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胃旁路术对口腔健康、唾液炎症生物标志物和微生物群有影响:一项对照研究。

Bypass gastroplasty impacts oral health, salivary inflammatory biomarkers, and microbiota: a controlled study.

机构信息

Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), R. São Nicolau, 210 - 1. Andar, Diadema, SP, Brazil.

Universidade Metodista de Piracicaba (UNIMEP), Rod. Do Açúcar, Piracicaba, Brazil.

出版信息

Clin Oral Investig. 2023 Aug;27(8):4735-4746. doi: 10.1007/s00784-023-05101-3. Epub 2023 Jun 9.

Abstract

OBJECTIVES

Knowledge about the impact of gastroplasty on oral health and salivary biomarkers is limited. The aim was to prospectively evaluate oral health status, salivary inflammatory markers, and microbiota in patients undergoing gastroplasty compared with a control group undergoing a dietary program.

MATERIALS AND METHODS

Forty participants with obesity class II/III were included (20 individuals in each sex-matched group; 23-44 years). Dental status, salivary flow, buffering capacity, inflammatory cytokines, and uric acid were assessed. Salivary microbiological analysis (16S-rRNA sequencing) assessed the abundance of genus, species, and alpha diversity. Cluster analysis and mixed-model ANOVA were applied.

RESULTS

Oral health status, waist-to-hip ratio, and salivary alpha diversity were associated at baseline. A subtle improvement in food consumption markers was observed, although caries activity increased in both groups, and the gastroplasty group showed worse periodontal status after three months. IFNγ and IL10 levels decreased in the gastroplasty group at 3 months, while a decrease was observed in the control group at 6 months; IL6 decreased in both groups (p < 0.001). Salivary flow and buffering capacity did not change. Significant changes in Prevotella nigrescens and Porphyromonas endodontalis abundance were observed in both groups, while alpha diversity (Sobs, Chao1, Ace, Shannon, and Simpson) increased in the gastroplasty group.

CONCLUSIONS

Both interventions changed in different degrees the salivary inflammatory biomarkers and microbiota, but did not improve the periodontal status after 6 months.

CLINICAL RELEVANCE

Although the observed discrete improvement in dietary habits, caries activity increased with no clinical improvement in the periodontal status, emphasizing the need of oral health monitoring during obesity treatment.

摘要

目的

胃旁路手术对口腔健康和唾液生物标志物影响的相关知识有限。本研究旨在前瞻性评估胃旁路手术患者与接受饮食计划的对照组相比的口腔健康状况、唾液炎症标志物和微生物群。

材料与方法

共纳入 40 名肥胖 II/III 级患者(男女各 20 例;年龄 23-44 岁)。评估了牙齿状况、唾液流率、缓冲能力、炎症细胞因子和尿酸。通过 16S-rRNA 测序评估唾液微生物群分析的属、种和 alpha 多样性的丰度。应用聚类分析和混合模型方差分析。

结果

口腔健康状况、腰臀比和唾液 alpha 多样性在基线时相关。尽管两组的龋齿活动度均增加,但两组的食物消耗标志物均有轻微改善,且胃旁路组三个月后牙周状况恶化。胃旁路组 IFNγ 和 IL10 水平在 3 个月时下降,而对照组在 6 个月时下降;两组的 IL6 均下降(p<0.001)。唾液流率和缓冲能力没有变化。两组中 Prevotella nigrescens 和 Porphyromonas endodontalis 的丰度均发生显著变化,而胃旁路组的 alpha 多样性(Sobs、Chao1、Ace、Shannon 和 Simpson)增加。

结论

两种干预措施均在不同程度上改变了唾液炎症生物标志物和微生物群,但 6 个月后并未改善牙周状况。

临床意义

尽管饮食习惯有所改善,但龋齿活动度增加,牙周状况无临床改善,强调肥胖治疗期间需要监测口腔健康。

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