Inflammation markers and the risk of hypertension in people living with HIV.

Background: The incidence of hypertension is high in people living with HIV (PLWH). High-sensitivity C-reactive protein (hsCRP), systemic inflammation response index (SIRI), and neutrophil-to-monocyte ratio (NMR) are considered economic and convenient parameters that reflect the levels of inflammation in patients. Our aim was to explore whether indirect inflammation markers are associated with hypertension in PLWH. Methods: This was a case-control study. The case group (hypertension) comprised PLWH with hypertension, and the control group (non-hypertension) comprised sex- and age-(± 3 years)-matched PLWH without hypertension. Demographic parameters, hsCRP, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune- inflammation index (SII), SIRI, lymphocyte-to-monocyte ratio (LMR), platelet-to-neutrophil ratio (PNR), platelet-to-monocyte ratio (PMR), NMR, time to HIV diagnosis, antiretroviral therapy (ART) duration, recent CD4+ and CD8+ cell counts, recent CD4+/CD8+ ratio, recent HIV viral load (HIV-RNA),and recent ART regimen were obtained from the patients' electronic medical records. A t-test or Wilcoxon rank-sum test was performed to compare differences between the two groups, and conditional logistic regression was used to analyze the risk factors of hypertension. Correlations between inflammation markers and CD4+ cell counts, CD8+ cell counts, and CD4+/CD8+ ratio were analyzed using Spearman's correlation. Results: In the hypertension group, body mass index (BMI), hsCRP, NLR, SII, SIRI, NMR, time to HIV diagnosis, ART duration, CD4+ and CD8+ cell counts, and CD4+/CD8+ ratio, the ratio of HIV-RNA < 100 copies/mL were all higher than those in the non-hypertension group, while the PNR was lower than that in the non-hypertension group. ART duration, CD4+ cell counts, HIV-RNA < 100 copies/mL, hsCRP, SIRI, and NMR were positively associated with hypertensive risk in PLWH. CD8+ cell counts and CD4+/CD8+ ratio was negatively associated with hypertensive risk in PLWH. SIRI was negatively correlated with CD4+ cell counts and CD8+ cell counts, but positively correlated with CD4+/CD8+ ratio. Conclusions: We identified positive associations between inflammation markers hsCRP, SIRI, NMR and hypertensive risk in PLWH. Alleviating inflammation may help control or delay the occurrence of hypertension in PLWH.

[Effect of regenerative therapy for the furcation involvements of mandibular molars evaluated by cone-beam computed tomography].

OBJECTIVE: To evaluate the effect of regenerative therapy for the treatment of furcation involvements of mandibular molars with cone-beam computed tomography (CBCT). METHODS: In the study, 38 furcation involvements of mandibular molars were included and randomly divided into two groups. The experimental group accepted guided tissue regeneration and bone graft therapy, and the control group only flap surgery. The clinical examination and CBCT examination were performed at baseline and 1 year post-surgery. RESULTS: The clinical and CBCT data of both groups were not statistically different at baseline (P>0.05). At the end of 1 year post-surgery, except gingival recession, the clinical parameters of both groups were significantly improved (P<0.001). The vertical and horizontal attachment gains of the experimental group were (3.20 ± 1.82) mm and (2.05 ± 1.27) mm, respectively, and significantly higher than the changes of the control group (P<0.001). And at the end of 1 year post-surgery, the experimental group showed significantly higher bone gain at the vertical and horizontal directions compared with those of the control group: (2.82 ± 0.97) mm and (2.24 ± 0.92) mm, respectively (P<0.001). CONCLUSION: With the limitation of this study, the effect of guided tissue regeneration surgery and bone graft therapy for the treatment of furcation involvements of mandibular molars is significantly better than that of the flap surgery. CBCT can reflect the horizontal and vertical bone changes of furcation area, which is more comprehensive than traditional periapicals.

[Effect of periodontal initial therapy on the serum level of lipid in the patients with both periodontitis and hyperlipidemia].

OBJECTIVE: To observe the effect of periodontal initial therapy on the serum level of lipid in the patients with both periodontitis and hyperlipidemia. METHODS: Twenty patients with both hyperlipidemia and moderate to severe chronic periodontitis were enrolled in this study. Periodontal parameters [plaque index (PLI), bleeding on probing (BOP), bleeding index (BI), probing depth (PD) and attachment level (AL)] were evaluated prior to and 3 months after periodontal initial therapy. Simultaneously, the patients' serum levels of total cholesterol, triglyceride, high-lipoprotein cholesterol, low-lipoprotein cholesterol were also measured. RESULTS: (1) Three months after periodontal therapy, the periodontal infection and inflammation in patients reduced comparing with baseline. The PD, PLI, BI, and BOP decreased significantly (the PD, PLI, BI, and BOP reduced from 3.98+/-0.12 to 2.39+/-0.13, 1.23+/-0.10 to 0.84+/-0.08, 2.63+/-0.14 to 1.48+/-0.08 and 94.26+/-1.84 to 33.57+/-2.06, respectively; P<0.05), and the attachment level increased significantly after periodontal treatment (AL decreased from 5.17+/-0.21 to 3.92+/-0.16, P<0.05). (2) The total cholesterol and triglyceride levels in these patients also reduced significantly (reducing 0.25 mmol/L and 0.20 mmol/L respectively, P<0.05) at 3 month after periodontal therapy comparing with baseline. At the same time, high-lipoprotein cholesterol levels in these patients increased significantly (increasing 0.18 mmol/L, P<0.05). Eight out of 20 patients showed their serum levels of lipid down to the normal levels. CONCLUSION: Our observation indicated that periodontal initial therapy could reduce the serum lipid levels of patients with both periodontitis and hyperlipidemia, which might be helpful for decreasing risk of cardiovascular disease such as coronary heart disease.