Maftei George-Alexandru, Martu Maria-Alexandra, Martu Marius-Cristian, Popescu Dora, Surlin Petra, Tatarciuc Diana, Popa Cristina, Foia Liliana-Georgeta
Department of Oral Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania.
Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania.
Antioxidants (Basel). 2021 Oct 30;10(11):1741. doi: 10.3390/antiox10111741.
Dental extraction can trigger certain sequences of complex processes that involve both hard (alveolar bone) and soft tissue (periodontal ligament, gingiva) remodeling. Type 2 diabetes is a serious risk factor for many oral pathologies, both in terms of progression and severity, but also regarding subsequent rehabilitation possibilities. The aim of this study was to establish whether certain molecules: osteoprotegerin (OPG), kappa B nuclear factor receptor activator ligand (RANKL), hepatocyte growth factor (HGF), tumor necrosis factor-α (TNF-α), interleukin 18 (IL-18), matrix metalloproteinase 9 (MMP-9) and oxidative stress markers-total oxidant status (TOS), total antioxidant capacity (TAC)-evaluated in saliva are modified post-extraction in type 2 diabetes mellitus subjects and whether there is a correlation with HbA1c levels. The aforementioned markers plus HbA1c were investigated in a group of systemically healthy subjects ( = 45) and in a type 2 diabetes mellitus group ( = 41) before and three months after a tooth extraction. Diabetes patients' recorded increased levels of OPG, RANKL, TNF-α, MMP-9, IL-18 and TOS compared to controls both pre- and post-extraction. In both study groups, the average OPG, HGF and TAC level recorded an upward trend three months post-extraction. TNF-α registered a statistically significant decrease only in the diabetes group after dental extraction, together with a decrement of mean HbA1c levels in the diabetes group. By plotting the ROC (receiver operating characteristic) curve, at baseline RANKL, TNF-α, IL-18, MMP-9, TOS and OPG were good predictors of HbA1c levels. Post-extraction, there was a significant correlation between HbA1c and oxidative status biomarkers, however the linear regression model indicated the influence of all studied salivary markers in HbA1c determinism, in a considerable proportion. In conclusion, our study demonstrated that several oxidative status markers and proinflammatory biomarkers are modified in the saliva of diabetic patients and they correlate to HbA1c levels, thus being potential indicators of the post-extraction healing status in the oral cavity.
拔牙可引发一系列复杂过程，涉及硬组织（牙槽骨）和软组织（牙周韧带、牙龈）的重塑。2型糖尿病是许多口腔疾病的严重风险因素，无论是在疾病进展和严重程度方面，还是在后续康复可能性方面。本研究的目的是确定在2型糖尿病患者拔牙后，唾液中检测的某些分子：骨保护素（OPG）、核因子κB受体活化因子配体（RANKL）、肝细胞生长因子（HGF）、肿瘤坏死因子-α（TNF-α）、白细胞介素18（IL-18）、基质金属蛋白酶9（MMP-9）以及氧化应激标志物——总氧化剂状态（TOS）、总抗氧化能力（TAC）是否发生改变，以及它们与糖化血红蛋白（HbA1c）水平是否存在相关性。在一组全身健康的受试者（n = 45）和一组2型糖尿病患者（n = 41）中，于拔牙前及拔牙后三个月对上述标志物及HbA1c进行了检测。与对照组相比，糖尿病患者在拔牙前后的OPG、RANKL、TNF-α、MMP-9、IL-18和TOS水平均有所升高。在两个研究组中，拔牙后三个月，OPG、HGF和TAC的平均水平均呈上升趋势。仅在糖尿病组中，拔牙后TNF-α有统计学意义的下降，同时糖尿病组的平均HbA1c水平也有所下降。通过绘制受试者工作特征（ROC）曲线，在基线时RANKL、TNF-α、IL-18、MMP-9、TOS和OPG是HbA1c水平的良好预测指标。拔牙后，HbA1c与氧化状态生物标志物之间存在显著相关性，然而线性回归模型表明，在相当大的比例上，所有研究的唾液标志物均对HbA1c的测定有影响。总之，我们的研究表明，糖尿病患者唾液中的几种氧化状态标志物和促炎生物标志物发生了改变，且它们与HbA1c水平相关，因此可能是口腔拔牙后愈合状态的潜在指标。
