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褪黑素补充剂联合非手术牙周治疗对 2 型糖尿病伴慢性牙周炎患者牙周状况、血清褪黑素和炎症标志物的影响:一项双盲、安慰剂对照试验。

The effects of melatonin supplementation in adjunct with non-surgical periodontal therapy on periodontal status, serum melatonin and inflammatory markers in type 2 diabetes mellitus patients with chronic periodontitis: a double-blind, placebo-controlled trial.

机构信息

Student Research Committee, Department of Nutrition, Faculty of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Inflammopharmacology. 2019 Feb;27(1):67-76. doi: 10.1007/s10787-018-0539-0. Epub 2018 Oct 16.

Abstract

BACKGROUND

Diabetes mellitus (DM) and periodontitis are two common chronic diseases with bidirectional relationship. Oxidative stress plays a key role in the pathogenesis of these two diseases. The aim of this study was to investigate the effects of melatonin supplementation in adjunct with non-surgical periodontal therapy on periodontal status, serum melatonin and inflammatory markers in type 2 DM patients with chronic periodontitis (CP).

MATERIALS AND METHODS

In this double-blind clinical trial study, 50 type 2 DM patients with CP were randomly allocated to the intervention and control groups. The intervention and control groups received either 6 mg melatonin or placebo (2 tablets) once a day. Serum levels of melatonin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), hs-C-reactive protein (hs-CRP), clinical attachment loss (CAL), pocket depth (PD), bleeding on probing (BOP) and plaque index were evaluated in all subjects pre- and post-intervention.

RESULTS

Melatonin supplementation significantly increased the mean serum levels of melatonin after intervention. The mean changes of melatonin were significantly higher in intervention group compared with control group. IL-6 and hs-CRP levels were significantly (p = 0.008 and p = 0.017, respectively) reduced in the intervention group. The mean changes of IL-6 were significantly lower in the intervention group compared with the control group (p = 0.04). In the intervention group, PD and CAL were significantly decreased after intervention (p < 0.001). There were significant differences in the mean change of PD and CAL between the intervention and control groups after intervention (p < 0.001).

CONCLUSIONS

Melatonin supplementation in adjunct with non-surgical periodontal therapy might improve inflammatory and periodontal status in T2DM with CP.

摘要

背景

糖尿病(DM)和牙周炎是两种常见的慢性疾病,它们之间存在双向关系。氧化应激在这两种疾病的发病机制中起着关键作用。本研究旨在探讨褪黑素补充剂联合非手术牙周治疗对 2 型糖尿病伴慢性牙周炎(CP)患者牙周状况、血清褪黑素和炎症标志物的影响。

材料和方法

在这项双盲临床试验研究中,将 50 名 2 型糖尿病伴 CP 的患者随机分为干预组和对照组。干预组和对照组分别每天服用 6 毫克褪黑素或安慰剂(2 片)。所有受试者在干预前和干预后评估血清褪黑素、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、高敏 C 反应蛋白(hs-CRP)、临床附着丧失(CAL)、探诊深度(PD)、探诊出血(BOP)和菌斑指数。

结果

褪黑素补充剂干预后血清褪黑素水平显著升高。与对照组相比,干预组褪黑素的平均变化显著更高。IL-6 和 hs-CRP 水平分别显著(p=0.008 和 p=0.017)降低。与对照组相比,干预组 IL-6 的平均变化明显更低(p=0.04)。干预组 PD 和 CAL 明显降低(p<0.001)。干预后,干预组和对照组 PD 和 CAL 的平均变化存在显著差异(p<0.001)。

结论

褪黑素补充剂联合非手术牙周治疗可能改善 T2DM 伴 CP 的炎症和牙周状况。

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