龈沟液中脂联素水平与糖尿病牙周炎患者病程进展的相关性
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摘要
目的探讨龈沟液中脂联素水平与糖尿病牙周炎患者病程发生发展的相关性。方法选取2015年1月～2017年1月于青岛市中心医院及青岛市中心医疗集团牙科治疗的40例2型糖尿病合并牙周炎患者,设为糖尿病牙周炎组,40例单纯牙周炎患者设为牙周炎组,同时选取40例正常体检人群设为对照组。记录3组菌斑指数(plaque index,PLI)、出血指数(sulcus bleeding index,SBI)、附着丧失(attachment loss,AL)、探诊深度(Probing depth,PD)等牙周指标,采用龈沟液测量仪定量龈沟液,采用酶联免疫吸附试验(ELISA)检测龈沟液脂联素、肿瘤坏死因子(tumor necrosis factor,TNF-α)、超敏C反应蛋白(Hypersensitive C reactive protein,hs-CRP)水平,并进行脂联素与牙周指标以及炎性因子的相关性分析。结果糖尿病牙周炎组、牙周炎组PLI、SBI、AL、PD均显著高于对照组,糖尿病牙周炎组各指标显著高于牙周炎组,差异均具有统计学意义(P<0.05);糖尿病牙周炎组、牙周炎组龈沟液脂联素均显著低于对照组,hs-CRP、TNF-α显著高于对照组,糖尿病牙周炎组各指标显著高于牙周炎组,组间比较差异均有统计学意义(P<0.05);龈沟液脂联素水平与PD、AL、龈沟液hs-CRP、TNF-α水平呈负相关(r=-0.321,r=-0.435,r=-0.443,r=-0.534,P<0.05),与SBI、PLI无相关性(r=2.323,r=2.117,P>0.05)。结论龈沟液中脂联素水平与糖尿病牙周炎患者AL、PD以及局部炎症反应具有明显关系,龈沟液中脂联素水平降低可能通过影响骨代谢与炎症反应参与糖尿病牙周炎患者病程的发生与发展。
Objective To investigate the correlation between adiponectin levels in gingival crevicular fluid and the course of diabetic periodontitis. Methods 40 chronic periodontitis patients with type 2 diabetes mellitus and 40 periodontitis patients from Jan 2015 to Jan 2017 were selected and divided into CD & P group and P group. At the same time, 40 healthy individuals were selected as control group. The plaque index(PLI), sulcus bleeding index(SBI), attachment loss(AL), probing depth(PD) and other periodontal indexes were recorded. Enzyme-linked immune sorbent assay(ELISA) was used to detect the expression of adiponectin, tumor necrosis factor(TNF-α) and hypersensitive C reactive protein(hs-CRP) levels. The correlation among the adiponectin and periodontal index and inflammatory factor were also analyzed. Results The levels of PLI, SBI, AL and PD P group and CD & P group were higher than that of the control group(P<0.05). The adiponectin levels, TNF-α and hs-CRP levels of control group were different from those of CD & P group and P group(P<0.05). The adiponectin levels was negatively correlated with PD, AL, TNF-α and hs-CRP(r =-0.321, r =-0.435, r =-0.443, P<0.05), and was not correlated with PLI and SBI(r = 2.323, r = 2.117, P>0.05). Conclusion The adiponectin levels in gingival crevicular fluid are correlated with AL, PD and local inflammation reaction in patients with periodontitis. Moreover, the decrease of adiponectin level in gingival crevicular fluid may play an important role in the pathogenesis of periodontitis by influencing bone metabolism and inflammatory reaction.
