Xu Xin-Ran, Xu Jing-Ling, He Lu, Wang Xian-E, Lu Hong-Ye, Meng Huan-Xin
Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China.
Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, China.
J Dent Sci. 2023 Jul;18(3):1125-1133. doi: 10.1016/j.jds.2022.11.006. Epub 2022 Nov 16.
There is a two-way relationship between periodontitis and type 2 diabetes mellitus. This study aimed to compare the inflammatory states in serum and gingival crevicular fluid (GCF) in periodontitis patients with or without type 2 diabetes mellitus (T2DM) and healthy subjects.
20 subjects were systematic and periodontal healthy (H group), 40 subjects were with periodontitis (CP group), and other 40 were with periodontitis and type 2 diabetes mellitus (DC group). Fasting blood glucose (FBG) and HbA1c was tested. GCF and serum level of interleukin (IL) -17, visfatin, receptor activator of nuclear factor-kappa B (NF-κB) ligand (RANKL)/osteoprotegerin (OPG) ratio were measured.
The GCF volume, total amount of IL-17, vastatin, RANKL/OPG ratio in GCF and their concentrations in serum were higher ( < 0.05) in CP and DC groups than in H group, which were also higher ( < 0.05) in DC group than in CP group except for visfatin in GCF and IL-17 in serum. At sample sites of PD ≤ 3 mm, GCF volume, IL-17, visfatin and RANKL/OPG ratio in DC and CP groups were higher ( < 0.05) than that in H group, which were also higher in DC group than in CP group either with PD ≤ 3 mm or PD > 3 mm. Inflammatory state in GCF was positively correlated to systemic inflammation, and both of them were positively correlated to FBG.
Moderate and severe periodontitis aggravated systemic inflammation. T2DM together with periodontitis resulted in more severe systemic inflammation. The positive correlation between the periodontal and systemic inflammation and their association with FBG indicated an inflammatory link between periodontitis and T2DM.
牙周炎与2型糖尿病之间存在双向关系。本研究旨在比较患有或未患有2型糖尿病(T2DM)的牙周炎患者以及健康受试者血清和龈沟液(GCF)中的炎症状态。
20名受试者系统和牙周健康(H组),40名受试者患有牙周炎(CP组),另外40名患有牙周炎和2型糖尿病(DC组)。检测空腹血糖(FBG)和糖化血红蛋白(HbA1c)。测量龈沟液和血清中白细胞介素(IL)-17、内脂素、核因子κB受体激活剂配体(RANKL)/骨保护素(OPG)比值。
CP组和DC组的龈沟液量、IL-17总量、内脂素、龈沟液中RANKL/OPG比值及其血清浓度均高于H组(P<0.05),除龈沟液内脂素和血清IL-17外,DC组也高于CP组(P<0.05)。在探诊深度(PD)≤3mm的样本部位,DC组和CP组的龈沟液量、IL-17、内脂素和RANKL/OPG比值均高于H组(P<0.05),无论PD≤3mm还是PD>3mm,DC组均高于CP组。龈沟液中的炎症状态与全身炎症呈正相关,且二者均与FBG呈正相关。
中度和重度牙周炎加重全身炎症。T2DM合并牙周炎导致更严重的全身炎症。牙周炎症与全身炎症之间的正相关及其与FBG的关联表明牙周炎与T2DM之间存在炎症联系。