Liu F, Zhou Z F, Mi Y, Ma M, Hong Y L, Chen F M
Department of Periodontology, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an 710032, China.
Department of Stomatology, General Hospital of Tibetan Military Command, Lasa 850007, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2022 Jun 9;57(6):569-575. doi: 10.3760/cma.j.cn112144-20220321-00124.
To explore the effects of periodontitis and inflammatory factors toward the occurrence of gestational diabetes mellitus (GDM). Pregnant women who came to the Department of Obstetrics, Northwest Women's and Children's Hospital for prenatal examinations during March to November of 2021 were invited to participate in this study. Participants with GDM who met the inclusion criteria (100) were assigned into the case group; while healthy participants (100) were assigned into the control group. Information of participants from the two groups were collected by questionnaires and periodontal statuses were clinically recorded in the meantime. Gingival crevicular fluid (GCF) and venous blood were also collected from participants of two groups to analyze the expression levels of inflammatory factors like C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10 and IL-33. Factors different between the two groups were included in the multivariate regression analysis model to determine the risk factors of GDM. The age of participants was (33.4±5.1) years in case group and (30.5±4.5) years in control group respectively, which had statistical differences (4.33,0.001). Besides, the body mass index of participants from case group was also significantly higher than control group [(28.11±3.85) kg/m . (23.31±3.15) kg/m, 9.65, 0.001]. Participants with GDM had more adverse periodontal clinical parameters. Prevalence of periodontitis in GDM group was 47.0% (47/100) compared with 29.0% (29/100) in control group (χ²=6.88, 0.009). Multivariate regression analysis results indicated that periodontitis was a critical risk factor for the occurrence of GDM (1.882, 0.001). Besides, GCF IL-8, serum TNF-α, IL-8 and IL-10 were also risk factors of GDM due to their higher expressions. Among them, TNF-α in serum (2.077) and IL-8 in serum (=2.060) had more significant impacts (0.001). This study demonstrated that periodontitis was associated with the occurrence of GDM. Up-regulation of serum pro-inflammatory mediators leaded by local periodontal inflammatory microenvironment might play a critical role in this pathological process.
探讨牙周炎及炎症因子对妊娠期糖尿病（GDM）发生的影响。邀请2021年3月至11月期间到西北妇女儿童医院产科进行产前检查的孕妇参与本研究。符合纳入标准的GDM患者（100例）被分配到病例组；健康参与者（100例）被分配到对照组。通过问卷调查收集两组参与者的信息，同时临床记录牙周状况。还从两组参与者中采集龈沟液（GCF）和静脉血，以分析炎症因子如C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1β、IL-6、IL-8、IL-10和IL-33的表达水平。将两组之间不同的因素纳入多因素回归分析模型，以确定GDM的危险因素。病例组参与者年龄分别为（33.4±5.1）岁，对照组为（30.5±4.5）岁，差异有统计学意义（4.33，0.001）。此外，病例组参与者的体重指数也显著高于对照组[（28.11±3.85）kg/m² 、（23.31±3.15）kg/m²，9.65，0.001]。GDM患者有更多不良牙周临床参数。GDM组牙周炎患病率为47.0%（47/100），对照组为29.0%（29/100）（χ²=6.88，P=0.009）。多因素回归分析结果表明，牙周炎是GDM发生的关键危险因素（1.882，0.001）。此外，GCF中IL-8、血清TNF-α、IL-8和IL-10由于表达较高也是GDM的危险因素。其中，血清TNF-α（2.077）和血清IL-8（2.060）影响更显著（P=0.001）。本研究表明，牙周炎与GDM的发生有关。局部牙周炎症微环境导致的血清促炎介质上调可能在这一病理过程中起关键作用。
