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2型糖尿病合并慢性牙周炎患者牙周治疗后的血糖控制与脂肪因子

Glycemic control and adipokines after periodontal therapy in patients with Type 2 diabetes and chronic periodontitis.

作者信息

Wang Shunqin, Liu Jingsong, Zhang Junfeng, Lin Jiancheng, Yang Shuyu, Yao Jiangwu, Du Minquan

机构信息

Wuhan University, School & Hospital of Stomatology, Wuhan, China.

Xiamen Lianqian Community Health Center, Xiamen, China.

出版信息

Braz Oral Res. 2017 Nov 27;31:e90. doi: 10.1590/1807-3107BOR-2017.vol31.0090.

DOI:10.1590/1807-3107BOR-2017.vol31.0090
PMID:29185604
Abstract

The mechanism by which chronic periodontitis (CP) affects type 2 diabetes (T2DM) remains unclear. Therefore, the aim of this study is to evaluate the effects of periodontal therapy (PT) on the glycemic control and adipokines of patients with T2DM and CP with the purpose of elucidating the possible mechanisms by which CP influences T2DM. Forty-four patients with T2DM and CP were randomly divided into two groups according to whether they underwent PT. Periodontal status, blood glucose, and the levels of serum tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), adiponectin (APN), and fibroblast growth factor-21 (FGF-21) were measured at baseline and after 3 months. The results revealed that the probing depth (PD) and attachment loss (AL) were significantly improved, the serum levels of TNF-α and IL-6 were significantly decreased, and APN and FGF-21 exhibited substantial increases in the intervention group after 3 months (p < 0.05), whereas no significant changes were observed in the control group. The glycated hemoglobin (HbA1c) levels in both groups decreased significantly after 3 months compared with baseline (p < 0.05), but the intervention group exhibited a significantly greater change (p < 0.05). In conclusion, PT may relieve periodontal inflammation, which causes a reduction of insulin-antagonizing adipokines and an increase in insulin-sensitizing adipokines, thereby eliciting an improvement in glycemic control.

摘要

慢性牙周炎(CP)影响2型糖尿病(T2DM)的机制尚不清楚。因此,本研究旨在评估牙周治疗(PT)对T2DM和CP患者血糖控制及脂肪因子的影响,以阐明CP影响T2DM的可能机制。44例T2DM和CP患者根据是否接受PT随机分为两组。在基线和3个月后测量牙周状况、血糖以及血清肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、脂联素(APN)和成纤维细胞生长因子-21(FGF-21)水平。结果显示,3个月后干预组的探诊深度(PD)和附着丧失(AL)显著改善,血清TNF-α和IL-6水平显著降低,APN和FGF-21显著升高(p<0.05),而对照组未观察到显著变化。与基线相比,两组糖化血红蛋白(HbA1c)水平在3个月后均显著降低(p<0.05),但干预组变化更显著(p<0.05)。总之,PT可能减轻牙周炎症,导致胰岛素拮抗脂肪因子减少和胰岛素增敏脂肪因子增加,从而改善血糖控制。

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