代谢控制是否会影响2型糖尿病患者的唾液脂肪因子？

Does metabolic control affect salivary adipokines in type 2 diabetes mellitus?

作者信息

Teke Elif, Kırzıoğlu Fatma Yeşim, Korkmaz Hakan, Calapoğlu Mustafa, Orhan Hikmet

机构信息

Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey.

Department of Internal Medicine, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.

出版信息

Dent Med Probl. 2019 Jan-Mar;56(1):11-20. doi: 10.17219/dmp/103417.

DOI:10.17219/dmp/103417

PMID:30951617

Abstract

BACKGROUND

Adipokines produced by adipose tissue initiate pro-inflammatory events and contribute to the pathogenesis of diabetic periodontitis.

OBJECTIVES

The aim of this study was to evaluate the effect of the metabolic status on the level of salivary adipokines in type 2 diabetes mellitus (T2DM) patients.

MATERIAL AND METHODS

A total of 239 individuals, including 161 T2DM patients and 78 healthy (H) controls, participated in the study. The metabolic control status was evaluated in each person. Periodontal measurements were recorded. Periodontal epithelial surface area (PESA), periodontal inflamed surface area (PISA) and the total dental index (TDI) were calculated. The salivary adiponectin, tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and vaspin levels were determined.

RESULTS

The T2DM patients had higher periodontal parameters and adiponectin, TNF-α, IL-6, and vaspin levels as compared with the H controls (p < 0.05). As the metabolic control worsened, periodontal pocket depth (PPD) and clinical attachment level (CAL) increased. When covariates (age, gender, body mass index - BMI, education level, smoking, dental visit and tooth brushing frequency) were adjusted, only the TNF-α and vaspin levels were significantly higher in the T2DM patients (p < 0.05). In the T2DM patients, positive correlations were found between the TNF-α level and the percentage of bleeding on probing (BOP%), PPD, PESA, and PISA, and between the adiponectin level and PISA. Moreover, there was a negative relationship between the salivary volume and TDI. While the correlations IL-6-TNF-α, vaspin-triglycerides and vaspin-tooth brushing frequency were positive, the statistically significant associations vaspin-IL-6 and vaspin-low-density lipoprotein (LDL) were negative (p < 0.05).

CONCLUSIONS

The severity of periodontal disease increases as the metabolic control status worsens. The levels of salivary adipokines were changed by T2DM, while being independent from the metabolic control.

摘要

背景

脂肪组织产生的脂肪因子引发促炎事件，并参与糖尿病性牙周炎的发病机制。

目的

本研究旨在评估代谢状态对2型糖尿病（T2DM）患者唾液脂肪因子水平的影响。

材料与方法

共有239人参与本研究，其中包括161例T2DM患者和78例健康（H）对照者。评估了每个人的代谢控制状况。记录牙周测量数据。计算牙周上皮表面积（PESA）、牙周炎症表面积（PISA）和总牙指数（TDI）。测定唾液脂联素、肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）和内脏脂肪素水平。

结果

与H对照组相比，T2DM患者的牙周参数以及脂联素、TNF-α、IL-6和内脏脂肪素水平更高（p<0.05）。随着代谢控制变差，牙周袋深度（PPD）和临床附着水平（CAL）增加。调整协变量（年龄、性别、体重指数 - BMI、教育水平、吸烟、看牙次数和刷牙频率）后，仅T2DM患者的TNF-α和内脏脂肪素水平显著更高（p<0.05）。在T2DM患者中，发现TNF-α水平与探诊出血百分比（BOP%）、PPD、PESA和PISA之间存在正相关，脂联素水平与PISA之间存在正相关。此外，唾液量与TDI之间存在负相关。虽然IL-6与TNF-α、内脏脂肪素与甘油三酯以及内脏脂肪素与刷牙频率之间的相关性为正，但内脏脂肪素与IL-6以及内脏脂肪素与低密度脂蛋白（LDL）之间的统计学显著关联为负（p<0.05）。