Tasdemir Zekeriya, Özsarı Tasdemir Funda, Gürgan Cem, Eroglu Eray, Gunturk Inayet, Kocyigit Ismail
Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.
Dentalpark Hospital, Kayseri, Turkey.
Int Urol Nephrol. 2018 Aug;50(8):1519-1528. doi: 10.1007/s11255-018-1913-y. Epub 2018 Jun 20.
Chronic inflammation is an obvious risk factor of atherosclerotic diseases, and the presence of periodontal disease is one of the important sources of chronic inflammation in patients with chronic kidney disease (CKD) and diabetes mellitus (DM). Thus, we aimed to investigate the effects of non-surgical periodontal therapy of the patients undergoing CAPD due to diabetic nephropathy, diabetic patients without CKD, and healthy controls on inflammation exponents.
Thirty-two CAPD patients due to diabetic nephropathy (group III), 31 diabetic patients without nephropathy (group II), and 38 healthy subjects (group I) were enrolled to the study. All patients enrolled to the study (to all groups) suffered from chronic periodontitis. Plaque index, Gingival index, pocket depth (PD) measurements were recorded before and after periodontal therapy. All blood samples for biochemical parameters were measured by using standard laboratory techniques with an automatic analyser. Blood samples for TNF-α, IL-6, and PTX-3 were centrifuged, and separated serum and plasma samples were stored at - 80 °C until analysis.
All inflammatory markers were significantly higher in group III than the other two at baseline. TNF-α levels were significantly decreased after periodontal treatment at 3-month visit in all groups. PTX-3, IL-6, and Hs-CRP levels were significantly reduced after periodontal treatment at 3 months in group III.
Periodontal disease is an important source of inflammation in diabetic CAPD patients and treatment of periodontal disease can be monitored by inflammatory markers including TNF-alpha, PTX-3, IL-6, and Hs-CRP. TNF-alpha may be useful and more sensitive monitoring inflammation in healthy patients and diabetic patients after periodontal treatment.
慢性炎症是动脉粥样硬化性疾病的一个明显危险因素,而牙周病的存在是慢性肾脏病(CKD)和糖尿病(DM)患者慢性炎症的重要来源之一。因此,我们旨在研究非手术牙周治疗对因糖尿病肾病接受持续性非卧床腹膜透析(CAPD)的患者、无CKD的糖尿病患者以及健康对照者炎症指标的影响。
本研究纳入了32例因糖尿病肾病接受CAPD的患者(III组)、31例无肾病的糖尿病患者(II组)和38例健康受试者(I组)。所有纳入研究的患者(所有组)均患有慢性牙周炎。在牙周治疗前后记录菌斑指数、牙龈指数、牙周袋深度(PD)测量值。所有用于生化参数检测的血样均采用标准实验室技术和自动分析仪进行检测。采集用于检测肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和3-磷酸五聚素(PTX-3)的血样,离心后,分离出的血清和血浆样本储存在-80°C直至分析。
在基线时,III组的所有炎症标志物均显著高于其他两组。在所有组中,牙周治疗后3个月复诊时TNF-α水平显著降低。III组在牙周治疗后3个月时,PTX-3、IL-6和超敏C反应蛋白(Hs-CRP)水平显著降低。
牙周病是糖尿病CAPD患者炎症的重要来源,牙周病的治疗可通过包括TNF-α、PTX-3、IL-6和Hs-CRP在内的炎症标志物进行监测。TNF-α可能有助于更敏感地监测健康患者和糖尿病患者牙周治疗后的炎症情况。