Brown Ronald B
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
Dent J (Basel). 2019 Feb 11;7(1):18. doi: 10.3390/dj7010018.
An association between periodontal disease and cancer has been established in recent studies, but no common etiology has been identified in the hopes of reducing the global burden of these non-communicable diseases. This perspective article hypothesizes that the determinant mediating the association of periodontal disease with cancer is dysregulated phosphate metabolism. Phosphate, an essential dietary micronutrient, is dysregulated in chronic kidney disease, and both cancer and periodontal disease are associated with chronic kidney disease. Reviewed evidence includes the association between phosphate toxicity and cancer development, and the association between periodontal disease and chronic kidney disease-mineral and bone disorder includes conditions such as ectopic calcification and bone resorption, which may be indirectly related to periodontal disease. Dental calculus in periodontal disease contains calcium phosphate crystals that are deposited from excess calcium and phosphate in saliva. Alveolar bone resorption may be linked systemically to release of parathyroid hormone in response to hypocalcemia induced by hyperphosphatemia. More research is needed to examine the role of dysregulated phosphate metabolism in periodontal disease.
近期研究已证实牙周病与癌症之间存在关联，但尚未确定共同病因，以期减轻这些非传染性疾病的全球负担。这篇观点文章提出假说，认为介导牙周病与癌症关联的决定因素是磷酸盐代谢失调。磷酸盐是一种必需的膳食微量营养素，在慢性肾病中会失调，而癌症和牙周病都与慢性肾病有关。综述的证据包括磷酸盐毒性与癌症发展之间的关联，以及牙周病与慢性肾病 - 矿物质和骨紊乱之间的关联，后者包括异位钙化和骨吸收等情况，这些可能与牙周病间接相关。牙周病中的牙结石含有从唾液中过量的钙和磷酸盐沉积而成的磷酸钙晶体。牙槽骨吸收可能通过全身途径与甲状旁腺激素的释放相关联，以应对高磷血症引起的低钙血症。需要更多研究来探讨磷酸盐代谢失调在牙周病中的作用。
