非手术性牙周治疗改善肥胖伴牙周炎大鼠肾功能异常和氧化应激状态
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摘要
目的:观察非手术性牙周治疗对肥胖伴实验性牙周炎大鼠肾功能和氧化应激水平的影响.方法:45只SD大鼠随机分为健康对照组、肥胖对照组、肥胖伴实验性牙周炎组和牙周治疗组.通过HE染色观察牙周和肾组织结构改变,并检测血清肌酐水平及肾脏的丙二醛(MDA)、8-羟基脱氧鸟苷(8-OHd G)、还原性谷胱甘肽(GSH)含量和总超氧化物歧化酶(SOD)活力.结果:肥胖伴实验性牙周炎组的牙周组织破坏明显,肾小管上皮病理结构出现早期破坏.牙周治疗组的血清肌酐水平[(26. 38±1. 51) mmol/L]显著低于肥胖伴实验性牙周炎组(30. 13±2. 47) mmol/L(P=0. 001).牙周治疗组肾脏的MDA(6. 29±1. 24) n M/mgprot、8-OHd G(0. 32±0. 14) ng/gprot水平显著低于肥胖伴实验性牙周炎组MDA(7. 88±1. 99) n M/mgprot、8-OHd G(0. 50±0. 26) ng/gprot(P <0. 05);牙周治疗组肾脏的GSH水平[(55. 85±7. 26)μmol/gprot]显著高于肥胖伴实验性牙周炎组[(43. 91±12. 48)μmol/gprot](P=0. 041);牙周治疗组的SOD活力与肥胖伴实验性牙周炎组的无统计学差异(P> 0. 05).结论:非手术性牙周治疗可一定程度改善肥胖伴实验性牙周炎大鼠肾功能异常和氧化应激状态.
Objective: The purpose of this study was to investigate the effect of non-surgical periodontal therapy on the renal function and oxidative stress in obese rats combined with experimental periodontitis. Methods: Forty-five Sprague-Dawley rats were randomly divided into healthy group,obese group,obesity combined with experimental periodontitis group and periodontal therapy group. The histology change of periodontal and renal tissue was observed by using HE staining method. Serum creatinine and malondialdehyde( MDA),8-hydroxydeoxyguanosine( 8-OHdG),reduced glutathione( GSH) content and total superoxide dismutase( SOD) activity in renal tissue were detected. Results:Obvious destruction of periodontal tissue and early damage of renal tubular epithelium was observed in obesity combined with periodontitis group. Serum creatinine [( 26. 38 ± 1. 51) mmol/L] in periodontal therapy group was significantly lower than that in obesity combined with experimental periodontitis group[( 30. 13 ± 2. 47) mmol/L]( P = 0. 001). MDA [( 6. 29 ± 1. 24) nM/mgprot]and 8-OHdG [( 0. 32± 0. 14) ng/gprot] in renal tissue of periodontal therapy group were significantly lower,while GSH[( 55. 85 ± 7. 26) μmol/gprot]was significantly higher than those in obesity combined with experimental periodontitis group [( MDA 7. 88 ± 1. 99) nM/mgprot],8-OHdG [( 0. 50 ± 0. 26) ng/gprot],GSH[( 43. 91 ± 12. 48) μmol/gprot]( P < 0. 05). There was no significant difference in SOD activity between obesity combined with experimental periodontitis group and periodontal therapy group( P > 0. 05).Conclusion: Non-surgical periodontal therapy may improve renal dysfunction and oxidative stress in obese rats combined with experimental periodontitis.
Objective: The purpose of this study was to investigate the effect of non-surgical periodontal therapy on the renal function and oxidative stress in obese rats combined with experimental periodontitis. Methods: Forty-five Sprague-Dawley rats were randomly divided into healthy group,obese group,obesity combined with experimental periodontitis group and periodontal therapy group. The histology change of periodontal and renal tissue was observed by using HE staining method. Serum creatinine and malondialdehyde( MDA),8-hydroxydeoxyguanosine( 8-OHdG),reduced glutathione( GSH) content and total superoxide dismutase( SOD) activity in renal tissue were detected. Results:Obvious destruction of periodontal tissue and early damage of renal tubular epithelium was observed in obesity combined with periodontitis group. Serum creatinine [( 26. 38 ± 1. 51) mmol/L] in periodontal therapy group was significantly lower than that in obesity combined with experimental periodontitis group[( 30. 13 ± 2. 47) mmol/L]( P = 0. 001). MDA [( 6. 29 ± 1. 24) nM/mgprot]and 8-OHdG [( 0. 32± 0. 14) ng/gprot] in renal tissue of periodontal therapy group were significantly lower,while GSH[( 55. 85 ± 7. 26) μmol/gprot]was significantly higher than those in obesity combined with experimental periodontitis group [( MDA 7. 88 ± 1. 99) nM/mgprot],8-OHdG [( 0. 50 ± 0. 26) ng/gprot],GSH[( 43. 91 ± 12. 48) μmol/gprot]( P < 0. 05). There was no significant difference in SOD activity between obesity combined with experimental periodontitis group and periodontal therapy group( P > 0. 05).Conclusion: Non-surgical periodontal therapy may improve renal dysfunction and oxidative stress in obese rats combined with experimental periodontitis.
