reports 20190603 1

Periodontitis is a chronic inflammation that destroys periodontal tissues caused by the accumulation of bacterial biofilms that can be affected by environmental factors. This report describes an association study to evaluate the relationship of environmental factors to the expression of periodontitis using the National Health and Nutrition Examination Study (NHANES) from 1999-2004. A wide range of environmental variables (156) were assessed in patients categorized for periodontitis (n = 8884). M ...[more]

PMID: 31160648

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Project description:ObjectiveA growing body of evidence suggests that environmental pollutants, such as heavy metals, persistent organic pollutants and plasticizers play an important role in the development of chronic diseases. Most epidemiologic studies have examined environmental pollutants individually, but in real life, we are exposed to multi-pollutants and pollution mixtures, not single pollutants. Although multi-pollutant approaches have been recognized recently, challenges exist such as how to estimate the risk of adverse health responses from multi-pollutants. We propose an "Environmental Risk Score (ERS)" as a new simple tool to examine the risk of exposure to multi-pollutants in epidemiologic research.Methods and resultsWe examined 134 environmental pollutants in relation to serum lipids (total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL) and triglycerides) using data from the National Health and Nutrition Examination Survey between 1999 and 2006. Using a two-stage approach, stage-1 for discovery (n = 10818) and stage-2 for validation (n = 4615), we identified 13 associated pollutants for total cholesterol, 9 for HDL, 5 for LDL and 27 for triglycerides with adjustment for sociodemographic factors, body mass index and serum nutrient levels. Using the regression coefficients (weights) from joint analyses of the combined data and exposure concentrations, ERS were computed as a weighted sum of the pollutant levels. We computed ERS for multiple lipid outcomes examined individually (single-phenotype approach) or together (multi-phenotype approach). Although the contributions of ERS to overall risk predictions for lipid outcomes were modest, we found relatively stronger associations between ERS and lipid outcomes than with individual pollutants. The magnitudes of the observed associations for ERS were comparable to or stronger than those for socio-demographic factors or BMI.ConclusionsThis study suggests ERS is a promising tool for characterizing disease risk from multi-pollutant exposures. This new approach supports the need for moving from a single-pollutant to a multi-pollutant framework.

Project description:Periodontitis (gum disease) is a common biofilm-mediated oral condition, with around 7% of the adult population suffering from severe disease with risk for tooth loss. Moreover, periodontitis virulence markers have been found in atherosclerotic plaque and brain tissue, suggesting a link to cardiovascular and Alzheimer's diseases. The lack of accurate, fast, and sensitive clinical methods to identify patients at risk leads, on the one hand, to patients being undiagnosed until the onset of severe disease and, on the other hand, to overtreatment of individuals with mild disease, diverting resources from those patients most in need. The periodontitis-associated bacterium, Porphyromonas gingivalis, secrete gingipains which are highly active proteases recognized as key virulence factors during disease progression. This makes them interesting candidates as predictive biomarkers, but currently, there are no methods in clinical use for monitoring them. Quantifying the levels or proteolytic activity of gingipains in the periodontal pocket surrounding the teeth could enable early-stage disease diagnosis. Here, we report on a monitoring approach based on high-affinity microcontact imprinted polymer-based receptors for the Arg and Lys specific gingipains Rgp and Kgp and their combination with surface plasmon resonance (SPR)-based biosensor technology for quantifying gingipain levels in biofluids and patient samples. Therefore, Rgp and Kgp were immobilized on glass coverslips followed by microcontact imprinting of poly-acrylamide based films anchored to gold sensor chips. The monomers selected were N-isopropyl acrylamide (NIPAM), N-hydroxyethyl acrylamide (HEAA) and N-methacryloyl-4-aminobenzamidine hydrochloride (BAM), with N,N'-methylene bis(acrylamide) (BIS) as the crosslinker. This resulted in imprinted surfaces exhibiting selectivity towards their templates high affinity and selectivity for the templated proteins with dissociation constants (K d) of 159 and 299 nM for the Rgp- and Kgp-imprinted, surfaces respectively. The former surface displayed even higher affinity (K d = 71 nM) when tested in dilute cell culture supernatants. Calculated limits of detection for the sensors were 110 and 90 nM corresponding to levels below clinically relevant concentrations.

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Epidemiologic evaluation of Nhanes for environmental Factors and periodontal disease.

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Epidemiologic evaluation of Nhanes for environmental Factors and periodontal disease.

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