Department of Periodontology, Faculty of Dentistry, Lokman Hekim University, Ankara, Turkey.
Department of Periodontoloy, Faculty of Dentistry, Ankara University, Ankara, Turkey.
J Periodontol. 2021 Sep;92(9):1274-1285. doi: 10.1002/JPER.20-0406. Epub 2021 Jan 4.
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.
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.
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).
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.
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。
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。
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）。
唾液 8-OHdG 单独或联合 4-HNE、AGE 和 RAGE 用于糖尿病患者，以及唾液 8-OHdG 单独或联合 MDA 和 hsCRP 用于系统性健康人群，可能成为牙周炎的非侵入性筛查标志物。