引文
[1] ATABAY V E,LUTFIOGLU M,AVCI B,et al.Obesity and oxidative stress in patients with different periodontal status:a case-control study[J]. Journal of Periodontal Research,2017,52(1):51-60.
[2] CHEN L,LUO G,XUAN D,et al. Effects of nonsurgical periodontal treatment on clinical response,serum Inflammatory parameters,and metabolic control in patients with type 2 diabetes:a randomized study[J]. Journal of Periodontology,2012,83(4):435-443.
[3]李培森,李贺,梁秋娟,等. 2型糖尿病伴慢性牙周炎患者的血清学指标及意义[J].口腔疾病防治,2018,26(7):456-459.LI P C,LI H,LIANG Q J,et al. Clinical value of serum markers of type 2 diabetes mellitus complicated by chronic periodontitis[J]. Journal of Prevention and Treatment for Stomatological Diseases,2018,26(7):456-459.
[4]王洁琪,雷蕾,卢嘉健,等.牙周病与2型糖尿病相关性的临床研究[J].暨南大学学报(自然科学与医学版),2013,34(6):636-639.WANG J Q,LEI L,LU J J,et al. Clinical research on correlation between periodontal diseases and type 2diabetes mellitus[J]. Journal of Jinan University(Natural Science&Medicine Edition),2013,34(6):636-639.
[5] NORDENDAHL E,GUSTAFSSON A,NORHAMMAR A, et al. Severe periodontitis is associated with myocardial infarction in females[J]. Journal of Dental Research,2018,97(10):1114-1121.
[6]王蔚璐,吴昌敬,夏长普,等.慢性牙周炎合并高脂血症患者阿托伐他汀治疗期间血清脂蛋白磷脂酶A2和C反应蛋白水平变化[J].口腔疾病防治,2017,25(7):449-453.WANG W L,WU C J,XIA C P,et al. Changes of serum lipoprotein phospholipase A2 and CRP levels in patients with chronic periodontitis and hyperlipidemia after atorvastatin treatment[J]. Journal of Prevention and Treatment for Stomatological Diseases,2017,25(7):449-453.
[7] KSHIRSAGAR A V,GRUBBS V. Periodontal disease and CKD-associated morbidity:is there now enough evidence to move from observation to intervention?[J]. American Journal of Kidney Diseases,2015,66(2):181-183.
[8] FURUKAWA S,FUJITA T,SHIMABUKURO M,et al.Increased oxidative stress in obesity and its impact on metabolic syndrome[J]. J Clin Invest,2004,114(12):1752-1761.
[9] BROTTO R S,VENDRAMINI R C,BRUNETTI I L,et al. Lack of correlation between periodontitis and renal dysfunction in systemically healthy patients[J]. Eur J Dent,2011,5(1):8-18.
[10] FRANCA L F C,VASCONCELOS A C C G,DASILVA F R P,et al. Periodontitis changes renal structures by oxidative stress and lipid peroxidation[J]. Journal of Clinical Periodontology,2017,44(6):568-576.
[11] SHULTIS W A,WEIL E J,LOOKER H C,et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes[J]. Diabetes Care,2007,30(2):306-311.
[12] ALMEIDA S,FIGUEREDO C M,LEMOS C,et al.Periodontal treatment in patients with chronic kidney disease:a pilot study[J]. J Periodontal Res,2017,52(2):262-267.
[13]柴巧学,钟素兰,倪佳,等.牙周基础治疗对肥胖大鼠实验性牙周炎及代谢水平的影响[J].南方医科大学学报,2017,37(5):663-667.CHAI Q X,ZHONG S L,NI J,et al. Beneficial effect of periodontal therapy on insulin resistance and lipid metabolism in obese rats with periodontitis[J]. Journal of Southern Medical University,2017,37(5):663-667.
[14]钟素兰,倪佳,柴巧学,等.实验性牙周炎对肥胖大鼠血清C反应蛋白及胰岛素抵抗的影响[J].实用口腔医学杂志,2017,33(3):327-330.ZHONG S L,NI J,CHAI Q X,et al. The effects of experimental periodontitis on serum C reactive protein and insulin resistance in obese rats[J]. Journal of Practical Stomatology,2017,33(3):327-330.
