SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa.
Department of Global Health, Stellenbosch University, Cape Town, South Africa.
J Dent Res. 2020 Jun;99(6):658-665. doi: 10.1177/0022034520913818. Epub 2020 Apr 16.
Disturbances in the oral microbiome are associated with periodontal disease initiation and progression and diabetes mellitus (DM), but how this contributes to the cause-and-effect relationship between periodontal disease and DM is poorly understood. We examined the bacterial composition in plaque samples from 128 South Africans with periodontal disease across glycemic statuses using 16S rDNA sequencing of regions 2, 3, 4, 6-7, 8, and 9. Of the 9 phyla identified, Firmicutes, Proteobacteria, Bacteroidetes, Fusobacteria, and Actinobacteria made up >98%. Fusobacteria and Actinobacteria were significantly more abundant in subjects with diabetes, while Proteobacteria were less abundant. However, in the presence of gingival bleeding and DM, as compared with DM without gingival bleeding, Actinobacteria were markedly reduced while Bacteroidetes were more abundant. In contrast, no differences in Actinobacteria or Bacteroidetes abundance were observed between DM with and without pocket depth (PD) ≥4 mm. At the genus level, similar changes in relative abundance were observed in the presence of DM and periodontal disease. Our findings remained in conditional logistic regression models adjusted for age, sex, waist circumference, and the 5 most dominant phyla. For example, Actinobacteria significantly increased the odds of diabetes by 10% in subjects with gingival bleeding, while Fusobacteria increased this odd by 14%; yet, among subjects with PD ≥4 mm, Fusobacteria decreased the odds of DM by 47%. Our findings have confirmed the alterations in the composition of the oral microbiota across glycemic statuses as well as different stages of periodontal disease. However, it is not clear whether these differences were the consequence of hyperglycemia or the presence of periodontal diseases. Therefore, we recommend further investigations in a longitudinal study design.
口腔微生物组的紊乱与牙周病的发生和进展以及糖尿病（DM）有关，但这种紊乱如何导致牙周病和 DM 之间的因果关系尚不清楚。我们使用 16S rDNA 测序技术对来自 128 名南非人牙周病患者的斑块样本进行了研究，这些患者的血糖状况各不相同，涵盖了区域 2、3、4、6-7、8 和 9。在所鉴定的 9 个门中，厚壁菌门、变形菌门、拟杆菌门、梭杆菌门和放线菌门占比>98%。在患有糖尿病的患者中，梭杆菌门和放线菌门的丰度明显更高，而变形菌门的丰度则更低。然而，在牙龈出血和 DM 存在的情况下，与无牙龈出血的 DM 相比，放线菌门明显减少，而拟杆菌门则更丰富。相反，在 DM 存在或不存在袋深（PD）≥4mm 的情况下，放线菌门和拟杆菌门的丰度没有差异。在属水平上，在 DM 和牙周病存在的情况下，也观察到相对丰度的相似变化。我们的研究结果在调整了年龄、性别、腰围和 5 个最主要的门后，仍保留在条件逻辑回归模型中。例如，在有牙龈出血的患者中，放线菌门使糖尿病的发病几率增加了 10%，而梭杆菌门则使这一几率增加了 14%；然而，在 PD≥4mm 的患者中，梭杆菌门使 DM 的发病几率降低了 47%。我们的研究结果证实了口腔微生物组在不同血糖状态以及牙周病不同阶段的组成变化。然而，目前尚不清楚这些差异是高血糖的结果还是牙周病的结果。因此，我们建议在一项纵向研究设计中进一步调查。
