Table 1_Calprotectin and aMMP-8 as biomarkers in gingival crevicular fluid in geriatric inpatients.docx

BackgroundAccurate detection of periodontal inflammation and tissue degradation remains challenging in frail, hospitalized older adults with high periodontitis prevalences, where conventional diagnostics are often not feasible. Biochemical biomarkers such as Calprotectin (CP) and Active Matrix Metalloproteinase-8 (aMMP-8) in Gingival Crevicular Fluid (GCF) may offer low-barrier, bedside-compatible diagnostic alternatives for the future. While aMMP-8 is already well-studied and rather reflects collagen degradation, CP is supposed to indicate neutrophil-driven inflammation.
MethodsIn this cross-sectional study of 30 neurogeriatric inpatients (mean age 79 ± 6 years) with minimal systemic inflammation (CRP < 5 mg/dL), GCF samples were collected at bedside to assess aMMP-8 and CP levels and analyzed in addition to periodontal parameters [Probing Pocket Depth [PPD], Bleeding On Probing [BoP], Clinical Attachment Loss] and systemic status (blood values). Correlation and regression analyses were performed to explore associations between biomarkers and clinical indices. Correlation benchmarks were set as r = .10 weak, r = .30 moderate, r = .50 strong correlations.
ResultsCP and aMMP-8 showed a strong correlation (rs = .521), suggesting complementary diagnostic value. CP correlated moderately with BoP (rs = .365), mean PPD (rs = .455) and mean PPD at the sampling sites (rs = .478). aMMP-8 correlated moderately with BoP (rs = .329) and mean PDD (rs = .309). Both biomarkers were not associated with systemic variables. ANOVA revealed an effect of BoP on CP levels (p < .05). post hoc analysis showed higher CP higher in patients with BoP >30% compared to those with BoP >10%–30%. No group differences of aMMP-8 levels were observed across the BoP categories.
ConclusionBoth biomarkers demonstrate a feasibility assessment for geriatric inpatients. In this population, CP reflects localized periodontal processes and inflammation. CP may in the future be particularly suited for inflammatory screening in care-dependent older adults. These findings contribute initial reference data and underscore the need for larger studies to validate biomarker-based diagnostics in broader geriatric populations.

【背景】在牙周炎患病率较高的衰弱住院老年人群中，准确检测牙周炎症与组织降解仍颇具挑战，传统诊断手段往往难以实施。龈沟液（Gingival Crevicular Fluid, GCF）中的钙卫蛋白（Calprotectin, CP）与活化基质金属蛋白酶-8（Active Matrix Metalloproteinase-8, aMMP-8）等生化生物标志物，有望成为未来低门槛、可床边操作的诊断替代方案。其中，aMMP-8已得到充分研究，主要反映胶原降解；而CP则被认为可提示中性粒细胞介导的炎症反应。
【方法】本研究为横断面研究，纳入30例老年神经科住院患者（平均年龄79±6岁），均存在轻度全身炎症（C反应蛋白CRP<5 mg/dL）。研究人员于床边采集龈沟液样本以检测aMMP-8与CP水平，同时采集牙周参数[探诊深度（Probing Pocket Depth, PPD）、探诊出血（Bleeding On Probing, BoP）、临床附着丧失]及全身状态指标（血液学指标）。通过相关性与回归分析，探索生物标志物与临床指标间的关联。相关性判定标准设定为：r=0.10为弱相关，r=0.30为中等相关，r=0.50为强相关。
【结果】CP与aMMP-8呈强相关（rs=0.521），提示二者具备互补诊断价值。CP与探诊出血（BoP，rs=0.365）、平均探诊深度（PPD，rs=0.455）及采样位点平均PPD（rs=0.478）均呈中等相关；aMMP-8与BoP（rs=0.329）及平均探诊深度（原文笔误为PDD，rs=0.309）呈中等相关。两种生物标志物均与全身变量无关联。方差分析（ANOVA）显示，BoP对CP水平存在显著影响（p<0.05）；事后分析表明，BoP>30%的患者CP水平显著高于BoP为10%~30%的患者。不同BoP分组间的aMMP-8水平未观察到组间差异。
【结论】两种生物标志物均证实可用于老年住院患者的可行性评估。在本研究人群中，CP可反映局部牙周病变与炎症状态，未来或尤其适用于需要照护的老年人群的炎症筛查。本研究提供了初始参考数据，同时强调需开展更大规模的研究，以验证基于生物标志物的诊断方法在更广泛老年人群中的应用价值。