Objective To investigate the correlation between adiponectin levels in gingival crevicular fluid and the course of diabetic periodontitis. Methods 40 chronic periodontitis patients with type 2 diabetes mellitus and 40 periodontitis patients from Jan 2015 to Jan 2017 were selected and divided into CD & P group and P group. At the same time, 40 healthy individuals were selected as control group. The plaque index(PLI), sulcus bleeding index(SBI), attachment loss(AL), probing depth(PD) and other periodontal indexes were recorded. Enzyme-linked immune sorbent assay(ELISA) was used to detect the expression of adiponectin, tumor necrosis factor(TNF-α) and hypersensitive C reactive protein(hs-CRP) levels. The correlation among the adiponectin and periodontal index and inflammatory factor were also analyzed. Results The levels of PLI, SBI, AL and PD P group and CD & P group were higher than that of the control group(P<0.05). The adiponectin levels, TNF-α and hs-CRP levels of control group were different from those of CD & P group and P group(P<0.05). The adiponectin levels was negatively correlated with PD, AL, TNF-α and hs-CRP(r =-0.321, r =-0.435, r =-0.443, P<0.05), and was not correlated with PLI and SBI(r = 2.323, r = 2.117, P>0.05). Conclusion The adiponectin levels in gingival crevicular fluid are correlated with AL, PD and local inflammation reaction in patients with periodontitis. Moreover, the decrease of adiponectin level in gingival crevicular fluid may play an important role in the pathogenesis of periodontitis by influencing bone metabolism and inflammatory reaction.
引文
[1] 马钧,常静,李罗玉.慢性牙周炎患者口腔健康生存质量分析[J].解放军预防医学杂志,2017,35(1):58-59.
[2] 胥丹妮,靳赢,王越,等.肥胖伴牙周炎患者龈沟液及血清中脂联素与内脂素的表达[J].中国医科大学学报,2017,46(12):1129-1132.
[3] Patel S P,Raju P A.Gingival crevicular fluid and serum levels of resistin in obese and non-obese subjects with and without periodontitis and association with single nucleotide polymorphism at 420[J].Journal of Indian Society of Periodontology,2014,18(5):555-559.
[4] 丁岩,凌厉,林杰,等.2型糖尿病合并牙周病患者龈沟液中基质金属蛋白酶-3水平和意义[J].实用口腔医学杂志,2013,29(1):97-100.
[5] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):447-498.
[6] 冯辉,邓礼辉,谭小尧,等.牙周组织再生术与正畸联合治疗牙周炎患者临床疗效观察[J].西部医学,2015,27(1):108-110.
[7] Dolińska E,Skurska A,Pietruska M,et al.The Effect of Nonsurgical Periodontal Therapy on HNP1-3 Level in Gingival Crevicular Fluid of Chronic Periodontitis Patients[J].Archivum Immunologiae Et Therapiae Experimentalis,2017,65(4):1-7.
[8] 林玉玲,刘琳,籍胤玺,等.2型糖尿病合并牙周炎患者龈沟液中炎症因子、瘦素和脂多糖水平的变化及其临床意义[J].中国糖尿病杂志,2016,24(9):815-819.
[9] Ghallab N,Hamdy E,Shaker O.Malondialdehyde,superoxide dismutase and melatonin levels in gingival crevicular fluid of aggressive and chronic periodontitis patients[J].Australian Dental Journal,2016,61(1):53-61.
[10] 张新,刘艳丽.糖尿病合并牙周病牙周基础治疗对龈沟液中MMP-3的影响[J].陕西医学杂志,2016,45(7):796-798.
[11] 黄业翔,方玲,高瑞华,等.不同HbA1c水平2型糖尿病患者牙周炎状况分析[J].牙体牙髓牙周病学杂志,2017,27(7):401-403.
[12] 刘崇武,吴春芳,骆凯,等.不同牙周状态下龈沟液中瘦素水平的比较[J].口腔医学研究,2015,31(8):798-800.
[13] ngz Dede F,Bozkurt D,Balli U,et al.Glutathione levels in plasma,saliva and gingival crevicular fluid after periodontal therapy in obese and normal weight individuals[J].Journal of Periodontal Research,2016,51(6):726.
[14] Xuan D,Han Q,Tu Q,et al.Epigenetic Modulation in Periodontitis:Interaction of Adiponectin and JMJD3‐IRF4 Axis in Macrophages[J].Journal of Cellular Physiology,2016,231(5):1090-1096.
[15] 赵博,王永兰.糖尿病牙周炎昆明系模型小鼠牙周组织中脂联素的表达[J].中国组织工程研究,2015,19(5):721-726.
[16] Ebersole J L,Kryscio R J,Campbell C,et al.Salivary and serum adiponectin and C‐reactive protein levels in acute myocardial infarction related to body mass index and oral health[J].Journal of Periodontal Research,2016,52(3):419.
