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幼年型皮肌炎:牙周病与血脂异常有关吗?

Juvenile dermatomyositis: is periodontal disease associated with dyslipidemia?

机构信息

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.

出版信息

Adv Rheumatol. 2018 Sep 5;58(1):28. doi: 10.1186/s42358-018-0024-x.

Abstract

BACKGROUND

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.

RESULTS

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.

CONCLUSION

Our study showed that gingival inflammation seems to be related to dyslipidemia in JDM patients, suggesting underlying mechanisms for both complications.

摘要

背景

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。

结果

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。

结论

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。

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