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牙周治疗对 2 型糖尿病患者代谢控制、全身炎症和细胞因子的影响。

Effect of periodontal treatment on metabolic control, systemic inflammation and cytokines in patients with type 2 diabetes.

机构信息

Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, SP, Brazil.

出版信息

J Clin Periodontol. 2010 Jan;37(1):53-8. doi: 10.1111/j.1600-051X.2009.01498.x. Epub 2009 Nov 24.

Abstract

OBJECTIVE

The aim of this study was to investigate the effect of periodontal therapy on the circulating concentration of high-sensitivity capsule-reactive protein (hs-CRP), fibrinogen (FIB), interleukin (IL)-4, IL-6, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-alpha) and on the metabolic control in type 2 diabetes mellitus (T2DM) patients.

MATERIAL AND METHODS

Twenty-three T2DM patients with chronic periodontitis were enrolled in this study. Periodontal clinical parameters, namely visible plaque index, gingival bleeding index, bleeding on probing, probing depth and clinical attachment levels, were evaluated. Blood samples for plasma were collected and assessed for the levels of hs-CRP, FIB, IL-4, IL-6, IL-8, IL-10 and TNF-alpha. The glycated haemoglobin (HbA(1c)) and fasting plasma glucose were also measured. All parameters were evaluated before and 3 months after non-surgical periodontal therapy.

RESULTS

All clinical parameters were significantly improved 3 months after the periodontal therapy. A univariate comparison showed a tendency towards a decrease of the measured biomarkers, most pronounced for TNF-alpha and FIB, after therapy. Periodontal treatment also reduced HbA(1c) and hs-CRP levels, albeit not significantly.

CONCLUSIONS

The clinically successful non-surgical periodontal therapy tended to reduce systemic inflammation and the concentration of some circulating cytokines.

摘要

目的

本研究旨在探讨牙周治疗对 2 型糖尿病(T2DM)患者循环中高敏 C 反应蛋白(hs-CRP)、纤维蛋白原(FIB)、白细胞介素(IL)-4、IL-6、IL-8、IL-10 和肿瘤坏死因子-α(TNF-α)浓度及代谢控制的影响。

材料与方法

本研究纳入 23 例患有慢性牙周炎的 T2DM 患者。评估了牙周临床参数,即可见菌斑指数、牙龈出血指数、探诊出血、探诊深度和临床附着水平。采集血浆样本,检测 hs-CRP、FIB、IL-4、IL-6、IL-8、IL-10 和 TNF-α的水平。还测量了糖化血红蛋白(HbA1c)和空腹血糖。所有参数均在牙周非手术治疗前和 3 个月进行评估。

结果

牙周治疗 3 个月后,所有临床参数均显著改善。单因素比较显示,治疗后测量的生物标志物呈下降趋势,TNF-α和 FIB 最为明显。牙周治疗还降低了 HbA1c 和 hs-CRP 水平,但无统计学意义。

结论

临床成功的非手术牙周治疗倾向于减轻全身炎症和某些循环细胞因子的浓度。

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