Engebretson Steven P, Vossughi Faranak, Hey-Hadavi Judith, Emingil Gülnur, Grbic John T
Department of Periodontics, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
J Clin Periodontol. 2006 Nov;33(11):784-90. doi: 10.1111/j.1600-051X.2006.00984.x. Epub 2006 Aug 14.
Polymorphonuclear neutrophil (PMN) dysfunction is associated with diabetes. We examined the gingival crevicular fluid (GCF) beta-glucuronidase (BG) and interleukin-8 (IL-8) levels of periodontitis patients with and without type 2 diabetes mellitus (DM).
Forty five adults with type 2 DM and 32 adults without DM, both with chronic periodontitis were enrolled. GCF was collected from eight posterior sites in each quadrant, and periodontal parameters were recorded. GCF was assayed for IL-8 by ELISA and BG by a fluorometric assay.
GCF IL-8 was positively correlated with probing depth (PD), and GCF BG but not clinical attachment level (CAL), bleeding on probing (BOP), or plaque index (PI). In contrast, GCF BG was strongly correlated with each of the clinical measures of periodontal disease. Subjects with DM significantly lower levels of both BG (73.0+/-44.8 versus 121.9+/-84.6 pg/sample; p=0.002) and IL-8 (32.1+/-33.1 versus 90.8+/-83.2 pg/sample; p<0.0001) even after adjustments for age, gender, PD, CAL, BOP, and PI. Neither BG nor IL-8 was correlated with HbA1c levels in subjects with DM.
These data suggest that an inadequate local response by PMN, partially explained by an altered chemokine gradient, may contribute to periodontal disease in patients with type 2 DM.
多形核中性粒细胞(PMN)功能障碍与糖尿病有关。我们检测了患有和未患2型糖尿病(DM)的牙周炎患者龈沟液(GCF)中的β-葡萄糖醛酸酶(BG)和白细胞介素-8(IL-8)水平。
纳入45名患有2型糖尿病的成年人和32名未患糖尿病的成年人,二者均患有慢性牙周炎。从每个象限的8个后牙部位采集龈沟液,并记录牙周参数。采用酶联免疫吸附测定法(ELISA)检测龈沟液中的IL-8,采用荧光测定法检测BG。
龈沟液IL-8与探诊深度(PD)呈正相关,与龈沟液BG相关,但与临床附着水平(CAL)、探诊出血(BOP)或菌斑指数(PI)无关。相比之下,龈沟液BG与牙周疾病的各项临床指标均密切相关。即使在对年龄、性别、PD、CAL、BOP和PI进行校正后,糖尿病患者的BG(73.0±44.8对121.9±84.6 pg/样本;p=0.002)和IL-8水平(32.1±33.1对90.8±83.2 pg/样本;p<0.0001)仍显著较低。糖尿病患者的BG和IL-8水平均与糖化血红蛋白(HbA1c)水平无关。
这些数据表明,PMN局部反应不足(部分原因是趋化因子梯度改变)可能导致2型糖尿病患者发生牙周疾病。