[15] VASSALOTTI J A,STEVENS L A,LEVEY A S. Testing for chronic kidney disease:a position statement from the national kidney foundation[J]. American Journal of Kidney Diseases,2007,50(2):169-180.
[16]柯振符.血清肌酐、胱抑素-C、尿素氮及尿β2-微球蛋白检测在2型糖尿病早期肾损伤中的价值[J].中国医药导报,2013,10(22):94-96.KE Z F. Value of the serum creatinine,cystatin C,urea nitrogen andβ2-microglobulin detection in the early renal damage in type 2 diabetes mellitus[J]. China Medical Herald,2013,10(22):94-96.
[17] WANG Y, ANDRUKHOV O, RAUSCH-FAN X.Oxidative stress and antioxidant system in periodontitis[J]. Frontiers in Physiology,2017,8:910.
[18] RATLIFF B B,ABDULMAHDI W,PAWAR R,et al.Oxidant mechanisms in renal injury and disease[J].Antioxidants&Redox Signaling,2016,25(3):119-146.
[19]唐阁,杨洪涛,林燕,等.扶肾颗粒改善腹透模型大鼠肾性贫血的机制研究[J].辽宁中医杂志,2018,45(9):1971-1973,2018.TANG G, YANG H T, LIN Y, et al. Study on mechanism of fushen granules in improving renal anemia in peritoneal model rats[J]. Liaoning Journal of Traditional Chinese Medicine,2018,45(9):1971-1973,2018.
[20] SANCHEZ M,ROUSSEL R,HADJADJ S,et al. Plasma concentrations of 8-hydroxy-2'-deoxyguanosine and risk of kidney disease and death in individuals with type1 diabetes[J]. Diabetologia,2018,61(4):977-984.
[21]何铃,朱诗平,金鑫,等.慢肾康宁方对慢性肾衰大鼠肾组织氧化应激状态及Caspase-3,JNK,p66Shc蛋白表达影响[J].暨南大学学报(自然科学与医学版),2012,33(6):559-564.HE L, ZHU S P, LI X, et al. Effects of Manshenkangning Fang on oxidative stress state and expression levels of Caspase-3,JNK and p66Shc in rat kidneys of chronic renal failure[J]. Journal of Jinan University(Natural Science&Medicine Edition),2012,33(6):559-564.
[22] MITTWEDE P N,XIANG L,LU S,et al. Oxidative stress contributes to orthopedic trauma-induced acute kidney injury in obese rats[J]. Am J Physiol Renal Physiol,2015,308(2):F157-F163.
[23] RAZA H, JOHN A, HOWARTH F C. Increased metabolic stress in Zucker diabetic fatty rat kidney and pancreas[J]. Cell Physiol Biochem,2013,32(6):1610-1620.
[2] CHEN L,LUO G,XUAN D,et al. Effects of nonsurgical periodontal treatment on clinical response,serum Inflammatory parameters,and metabolic control in patients with type 2 diabetes:a randomized study[J]. Journal of Periodontology,2012,83(4):435-443.
[3]李培森,李贺,梁秋娟,等. 2型糖尿病伴慢性牙周炎患者的血清学指标及意义[J].口腔疾病防治,2018,26(7):456-459.LI P C,LI H,LIANG Q J,et al. Clinical value of serum markers of type 2 diabetes mellitus complicated by chronic periodontitis[J]. Journal of Prevention and Treatment for Stomatological Diseases,2018,26(7):456-459.
[4]王洁琪,雷蕾,卢嘉健,等.牙周病与2型糖尿病相关性的临床研究[J].暨南大学学报(自然科学与医学版),2013,34(6):636-639.WANG J Q,LEI L,LU J J,et al. Clinical research on correlation between periodontal diseases and type 2diabetes mellitus[J]. Journal of Jinan University(Natural Science&Medicine Edition),2013,34(6):636-639.
[5] NORDENDAHL E,GUSTAFSSON A,NORHAMMAR A, et al. Severe periodontitis is associated with myocardial infarction in females[J]. Journal of Dental Research,2018,97(10):1114-1121.
[6]王蔚璐,吴昌敬,夏长普,等.慢性牙周炎合并高脂血症患者阿托伐他汀治疗期间血清脂蛋白磷脂酶A2和C反应蛋白水平变化[J].口腔疾病防治,2017,25(7):449-453.WANG W L,WU C J,XIA C P,et al. Changes of serum lipoprotein phospholipase A2 and CRP levels in patients with chronic periodontitis and hyperlipidemia after atorvastatin treatment[J]. Journal of Prevention and Treatment for Stomatological Diseases,2017,25(7):449-453.
[7] KSHIRSAGAR A V,GRUBBS V. Periodontal disease and CKD-associated morbidity:is there now enough evidence to move from observation to intervention?[J]. American Journal of Kidney Diseases,2015,66(2):181-183.
