Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey.
Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.
J Periodontol. 2017 Nov;88(11):1145-1152. doi: 10.1902/jop.2017.170043. Epub 2017 Jun 9.
The objective of this cross-sectional study is to investigate levels of salivary and serum matrix metalloproteinase (MMP)-9, myeloperoxidase (MPO), neutrophil elastase (NE), and MMP-9/tissue inhibitor of MMP-1 (TIMP)-1 ratio in patients with polycystic ovary syndrome (PCOS) and systemically healthy controls in the presence or absence of gingivitis.
Serum and salivary levels of these biomarkers were evaluated in the following: 1) periodontally healthy women with PCOS (n = 45); 2) women with PCOS and gingivitis (n = 35); 3) systemically and periodontally healthy women (n = 25); and 4) systemically healthy women with gingivitis (n = 20). Enzyme-linked immunosorbent assay was used to determine levels of these biomarkers. A full-mouth clinical periodontal evaluation was performed for each patient.
Salivary MMP-9 and NE levels, as well as MMP-9/TIMP-1 ratios, were higher in the systemically healthy women with gingivitis compared with periodontally healthy women with PCOS (P <0.001; P <0.01; and P <0.0001, respectively). Serum MMP-9 and MPO levels were higher in women with PCOS and gingivitis compared with periodontally healthy women with PCOS (P <0.05). Serum MMP-9 levels were lower in healthy women with gingivitis than systemically and periodontally healthy women or women with PCOS and gingivitis (P <0.05). PCOS groups exhibited a positive correlation among clinical periodontal parameters and serum MMP-9 levels or salivary MPO, NE levels, and MMP-9/MMP-1 ratio. Correlation was negative among clinical periodontal parameters and serum MMP-9 levels and MMP-9/TIMP-1 ratio in systemically healthy patients (P <0.05).
The present findings emphasize that PCOS and gingival inflammation are associated with each other, as evidenced by salivary and serum levels of neutrophilic enzymes. This interaction may contribute to the perturbation of ovarian remodeling in PCOS.
本横断面研究的目的是调查多囊卵巢综合征（PCOS）患者和系统性健康对照者在伴或不伴牙龈炎时唾液和血清基质金属蛋白酶（MMP）-9、髓过氧化物酶（MPO）、中性粒细胞弹性蛋白酶（NE）和 MMP-9/基质金属蛋白酶抑制剂-1（TIMP）-1 比值的水平。
采用酶联免疫吸附试验检测以下各组患者的这些生物标志物水平：1）牙周健康的 PCOS 患者（n=45）；2）患有 PCOS 和牙龈炎的患者（n=35）；3）系统性和牙周健康的女性（n=25）；4）患有牙龈炎的系统性健康女性（n=20）。对每位患者进行全口临床牙周评估。
与牙周健康的 PCOS 患者相比，系统性健康伴牙龈炎的女性唾液 MMP-9 和 NE 水平以及 MMP-9/TIMP-1 比值更高（P<0.001；P<0.01；P<0.0001）。患有 PCOS 和牙龈炎的女性血清 MMP-9 和 MPO 水平高于牙周健康的 PCOS 患者（P<0.05）。与系统性和牙周健康的女性或患有 PCOS 和牙龈炎的女性相比，患有牙龈炎的健康女性血清 MMP-9 水平更低（P<0.05）。PCOS 组患者的临床牙周参数与血清 MMP-9 水平或唾液 MPO、NE 水平和 MMP-9/MMP-1 比值呈正相关。在系统性健康患者中，临床牙周参数与血清 MMP-9 水平和 MMP-9/TIMP-1 比值呈负相关（P<0.05）。
本研究结果强调了 PCOS 和牙龈炎症之间的相互关系，这与中性粒细胞酶的唾液和血清水平有关。这种相互作用可能导致 PCOS 中卵巢重塑的紊乱。
