Pediatric Rheumatology Unit, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Joel Jorge de Melo, 600 apto 121, Vila Mariana, São Paulo, SP, 04128-081, Brazil.
Division of Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Adv Rheumatol. 2018 Sep 5;58(1):28. doi: 10.1186/s42358-018-0024-x.
Association between periodontal disease and dyslipidemia was recently reported in healthy adults. However, a systematic evaluation of concomitant periodontal diseases and lipid profile was not carried out in juvenile dermatomyositis (JDM). A cross-section study was performed in 25 JDM patients and 25 healthy controls, assessing demographic data, periodontal evaluation, fasting lipoproteins and anti-lipoprotein lipase antibodies. Disease parameters, laboratorial tests and treatment were also evaluated in JDM patients.
The mean current age was similar in patients and controls (11.5 ± 3.75 vs. 11.2 ± 2.58 years,p = 0.703). Regarding lipid profile, the median triglycerides [80(31-340) vs. 61(19-182)mg/dL,p = 0.011] and VLDL[16(6-68) vs. 13(4-36)mg/dL,p = 0.020] were significantly higher in JDM patients versus controls. Gingival vasculopathy pattern was significantly higher in the former group (60% vs. 0%,p = 0.0001), as well as the median of gingival bleeding index (GBI) [24.1(4.2-69.4) vs. 11.1(0-66.6)%,p = 0.001] and probing pocket depth (PPD) [1.7(0.6-2.4) vs.1.4(0-2.12)mm,p = 0.006]. Comparison between JDM patients with and without dyslipidemia revealed that the median of dental plaque index (PI) [100(26.7-100) vs. 59(25-100)%,p = 0.022], PPD[1.9(0.6-2.4) vs. 1.4(1.2-1.8)mm,p = 0.024] and clinical attachment level (CAL) [1.31(0.7-1.7) vs. 0.8(0.6-1.7)mm,p = 0.005] were significantly higher in patients with dyslipidemia. Further analysis between JDM patients with and without gingivitis revealed that the median of current age [12.4 (8.3-18.4) vs. 9.2 (5.5-17.5) years, p = 0.034] and disease duration [7.09 ± 3.07 vs. 3.95 ± 2.1 years, p = 0.008] were significantly higher in the former group.
Our study showed that gingival inflammation seems to be related to dyslipidemia in JDM patients, suggesting underlying mechanisms for both complications.
牙周病与血脂异常之间的关联最近在健康成年人中得到了报道。然而,在青少年皮肌炎(JDM)中,并没有对同时存在的牙周病和血脂状况进行系统评估。在 25 名 JDM 患者和 25 名健康对照者中进行了一项横断面研究,评估了人口统计学数据、牙周评估、空腹脂蛋白和抗脂蛋白脂肪酶抗体。还评估了 JDM 患者的疾病参数、实验室检查和治疗。
患者和对照组的平均当前年龄相似(11.5 ± 3.75 岁与 11.2 ± 2.58 岁,p = 0.703)。关于血脂谱,JDM 患者的中位数甘油三酯[80(31-340)与 61(19-182)mg/dL,p = 0.011]和 VLDL[16(6-68)与 13(4-36)mg/dL,p = 0.020]明显高于对照组。前者的牙龈血管病变模式明显更高(60%与 0%,p = 0.0001),牙龈出血指数(GBI)的中位数[24.1(4.2-69.4)与 11.1(0-66.6)%,p = 0.001]和探诊牙周袋深度(PPD)[1.7(0.6-2.4)与 1.4(0-2.12)mm,p = 0.006]也明显更高。JDM 患者中伴有和不伴有血脂异常的组间比较显示,前者的菌斑指数(PI)[100(26.7-100)与 59(25-100)%,p = 0.022]、PPD[1.9(0.6-2.4)与 1.4(1.2-1.8)mm,p = 0.024]和临床附着水平(CAL)[1.31(0.7-1.7)与 0.8(0.6-1.7)mm,p = 0.005]中位数明显更高。在 JDM 患者中伴有和不伴有牙龈炎的组间进一步分析显示,前者的当前年龄[12.4(8.3-18.4)与 9.2(5.5-17.5)岁,p = 0.034]和疾病持续时间[7.09 ± 3.07 与 3.95 ± 2.1 年,p = 0.008]中位数明显更高。
我们的研究表明,在 JDM 患者中,牙龈炎症似乎与血脂异常有关,提示这两种并发症存在潜在的机制。