Periodontitis and Platelets Status: A Systematic Review With Meta-Analysis and Trial Sequential Analysis.

IF 3.4 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Dimitris Sokos, Marja L Laine, Elena A Nicu, Kelly Hiu Lam Chung, Ni-Ni Dong Qing Sluijk, Dagmar Else Slot, Sergio Bizzarro
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引用次数: 0

Abstract

Aim: Circulating platelets are essential in hemostasis, thrombosis, and immune responses. Modifications in platelet function may impact immunological reactions to dental biofilm and cardiovascular health. Understanding changes in platelet status and activity in patients with periodontitis is still a subject of investigation. This study aimed to synthesize evidence from observational studies that investigated platelet status and activity in patients with and without periodontitis.

Methods: MEDLINE-PubMed, EMBASE, and Cochrane-CENTRAL Library databases were searched up to November 2024. Primary outcomes included platelet count (PC) and mean platelet volume (MPV). Secondary outcomes encompassed any other biomarker relevant to platelet status and activity. Methodological quality was evaluated using the Newcastle-Ottawa scale, and heterogeneity was analyzed. Descriptive analysis of outcomes and meta-analysis, incorporating trial sequential analysis of PC and MPV, were conducted. The body of evidence was graded by utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

Results: 3621 unique records were identified, resulting in 23 eligible studies with 22 variables evaluating the platelet status. Fourteen studies exhibited a low risk of bias, and 9 exhibited moderate risk of bias. PC in patients with periodontitis was significantly higher compared to individuals without periodontitis (Mean Difference (MD) = 23.55 ×109/L, 95% CI [7.68; 39.43]). There was no statistically significant difference between the groups for MPV (MD = 0.16 fL, 95% CI [-0.49; 0.82]). Trial sequential analysis indicated a conclusive meta-analysis of PC and highlighted the need for additional data on MPV from future trials.

Conclusions: The certainty is moderate for slightly higher PC in patients with periodontitis compared to individuals without it and low for no difference in MPV between the two groups. The evidence is not robust to claim a clear difference in other platelet activation biomarkers between the two groups.

Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) by number: CRD42023439051.

牙周炎和血小板状况:荟萃分析和试验序列分析的系统综述。
目的:循环血小板在止血、血栓形成和免疫反应中是必不可少的。血小板功能的改变可能影响牙齿生物膜的免疫反应和心血管健康。了解牙周炎患者血小板状态和活动的变化仍然是一个研究课题。本研究旨在综合观察性研究的证据,这些研究调查了牙周炎患者和非牙周炎患者的血小板状态和活动。方法:检索截至2024年11月的MEDLINE-PubMed、EMBASE和Cochrane-CENTRAL Library数据库。主要结局包括血小板计数(PC)和平均血小板体积(MPV)。次要结果包括与血小板状态和活性相关的任何其他生物标志物。采用纽卡斯尔-渥太华量表评估方法学质量,并分析异质性。对结果进行描述性分析和meta分析,包括PC和MPV的试验序列分析。采用推荐评估、发展和评价分级(GRADE)对证据体进行分级。结果:确定了3621条独特记录,产生23项符合条件的研究,22个变量评估血小板状态。14项研究显示低偏倚风险,9项研究显示中等偏倚风险。牙周炎患者的PC显著高于无牙周炎患者(Mean Difference (MD) = 23.55 ×109/L, 95% CI [7.68;39.43])。MPV组间差异无统计学意义(MD = 0.16 fL, 95% CI [-0.49;0.82])。试验序列分析表明,PC的荟萃分析是结论性的,并强调需要从未来的试验中获得更多关于MPV的数据。结论:与无牙周炎患者相比,牙周炎患者稍高的PC的确定性为中等,两组之间MPV无差异的确定性为低。证据并不足以证明两组之间在其他血小板活化生物标志物上有明显差异。试验注册:国际前瞻性系统评价注册(PROSPERO),编号:CRD42023439051。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of periodontal research
Journal of periodontal research 医学-牙科与口腔外科
CiteScore
6.90
自引率
5.70%
发文量
103
审稿时长
6-12 weeks
期刊介绍: The Journal of Periodontal Research is an international research periodical the purpose of which is to publish original clinical and basic investigations and review articles concerned with every aspect of periodontology and related sciences. Brief communications (1-3 journal pages) are also accepted and a special effort is made to ensure their rapid publication. Reports of scientific meetings in periodontology and related fields are also published. One volume of six issues is published annually.
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