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2型糖尿病伴牙周炎患者初始牙周治疗后口腔微生物群的动态变化研究

[Study on the dynamic changes of oral microbiota in type 2 diabetes patients with periodontitis after initial periodontal therapy].

作者信息

Song W J, Kang W Y, Liu X M, Sun L, Feng Q, Ge S H

机构信息

Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan 250012, China.

Department of Endocrinology, Cheeloo Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2022 Jun 9;57(6):585-594. doi: 10.3760/cma.j.cn112144-20220228-00076.

Abstract

To clarify the effect of initial periodontal therapy on the dynamic changes of oral (saliva, dorsal tongue and subgingival plaque) microbiota in periodontitis patients with or without type 2 diabetes mellitus (T2DM). A total of 14 patients with chronic periodontitis (CP group) and 14 CP patients with T2DM (CP-T2DM group) were included from Department of Periodontology, School and Hospital of Stomatology,Cheeloo College of Medicine, Shandong University. The microbial samples were collected from saliva, dorsal tongue and subgingival plaque of first molars at baseline, 1.5 and 3 months after initial periodontal therapy, and were detected by 16S rRNA (V3-V4 region) gene sequencing. The sequencing data were analyzed to obtain microbial distribution and community structure information. The same professional periodontist evaluated the periodontal status of patients according to periodontitis detection indices before and after initial periodontal therapy. Meanwhile, patients' blood samples were collected and related metabolic indices were evaluated. After initial periodontal therapy, the glycosylated hemoglobin levels [(7.46±1.69)%] in CP-T2DM group were significantly improved than that at baseline [(7.65±1.34)%] (0.52,=0.610). The probing depth of the sampling sites [CP group: (2.94±0.46) mm, CP-T2DM group: (2.95±0.35) mm] and bleeding index (CP group: 1.91±0.42, CP-T2DM group: 1.67±0.49) at 3 months after treatment were significantly decreased than the probing depth [CP group: (3.99±0.77) mm, CP-T2DM group: (3.80±0.76) mm] (25.61, 0.001; 17.63, 0.001) and bleeding index (CP group: 3.03±0.52, CP-T2DM group: 2.54±0.65) (28.43, 0.001; 20.21, 0.001) at baseline. The flora analysis showed that the α and β diversity indices of the same sites in the CP and CP-T2DM groups did not change significantly before and after the initial therapy, but the bacterial abundance at each site changed. There were commonalities and differences in the microbial composition of each site in the CP and CP-T2DM groups. Among them, the relative abundance of in saliva and dorsal tongue samples of the two groups after treatment was basically consistent with the change trend in the subgingival plaque microbes. In the subgingival plaque of the CP group, the relative abundance of showed a gradual increase with the prolongation of initial periodontal therapy; while in the CP-T2DM group, it showed a trend of first increase and then decrease. , and TG5 in CP and CP-T2DM groups were all significantly dominant bacteria in subgingival plaque at baseline (0.05). Moreover, in the CP-T2DM group also showed a significant advantage. At 1.5 months after treatment, , etc. were dominant in subgingival plaque (0.05). , and showed significant differences at 3 months (0.05). Plaques in saliva and tongue dorsal could reflect the effects of initial periodontal therapy on the dynamic changes of microorganisms to a certain extent. CP and CP-T2DM patients had differences in microbial composition and responses to initial periodontal therapy.

摘要

为阐明初始牙周治疗对伴或不伴2型糖尿病(T2DM)的牙周炎患者口腔(唾液、舌背和龈下菌斑)微生物群动态变化的影响。山东大学齐鲁医学院附属口腔医院牙周科纳入了14例慢性牙周炎患者(CP组)和14例伴T2DM的CP患者(CP-T2DM组)。在基线、初始牙周治疗后1.5个月和3个月时,从第一磨牙的唾液、舌背和龈下菌斑采集微生物样本,并通过16S rRNA(V3-V4区)基因测序进行检测。对测序数据进行分析以获得微生物分布和群落结构信息。同一位专业牙周医生根据初始牙周治疗前后的牙周炎检测指标评估患者的牙周状况。同时,采集患者血液样本并评估相关代谢指标。初始牙周治疗后,CP-T2DM组的糖化血红蛋白水平[(7.46±1.69)%]较基线时[(7.65±1.34)%]有显著改善(P = 0.52,P = 0.610)。治疗后3个月时,采样部位的探诊深度[CP组:(2.94±0.46)mm,CP-T2DM组:(2.95±0.35)mm]和出血指数(CP组:1.91±0.42,CP-T2DM组:1.67±0.49)较基线时的探诊深度[CP组:(3.99±0.77)mm,CP-T2DM组:(3.80±0.76)mm](P = 25.61,P < 0.001;P = 17.63,P < 0.001)和出血指数(CP组:3.03±0.52,CP-T2DM组:2.54±0.65)(P = 28.43,P < 0.001;P = 20.21,P < 0.001)显著降低。菌群分析显示,CP组和CP-T2DM组相同部位的α和β多样性指数在初始治疗前后无显著变化,但各部位的细菌丰度发生了改变。CP组和CP-T2DM组各部位的微生物组成既有共性也有差异。其中,两组治疗后唾液和舌背样本中的相对丰度与龈下菌斑微生物的变化趋势基本一致。在CP组的龈下菌斑中,随着初始牙周治疗时间的延长,的相对丰度呈逐渐增加趋势;而在CP-T2DM组中,呈先增加后降低的趋势。CP组和CP-T2DM组中的、和TG5在基线时均为龈下菌斑中的显著优势菌(P < 0.05)。此外,在CP-T2DM组中也显示出显著优势。治疗后1.5个月时,等在龈下菌斑中占优势(P < 0.05)。治疗后3个月时,、和有显著差异(P < 0.05)。唾液和舌背菌斑在一定程度上可反映初始牙周治疗对微生物动态变化的影响。CP患者和CP-T2DM患者在微生物组成及对初始牙周治疗的反应方面存在差异。

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