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慢性牙周炎患者与健康对照者的牙周状况、血脂水平、脂蛋白相关磷脂酶A2(Lp-PLA2)之间的关联。

The Association between Periodontal Status, Serum Lipid Levels, Lipoprotein Associated Phosholipase A2 (Lp-PLA2) in Chronic Periodontitis Subjects and Healthy Controls.

作者信息

Koshy Bittu Saira, Mahendra Jaideep

机构信息

Postgraduate Student, Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India.

Professor, Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India.

出版信息

J Clin Diagn Res. 2017 Sep;11(9):ZC17-ZC21. doi: 10.7860/JCDR/2017/27628.10565. Epub 2017 Sep 1.

Abstract

INTRODUCTION

Lipoprotein associated phospholipase A2 (Lp-PLA2) has been explored as a potential biomarker for Cardiovascular Disease (CVD). The human Lp-PLA2 is a serine-dependent, Ca2+- independent enzyme. It gives way to oxidised free fatty acids and lysophosphatidyl choline by hydrolysing oxidised phospholipids, that leads to smooth muscle cell apoptosis, inflammatory cell chemotaxis and endothelial cell dysfunction in CVD. Owing to its role in inflammation, it may influence the development and progression of periodontitis as well.

AIM

To compare the demographic variables, Gingival Index(GI), Bleeding On Probing (BOP), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) with serum lipid profile and Lp-PLA2 level in Chronic Periodontitis (CP) subjects.

MATERIALS AND METHODS

A total of 75 subjects were selected and divided into three groups; based on the inclusion and exclusion criteria: Group I - 25 subjects with severe generalized CP with CAL ≥ 5 mm in more than 30% of sites. Group II -25 subjects with moderate generalized CD with clinical CAL 3 mm-4 mm in more than 30% of sites. Group III- 25 systemically and periodontally healthy volunteers who served as control. Clinical parameters such as Plaque Index (PI), BOP, Probing Depth (PD) and CAL, lipid profile such as Total Cholesterol (TC), Triglyceride (TG), High density Lipoprotein (HDL), Low Density Lipoprotein (LDL), Very Low Density Lipoprotein (VLDL) as well as Lp-PLA2 were assessed. One-way ANOVA and Tukey's Post-hoc test were used for data analysis.

RESULTS

Age was higher in Group I and II when compared to Group III. Group II showed a significant correlation between PI and LDL. In Group III, lower PI was significantly correlated with high HDL and low LDL and BOP was positively correlated with TG and HDL. A significant association of Lp-PLA2 was found to be higher with increase in the TG and VLDL level in Group I and Group II when compared to Group III.

CONCLUSION

The study concluded that Lp-PLA2, TG and VLDL already being a predictor biomarker for atherosclerotic disease can be an inflammatory marker for periodontitis.

摘要

引言

脂蛋白相关磷脂酶A2(Lp-PLA2)已被探索作为心血管疾病(CVD)的一种潜在生物标志物。人Lp-PLA2是一种丝氨酸依赖性、钙离子非依赖性酶。它通过水解氧化磷脂产生氧化游离脂肪酸和溶血磷脂酰胆碱,这在心血管疾病中会导致平滑肌细胞凋亡、炎症细胞趋化和内皮细胞功能障碍。由于其在炎症中的作用,它也可能影响牙周炎的发生和发展。

目的

比较慢性牙周炎(CP)患者的人口统计学变量、牙龈指数(GI)、探诊出血(BOP)、探诊袋深度(PPD)和临床附着水平(CAL)与血脂谱及Lp-PLA2水平。

材料与方法

共选择75名受试者并分为三组;根据纳入和排除标准:第一组-25名重度广泛性慢性牙周炎患者,超过30%的位点临床附着水平(CAL)≥5mm。第二组-25名中度广泛性慢性牙周炎患者,超过30%的位点临床附着水平为3mm-4mm。第三组-25名全身和牙周健康的志愿者作为对照。评估临床参数如菌斑指数(PI)、探诊出血(BOP)、探诊深度(PD)和临床附着水平(CAL),血脂谱如总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)以及Lp-PLA2。采用单因素方差分析和Tukey事后检验进行数据分析。

结果

与第三组相比,第一组和第二组的年龄更高。第二组显示菌斑指数(PI)与低密度脂蛋白(LDL)之间存在显著相关性。在第三组中,较低的菌斑指数(PI)与高高密度脂蛋白(HDL)和低低密度脂蛋白(LDL)显著相关,探诊出血(BOP)与甘油三酯(TG)和高密度脂蛋白(HDL)呈正相关。与第三组相比,第一组和第二组中Lp-PLA2与甘油三酯(TG)和极低密度脂蛋白(VLDL)水平升高之间存在显著关联。

结论

该研究得出结论,Lp-PLA2、甘油三酯(TG)和极低密度脂蛋白(VLDL)作为动脉粥样硬化疾病的预测生物标志物,也可能是牙周炎的炎症标志物。

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