[8] FURUKAWA S,FUJITA T,SHIMABUKURO M,et al.Increased oxidative stress in obesity and its impact on metabolic syndrome[J]. J Clin Invest,2004,114(12):1752-1761.
[9] BROTTO R S,VENDRAMINI R C,BRUNETTI I L,et al. Lack of correlation between periodontitis and renal dysfunction in systemically healthy patients[J]. Eur J Dent,2011,5(1):8-18.
[10] FRANCA L F C,VASCONCELOS A C C G,DASILVA F R P,et al. Periodontitis changes renal structures by oxidative stress and lipid peroxidation[J]. Journal of Clinical Periodontology,2017,44(6):568-576.
[11] SHULTIS W A,WEIL E J,LOOKER H C,et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes[J]. Diabetes Care,2007,30(2):306-311.
[12] ALMEIDA S,FIGUEREDO C M,LEMOS C,et al.Periodontal treatment in patients with chronic kidney disease:a pilot study[J]. J Periodontal Res,2017,52(2):262-267.
[13]柴巧学,钟素兰,倪佳,等.牙周基础治疗对肥胖大鼠实验性牙周炎及代谢水平的影响[J].南方医科大学学报,2017,37(5):663-667.CHAI Q X,ZHONG S L,NI J,et al. Beneficial effect of periodontal therapy on insulin resistance and lipid metabolism in obese rats with periodontitis[J]. Journal of Southern Medical University,2017,37(5):663-667.
[14]钟素兰,倪佳,柴巧学,等.实验性牙周炎对肥胖大鼠血清C反应蛋白及胰岛素抵抗的影响[J].实用口腔医学杂志,2017,33(3):327-330.ZHONG S L,NI J,CHAI Q X,et al. The effects of experimental periodontitis on serum C reactive protein and insulin resistance in obese rats[J]. Journal of Practical Stomatology,2017,33(3):327-330.
[15] VASSALOTTI J A,STEVENS L A,LEVEY A S. Testing for chronic kidney disease:a position statement from the national kidney foundation[J]. American Journal of Kidney Diseases,2007,50(2):169-180.
[16]柯振符.血清肌酐、胱抑素-C、尿素氮及尿β2-微球蛋白检测在2型糖尿病早期肾损伤中的价值[J].中国医药导报,2013,10(22):94-96.KE Z F. Value of the serum creatinine,cystatin C,urea nitrogen andβ2-microglobulin detection in the early renal damage in type 2 diabetes mellitus[J]. China Medical Herald,2013,10(22):94-96.
[17] WANG Y, ANDRUKHOV O, RAUSCH-FAN X.Oxidative stress and antioxidant system in periodontitis[J]. Frontiers in Physiology,2017,8:910.
[18] RATLIFF B B,ABDULMAHDI W,PAWAR R,et al.Oxidant mechanisms in renal injury and disease[J].Antioxidants&Redox Signaling,2016,25(3):119-146.
[19]唐阁,杨洪涛,林燕,等.扶肾颗粒改善腹透模型大鼠肾性贫血的机制研究[J].辽宁中医杂志,2018,45(9):1971-1973,2018.TANG G, YANG H T, LIN Y, et al. Study on mechanism of fushen granules in improving renal anemia in peritoneal model rats[J]. Liaoning Journal of Traditional Chinese Medicine,2018,45(9):1971-1973,2018.
[20] SANCHEZ M,ROUSSEL R,HADJADJ S,et al. Plasma concentrations of 8-hydroxy-2'-deoxyguanosine and risk of kidney disease and death in individuals with type1 diabetes[J]. Diabetologia,2018,61(4):977-984.
[21]何铃,朱诗平,金鑫,等.慢肾康宁方对慢性肾衰大鼠肾组织氧化应激状态及Caspase-3,JNK,p66Shc蛋白表达影响[J].暨南大学学报(自然科学与医学版),2012,33(6):559-564.HE L, ZHU S P, LI X, et al. Effects of Manshenkangning Fang on oxidative stress state and expression levels of Caspase-3,JNK and p66Shc in rat kidneys of chronic renal failure[J]. Journal of Jinan University(Natural Science&Medicine Edition),2012,33(6):559-564.
[22] MITTWEDE P N,XIANG L,LU S,et al. Oxidative stress contributes to orthopedic trauma-induced acute kidney injury in obese rats[J]. Am J Physiol Renal Physiol,2015,308(2):F157-F163.
[23] RAZA H, JOHN A, HOWARTH F C. Increased metabolic stress in Zucker diabetic fatty rat kidney and pancreas[J]. Cell Physiol Biochem,2013,32(6):1610-1620.