Guzman Sergio, Karima Mamdouh, Wang Hwa-Ying, Van Dyke Thomas E
Department of Periodontology and Oral Biology, Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA.
J Periodontol. 2003 Aug;74(8):1183-90. doi: 10.1902/jop.2003.74.8.1183.
Recently, it has become evident that for many common chronic diseases, modifying factors amplify disease mechanisms to make the clinical condition more severe. The aims of this report were 1) to investigate the prevalence of periodontitis in a diabetic population, 2) to evaluate the association of periodontitis with metabolic control, and 3) to evaluate periodontitis in diabetics with different interleukin (IL)-1 genotypes.
One hundred diabetic patients were screened. Type and duration of diabetes, level of control (glycosylated hemoglobin), and demographic data were recorded. Periodontal disease was defined as two or more teeth with clinical attachment loss (CAL) > or = 5 mm. Poorly controlled diabetes was defined as glycosylated hemoglobin values > 8%. Finger-stick blood samples were collected and analyzed for genotyping of IL-1A (+4845), IL-1B (+3954), IL-1B (-511), and IL-1RN (+2018) polymorphisms.
Among the diabetic patients in the study, 66% showed periodontal destruction, and 43% of those could be characterized as severe. The prevalence of severe attachment loss increased with decreasing control of diabetes. Only the IL-1B (-511) genotype was found to be associated with periodontal disease in the African American patients (P<0.05). The frequency of allele 1 was 0.77 in periodontitis affected versus 0.33 in healthy African American diabetics. A borderline significant association between IL-1B (+3954) and periodontal disease also was noted in Caribbean periodontal patients (P=0.06); however, the allele 2 frequency in this population was only 10%.
These data confirm the high prevalence and severity of periodontitis in the diabetic population, and support the association between poor glycemic control and periodontal disease. The low prevalence of some of the IL-1 gene polymorphisms in the ethnic groups included in this study limits the validity of conclusions on genotype associations with clinical findings, but there was a trend suggesting that allele 1 at IL-1B (-511) and IL-1B (+3954) was overrepresented among diabetics with periodontal disease.
最近，有证据表明，对于许多常见的慢性疾病，修饰因素会放大疾病机制，使临床病情更加严重。本报告的目的是：1）调查糖尿病患者中牙周炎的患病率；2）评估牙周炎与代谢控制之间的关联；3）评估不同白细胞介素（IL）-1基因型的糖尿病患者的牙周炎情况。
对100名糖尿病患者进行筛查。记录糖尿病的类型和病程、控制水平（糖化血红蛋白）以及人口统计学数据。牙周疾病定义为两颗或更多颗牙齿的临床附着丧失（CAL）≥5mm。糖尿病控制不佳定义为糖化血红蛋白值＞8%。采集手指血样本，分析IL-1A（+4845）、IL-1B（+3954）、IL-1B（-511）和IL-1RN（+2018）多态性的基因分型。
在本研究的糖尿病患者中，66%表现出牙周破坏，其中43%可被归类为重度。重度附着丧失的患病率随着糖尿病控制的降低而增加。仅发现IL-1B（-511）基因型与非裔美国患者的牙周疾病相关（P＜0.05）。在患牙周炎的非裔美国糖尿病患者中，等位基因1的频率为0.77，而在健康患者中为0.33。在加勒比牙周炎患者中，也注意到IL-1B（+3954）与牙周疾病之间存在临界显著关联（P = 0.06）；然而，该人群中等位基因2的频率仅为10%。
这些数据证实了糖尿病患者中牙周炎的高患病率和严重性，并支持血糖控制不佳与牙周疾病之间的关联。本研究中纳入的种族群体中某些IL-1基因多态性的低患病率限制了关于基因型与临床发现关联结论的有效性，但有趋势表明，在患有牙周疾病的糖尿病患者中，IL-1B（-511）和IL-1B（+3954）的等位基因1的比例过高。
