牙周炎伴或不伴糖尿病患者的唾液和血清氧化应激生物标志物及晚期糖基化终产物：一项横断面研究。

Salivary and serum oxidative stress biomarkers and advanced glycation end products in periodontitis patients with or without diabetes: A cross-sectional study.

机构信息

Department of Periodontology, Faculty of Dentistry, Lokman Hekim University, Ankara, Turkey.

Department of Periodontoloy, Faculty of Dentistry, Ankara University, Ankara, Turkey.

出版信息

J Periodontol. 2021 Sep;92(9):1274-1285. doi: 10.1002/JPER.20-0406. Epub 2021 Jan 4.

DOI:10.1002/JPER.20-0406

PMID:33277933

Abstract

BACKGROUND

Non-invasive methods for periodontitis diagnosis would be a clinically important tool. This cross-sectional study aimed to investigate the association between oxidative stress, glycation, and inflammation markers and periodontal clinical parameters in periodontitis and periodontally healthy patients with type 2 diabetes and corresponding systemically healthy controls.

METHODS

Sixty-seven periodontally healthy (DM-H, n = 32) and periodontitis (DM-P, n = 35) patients with type 2 diabetes, and 54 systemically healthy periodontitis (H-P, n = 26) and periodontally healthy (H-H, n = 28) controls were included. Clinical periodontal parameters, body mass index, fasting glucose, hemoglobin A1c (HbA1c), along with saliva and serum 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), 4-hydroxy-2-nonenal (4-HNE), advanced glycation end products (AGE), AGE receptor (RAGE) and high sensitivity C-reactive protein (hsCRP) levels were recorded and analyzed.

RESULTS

Salivary 8-OHdG levels were significantly higher in periodontitis compared to periodontally healthy patients, regardless of systemic status (P < 0.001). Salivary MDA levels were significantly higher in all disease groups compared to H-H group (P ≤ 0.004). Serum AGE levels were significantly higher in diabetic groups than systemically healthy groups (P < 0.001) and in H-P compared to H-H (P < 0.001). Bleeding on probing (BOP) and clinical attachment level (CAL) strongly correlated with salivary 8-OHdG and serum hsCRP (P < 0.001). In systemically healthy patients, salivary 8-OHdG was the most accurate marker to differentiate periodontitis from controls (AUC = 0.84). In diabetics salivary 4-HNE and RAGE were the most accurate (AUC = 0.85 for both).

CONCLUSION

Salivary 8-OHdG alone or in combination with 4-HNE, AGE and RAGE for diabetics, and salivary 8-OHdG alone or in combination with MDA and hsCRP for systemically healthy persons, could potentially serve as non-invasive screening marker(s) of periodontitis.

摘要

背景

非侵入性的牙周炎诊断方法将是一种有临床重要意义的工具。本横断面研究旨在探讨氧化应激、糖基化和炎症标志物与牙周炎和牙周健康的 2 型糖尿病患者的牙周临床参数之间的关系，并与相应的系统性健康对照进行比较。

方法

共纳入 67 例牙周健康（DM-H，n=32）和牙周炎（DM-P，n=35）的 2 型糖尿病患者，以及 54 例牙周炎（H-P，n=26）和牙周健康（H-H，n=28）的系统性健康对照。记录和分析了临床牙周参数、体重指数、空腹血糖、糖化血红蛋白（HbA1c）以及唾液和血清 8-羟基-2'-脱氧鸟苷（8-OHdG）、丙二醛（MDA）、4-羟基-2-壬烯醛（4-HNE）、晚期糖基化终产物（AGE）、AGE 受体（RAGE）和高敏 C 反应蛋白（hsCRP）水平。

结果

与牙周健康患者相比，无论系统状态如何，牙周炎患者的唾液 8-OHdG 水平均显著升高（P<0.001）。所有疾病组的唾液 MDA 水平均显著高于 H-H 组（P≤0.004）。与系统性健康组相比，糖尿病组的血清 AGE 水平显著升高（P<0.001），与 H-P 组相比，H-H 组也显著升高（P<0.001）。探诊出血（BOP）和临床附着丧失（CAL）与唾液 8-OHdG 和血清 hsCRP 呈强相关性（P<0.001）。在系统性健康患者中，唾液 8-OHdG 是区分牙周炎与对照组的最准确标志物（AUC=0.84）。在糖尿病患者中，唾液 4-HNE 和 RAGE 是最准确的标志物（两者 AUC 均为 0.85）。