São Paulo State University (UNESP), School of Sciences and Technology, Department of Diagnosis and Surgery, São José dos Campos, Brazil.
University of São Paulo (USP), Institute of Physics, São Paulo, Brazil.
Sci Rep. 2019 Nov 6;9(1):16138. doi: 10.1038/s41598-019-52498-7.
The objective of the present study was to establish if individuals with Diabetes Mellitus (DM2) and periodontal diseases (gingivitis or periodontitis) presented an increase in the concentration of modified LDL (moLDL) and what is the influence of periodontal treatment on the decrease of moLDL particles with consequent improvement in the parameters of DM2. Twenty-four diabetic patients with periodontitis (Group 1) and twenty-four diabetic patients with gingivitis (Group 2) were followed up for a period of 12 months. Group 1 was treated with periodontal debridement, and Group 2 received supra-gingival scaling and prophylaxis. In both groups, periodontal clinical parameters: probing depth (PD), clinical attachment level (CAL), gingival resection (GR), bleeding on probing index (BOP) and plaque index; inflammatory serum markers (glycemia, A1c, total cholesterol, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), triglycerides and hs-CRP) and oxidized LDL (oxLDL) were measured at baseline, t = 6 and t = 12 months after treatment. Solutions of LDL were analyzed using the nonlinear optical Z-Scan and optical absorption techniques. The periodontal clinical parameters showed significant improvement (p < 0.05) in both Group after 12 months. For both groups, total cholesterol, HDL-c, LDL-c, triglycerides and A1c levels did not show significant reductions after periodontal therapy. hs-CRP levels in Group 1 presented a significant reduction after 12 months. The glycemic rate and the oxLDL concentrations did not show significant differences as a function of time. The optical measurements of LDL solutions revealed an improvement of the LDL-c quality in both groups. Periodontal debridement was able to improve periodontal parameters and the quality of LDL-c in diabetic patients but without changes in the oxLDL concentration in both groups. Considering the clinical relevance, the reduction of infectious and inflammatory sites present in the oral cavity through periodontal therapy may help with the control and prevention of hyperglycemia and precursors of cardiovascular diseases.
本研究的目的是确定是否患有 2 型糖尿病（DM2）和牙周疾病（牙龈炎或牙周炎）的个体的修饰 LDL（moLDL）浓度增加，以及牙周治疗对降低 moLDL 颗粒的影响如何，从而改善 DM2 的参数。对 24 例患有牙周炎的糖尿病患者（第 1 组）和 24 例患有牙龈炎的糖尿病患者（第 2 组）进行了为期 12 个月的随访。第 1 组接受牙周清创术治疗，第 2 组接受龈上洁治术和预防措施。在两组中，牙周临床参数：探诊深度（PD）、临床附着水平（CAL）、牙龈切除术（GR）、探诊出血指数（BOP）和菌斑指数；炎症血清标志物（血糖、A1c、总胆固醇、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL-c）、甘油三酯和 hs-CRP）和氧化 LDL（oxLDL）在治疗前、治疗后 6 个月和 12 个月时进行测量。使用非线性光学 Z 扫描和光吸收技术分析 LDL 溶液。在治疗后 12 个月，两组的牙周临床参数均有显著改善（p<0.05）。对于两组，总胆固醇、HDL-c、LDL-c、甘油三酯和 A1c 水平在牙周治疗后均无明显降低。第 1 组的 hs-CRP 水平在 12 个月后显著降低。血糖率和 oxLDL 浓度在功能上无时间差异。LDL 溶液的光学测量显示两组 LDL-c 质量均有所改善。牙周清创术能够改善糖尿病患者的牙周参数和 LDL-c 质量，但两组的 oxLDL 浓度均无变化。考虑到临床意义，通过牙周治疗减少口腔内感染和炎症部位可能有助于控制和预防高血糖和心血管疾病的前兆。