[17] 金晶,吴凯悦,许春姣,等.慢性牙周炎患者龈沟液及牙龈组织中Dickkopf-l水平[J].口腔医学研究,2016,32(4):379-382.
[18] 常炜,葛娅娜.慢性牙周炎患者治疗前后龈沟液中IL-23、IL-17表达水平的变化[J].口腔医学,2016,36(6):536-538.
[19] 杨柳青,徐雪,王黎明,等.慢性牙周炎患者龈沟液中IL-8和TNF-α水平变化及临床意义[J].现代生物医学进展,2016,16(30):5933-5936.
[2] 胥丹妮,靳赢,王越,等.肥胖伴牙周炎患者龈沟液及血清中脂联素与内脂素的表达[J].中国医科大学学报,2017,46(12):1129-1132.
[3] Patel S P,Raju P A.Gingival crevicular fluid and serum levels of resistin in obese and non-obese subjects with and without periodontitis and association with single nucleotide polymorphism at 420[J].Journal of Indian Society of Periodontology,2014,18(5):555-559.
[4] 丁岩,凌厉,林杰,等.2型糖尿病合并牙周病患者龈沟液中基质金属蛋白酶-3水平和意义[J].实用口腔医学杂志,2013,29(1):97-100.
[5] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):447-498.
[6] 冯辉,邓礼辉,谭小尧,等.牙周组织再生术与正畸联合治疗牙周炎患者临床疗效观察[J].西部医学,2015,27(1):108-110.
[7] Dolińska E,Skurska A,Pietruska M,et al.The Effect of Nonsurgical Periodontal Therapy on HNP1-3 Level in Gingival Crevicular Fluid of Chronic Periodontitis Patients[J].Archivum Immunologiae Et Therapiae Experimentalis,2017,65(4):1-7.
[8] 林玉玲,刘琳,籍胤玺,等.2型糖尿病合并牙周炎患者龈沟液中炎症因子、瘦素和脂多糖水平的变化及其临床意义[J].中国糖尿病杂志,2016,24(9):815-819.
[9] Ghallab N,Hamdy E,Shaker O.Malondialdehyde,superoxide dismutase and melatonin levels in gingival crevicular fluid of aggressive and chronic periodontitis patients[J].Australian Dental Journal,2016,61(1):53-61.
[10] 张新,刘艳丽.糖尿病合并牙周病牙周基础治疗对龈沟液中MMP-3的影响[J].陕西医学杂志,2016,45(7):796-798.
[11] 黄业翔,方玲,高瑞华,等.不同HbA1c水平2型糖尿病患者牙周炎状况分析[J].牙体牙髓牙周病学杂志,2017,27(7):401-403.
[12] 刘崇武,吴春芳,骆凯,等.不同牙周状态下龈沟液中瘦素水平的比较[J].口腔医学研究,2015,31(8):798-800.
[13] ngz Dede F,Bozkurt D,Balli U,et al.Glutathione levels in plasma,saliva and gingival crevicular fluid after periodontal therapy in obese and normal weight individuals[J].Journal of Periodontal Research,2016,51(6):726.
[14] Xuan D,Han Q,Tu Q,et al.Epigenetic Modulation in Periodontitis:Interaction of Adiponectin and JMJD3‐IRF4 Axis in Macrophages[J].Journal of Cellular Physiology,2016,231(5):1090-1096.
[15] 赵博,王永兰.糖尿病牙周炎昆明系模型小鼠牙周组织中脂联素的表达[J].中国组织工程研究,2015,19(5):721-726.
[16] Ebersole J L,Kryscio R J,Campbell C,et al.Salivary and serum adiponectin and C‐reactive protein levels in acute myocardial infarction related to body mass index and oral health[J].Journal of Periodontal Research,2016,52(3):419.
[17] 金晶,吴凯悦,许春姣,等.慢性牙周炎患者龈沟液及牙龈组织中Dickkopf-l水平[J].口腔医学研究,2016,32(4):379-382.
[18] 常炜,葛娅娜.慢性牙周炎患者治疗前后龈沟液中IL-23、IL-17表达水平的变化[J].口腔医学,2016,36(6):536-538.
[19] 杨柳青,徐雪,王黎明,等.慢性牙周炎患者龈沟液中IL-8和TNF-α水平变化及临床意义[J].现代生物医学进展,2016,16(30):5933-5936.