Collin H L, Sorsa T, Meurman J H, Niskanen L, Salo T, Rönkä H, Konttinen Y T, Koivisto A M, Uusitupa M
Institute of Dentistry, University of Helsinki, Finland.
J Periodontal Res. 2000 Oct;35(5):259-65. doi: 10.1034/j.1600-0765.2000.035005259.x.
We studied the salivary levels and activities of the matrix metalloproteinases (MMP) -8 and -9 in 45 type 2 diabetic patients and 77 control subjects. The patients' mean glycosylated haemoglobin (HbA1c) was 8.7%, indicating an unsatisfactory metabolic control of the disease. The MMP levels were further related to the clinical and microbiological periodontal findings as well as to salivary flow rate and other factors. The salivary flow rate, albumin and amylase concentrations were similar in type 2 diabetic patients to those in the control group. The mean gingival and periodontal pocket indexes were higher in the diabetes group. The number of potential periodontopathogenic bacteria was lower, however, in the diabetic than in the control group. Zymography and immunoblotting revealed that the major MMPs in the type 2 diabetic patients' saliva were MMP-8 and MMP-9. Salivary MMP levels and activities in type 2 diabetic patients were in general similar to those in the control group. However, the correlation coefficients using multiple regression analysis revealed that gingival bleeding, pocket depths and HbA1c were associated with increased MMP-8 levels which, in turn, were negatively predicted by elevated plasma lipid peroxide levels in the diabetic group. Our data on salivary MMP-8 and -9 do not support the concept of generalized neutrophil dysfunction in unbalanced diabetes. Moreover, plasma lipid peroxidation levels reflecting the increased oxidative burden, which is generated mainly by triggered neutrophils, do not indicate neutrophil dysfunction due to diabetes, but may rather be related to the increased tissue damage in an uncontrolled disease. However. advanced periodontitis in type 2 diabetes seems to be related to elevated salivary MMP-8 levels which might be useful in monitoring periodontal disease in diabetes.
我们研究了45例2型糖尿病患者和77例对照者唾液中基质金属蛋白酶（MMP）-8和-9的水平及活性。患者的平均糖化血红蛋白（HbA1c）为8.7%，表明疾病的代谢控制不理想。MMP水平进一步与临床和微生物学牙周检查结果以及唾液流速和其他因素相关。2型糖尿病患者的唾液流速、白蛋白和淀粉酶浓度与对照组相似。糖尿病组的平均牙龈和牙周袋指数更高。然而，糖尿病组中潜在牙周病原菌的数量低于对照组。酶谱分析和免疫印迹显示，2型糖尿病患者唾液中的主要MMP是MMP-8和MMP-9。2型糖尿病患者唾液中MMP的水平和活性总体上与对照组相似。然而，多元回归分析的相关系数显示，牙龈出血、牙周袋深度和HbA1c与MMP-8水平升高相关，而在糖尿病组中，血浆脂质过氧化物水平升高则对MMP-8水平有负向预测作用。我们关于唾液MMP-8和-9的数据不支持非平衡型糖尿病存在全身性中性粒细胞功能障碍的概念。此外，反映氧化负担增加的血浆脂质过氧化水平主要由活化的中性粒细胞产生，这并不表明糖尿病导致中性粒细胞功能障碍，而可能与未控制疾病中组织损伤增加有关。然而，2型糖尿病中的重度牙周炎似乎与唾液MMP-8水平升高有关，这可能有助于监测糖尿病患者的牙周疾病。
