Periodontology Unit, University College London Eastman Dental Institute, London, UK.
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
J Clin Endocrinol Metab. 2021 Jan 1;106(1):e74-e82. doi: 10.1210/clinem/dgaa757.
Periodontitis confers an increased risk of developing type 2 diabetes and, in patients with obesity, it might interfere with the incretin axis. The effect of periodontal treatment on glucoregulatory hormones remains unknown.
To evaluate the effect of periodontal treatment on incretin axis in obese and lean nondiabetic individuals.
King's College Dental Hospital and Institute, London, UK.
The metabolic profile of obese and normal-body-mass-index individuals affected by periodontitis was studied at baseline, 2, and 6 months after intensive periodontal treatment, by measuring plasma insulin, glucagon, glucagon-like peptide-1(GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) and markers of systemic inflammation and oxidative stress.
MAIN OUTCOME MEASURE(S): Circulating levels of incretins and inflammatory markers.
At baseline, periodontal parameters were worse for obese than nonobese; this was accompanied by higher levels of circulating high-sensitivity C-reactive protein (hs-CRP), insulin, and GLP-1. The response to periodontal treatment was less favorable in the obese group, without significant variations of hs-CRP or malondialdehyde. Glucoregulatory hormones changed differently after treatment: while insulin and glucagon did not vary at 2 and 6 months, GLP-1 and GIP significantly increased at 6 months in both groups. In particular, GLP-1 increased more rapidly in obese participants, while the increase of GIP followed similar trends across visits in both groups.
Nonsurgical treatment of periodontitis is associated with increased GLP-1 and GIP levels in nonobese and obese patients; changes in GLP-1 were more rapid in obese participants. This might have positive implications for the metabolic risk of these individuals.
牙周炎会增加 2 型糖尿病的发病风险，而在肥胖患者中，它可能会干扰肠促胰岛素轴。牙周治疗对糖调节激素的影响尚不清楚。
评估牙周治疗对肥胖和非肥胖 2 型糖尿病患者肠促胰岛素轴的影响。
英国伦敦国王学院牙科医院和研究所。
通过测量肥胖和正常体重指数的牙周炎患者的血浆胰岛素、胰高血糖素、胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性胰岛素释放肽（GIP）以及全身炎症和氧化应激标志物，在牙周治疗前、治疗后 2 个月和 6 个月评估肥胖和非肥胖患者牙周治疗对肠促胰岛素轴的影响。
循环中肠促胰岛素和炎症标志物的水平。
在基线时，肥胖者的牙周参数比非肥胖者差；这伴随着循环高敏 C 反应蛋白（hs-CRP）、胰岛素和 GLP-1 水平的升高。在肥胖组中，牙周治疗的反应不太理想，hs-CRP 或丙二醛没有明显变化。治疗后，糖调节激素的变化不同：虽然胰岛素和胰高血糖素在 2 个月和 6 个月时没有变化，但 GLP-1 和 GIP 在两组中均在 6 个月时显著增加。特别是，GLP-1 在肥胖参与者中增加得更快，而 GIP 的增加在两组中在各次就诊时均呈相似趋势。
非手术牙周治疗与非肥胖和肥胖患者的 GLP-1 和 GIP 水平升高有关；GLP-1 的变化在肥胖参与者中更为迅速。这可能对这些个体的代谢风险产生积极影响。
